AustralieFrV1, PascalFrancis, Corpus, bibRecord, 001111

Hyperfractionated or Accelerated Radiotherapy in Lung Cancer: An Individual Patient Data Meta-Analysis

Identifieur interne : 001111 ( PascalFrancis/Corpus ); précédent : 001110; suivant : 001112

Hyperfractionated or Accelerated Radiotherapy in Lung Cancer: An Individual Patient Data Meta-Analysis

Auteurs : Audrey Mauguen ; Cécile Le Pechoux ; Michele I. Saunders ; Steven E. Schild ; Andrew T. Turrisi ; Michael Baumann ; William T. Sause ; David Ball ; Chandra P. Belani ; James A. Bonner ; Aleksander Zajusz ; Suzanne E. Dahlberg ; Matthew Nankivell ; Sumithra J. Mandrekar ; Rebecca Paulus ; Katarzyna Behrendt ; Rainer Koch ; James F. Bishop ; Stanley Dische ; Rodrigo Arriagada ; Dirk De Ruysscher ; Jean-Pierre Pignon

Source :

Journal of clinical oncology [ 0732-183X ] ; 2012.

RBID : Pascal:12-0331397

Descripteurs français

Pascal (Inist)
- Radiothérapie, Traitement, Cancer du poumon, Homme, Analyse donnée, Métaanalyse, Cancérologie.

English descriptors

KwdEn :
- Cancerology, Data analysis, Human, Lung cancer, Metaanalysis, Radiotherapy, Treatment.

Abstract

Purpose In lung cancer, randomized trials assessing hyperfractionated or accelerated radiotherapy seem to yield conflicting results regarding the effects on overall (OS) or progression-free survival (PFS). The Meta-Analysis of Radiotherapy in Lung Cancer Collaborative Group decided to address the role of modified radiotherapy fractionation. Material and Methods We performed an individual patient data meta-analysis in patients with nonmetastatic lung cancer, which included trials comparing modified radiotherapy with conventional radiotherapy. Results In non-small-cell lung cancer (NSCLC; 10 trials, 2,000 patients), modified fractionation improved OS as compared with conventional schedules (hazard ratio [HR] = 0.88, 95% CI, 0.80 to 0.97; P = .009), resulting in an absolute benefit of 2.5% (8.3% to 10.8%) at 5 years. No evidence of heterogeneity between trials was found. There was no evidence of a benefit on PFS (HR = 0.94; 95% CI, 0.86 to 1.03; P = .19). Modified radiotherapy reduced deaths resulting from lung cancer (HR ₌ 0.89; 95% CI, 0.81 to 0.98; P = .02), and there was a nonsignificant reduction of non-lung cancer deaths (HR = 0.87; 95% CI, 0.66 to 1.15; P = .33). In small-cell lung cancer (SCLC; two trials, 685 patients), similar results were found: OS, HR = 0.87, 95% CI, 0.74 to 1.02, P = .08; PFS, HR = 0.88, 95% CI, 0.75 to 1.03, P = .11. In both NSCLC and SCLC, the use of modified radiotherapy increased the risk of acute esophageal toxicity (odds ratio [OR] = 2.44 in NSCLC and OR = 2.41 in SCLC; P < .001) but did not have an impact on the risk of other acute toxicities. Conclusion Patients with nonmetastatic NSCLC derived a significant OS benefit from accelerated or hyperfractionated radiotherapy; a similar but nonsignificant trend was observed for SCLC. As expected, there was increased acute esophageal toxicity.

Notice en format standard (ISO 2709)

Pour connaître la documentation sur le format Inist Standard.

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C01	`01`		`ENG`	@0 Purpose In lung cancer, randomized trials assessing hyperfractionated or accelerated radiotherapy seem to yield conflicting results regarding the effects on overall (OS) or progression-free survival (PFS). The Meta-Analysis of Radiotherapy in Lung Cancer Collaborative Group decided to address the role of modified radiotherapy fractionation. Material and Methods We performed an individual patient data meta-analysis in patients with nonmetastatic lung cancer, which included trials comparing modified radiotherapy with conventional radiotherapy. Results In non-small-cell lung cancer (NSCLC; 10 trials, 2,000 patients), modified fractionation improved OS as compared with conventional schedules (hazard ratio [HR] = 0.88, 95% CI, 0.80 to 0.97; P = .009), resulting in an absolute benefit of 2.5% (8.3% to 10.8%) at 5 years. No evidence of heterogeneity between trials was found. There was no evidence of a benefit on PFS (HR = 0.94; 95% CI, 0.86 to 1.03; P = .19). Modified radiotherapy reduced deaths resulting from lung cancer (HR ₌ 0.89; 95% CI, 0.81 to 0.98; P = .02), and there was a nonsignificant reduction of non-lung cancer deaths (HR = 0.87; 95% CI, 0.66 to 1.15; P = .33). In small-cell lung cancer (SCLC; two trials, 685 patients), similar results were found: OS, HR = 0.87, 95% CI, 0.74 to 1.02, P = .08; PFS, HR = 0.88, 95% CI, 0.75 to 1.03, P = .11. In both NSCLC and SCLC, the use of modified radiotherapy increased the risk of acute esophageal toxicity (odds ratio [OR] = 2.44 in NSCLC and OR = 2.41 in SCLC; P < .001) but did not have an impact on the risk of other acute toxicities. Conclusion Patients with nonmetastatic NSCLC derived a significant OS benefit from accelerated or hyperfractionated radiotherapy; a similar but nonsignificant trend was observed for SCLC. As expected, there was increased acute esophageal toxicity.
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Format Inist (serveur)

NO :	PASCAL 12-0331397 INIST
ET :	Hyperfractionated or Accelerated Radiotherapy in Lung Cancer: An Individual Patient Data Meta-Analysis
AU :	MAUGUEN (Audrey); LE PECHOUX (Cécile); SAUNDERS (Michele I.); SCHILD (Steven E.); TURRISI (Andrew T.); BAUMANN (Michael); SAUSE (William T.); BALL (David); BELANI (Chandra P.); BONNER (James A.); ZAJUSZ (Aleksander); DAHLBERG (Suzanne E.); NANKIVELL (Matthew); MANDREKAR (Sumithra J.); PAULUS (Rebecca); BEHRENDT (Katarzyna); KOCH (Rainer); BISHOP (James F.); DISCHE (Stanley); ARRIAGADA (Rodrigo); RUYSSCHER (Dirk De); PIGNON (Jean-Pierre)
AF :	Institut de Cancérologie Gustave-Roussy/Villejuif/France (1 aut., 2 aut., 20 aut., 22 aut.); Stanley Dische, University College London and Marie Curie Research Wing, Mount Vernon Hospital/Northwood Middlesex/Royaume-Uni (3 aut.); Medical Research Council Clinical Trials Unit/London/Royaume-Uni (13 aut.); Mayo Clinic/Phoenix, AZ/Etats-Unis (4 aut.); Sinai Grace Hospital/Detroit, MI/Etats-Unis (5 aut.); University Hospital and Medical Faculty Carl Gustav Carus/Dresden/Allemagne (6 aut., 17 aut.); Intermountain Medical Center/Murray, UT/Australie (7 aut.); University of Melbourne, East Melbourne/Victoria/Australie (8 aut.); Victorian Comprehensive Cancer Centre/Melbourne/Australie (18 aut.); Penn State Milton S. Hershey Medical Center/Hershey/Etats-Unis (9 aut.); Radiation Therapy Oncology Group/Philadelphia, PA/Etats-Unis (15 aut.); University of Alabama-Birmingham/Birmingham, AL/Etats-Unis (10 aut.); Maria Sklodowska-Curie Memorial Cancer Center, Gliwice Branch/Pologne (11 aut., 16 aut.); Dana-Farber Cancer Institute/Boston, MA/Etats-Unis (12 aut.); Mayo Clinic and North Central Cancer Treatment Group/Rochester, MN/Etats-Unis (14 aut.); Karolinska Institutet/Stockholm/Suède (20 aut.); Maastricht University Medical Center/Maastricht/Pays-Bas (21 aut.)
DT :	Publication en série; Niveau analytique
SO :	Journal of clinical oncology; ISSN 0732-183X; Etats-Unis; Da. 2012; Vol. 30; No. 22; Pp. 2788-2797; Bibl. 40 ref.
LA :	Anglais
EA :	Purpose In lung cancer, randomized trials assessing hyperfractionated or accelerated radiotherapy seem to yield conflicting results regarding the effects on overall (OS) or progression-free survival (PFS). The Meta-Analysis of Radiotherapy in Lung Cancer Collaborative Group decided to address the role of modified radiotherapy fractionation. Material and Methods We performed an individual patient data meta-analysis in patients with nonmetastatic lung cancer, which included trials comparing modified radiotherapy with conventional radiotherapy. Results In non-small-cell lung cancer (NSCLC; 10 trials, 2,000 patients), modified fractionation improved OS as compared with conventional schedules (hazard ratio [HR] = 0.88, 95% CI, 0.80 to 0.97; P = .009), resulting in an absolute benefit of 2.5% (8.3% to 10.8%) at 5 years. No evidence of heterogeneity between trials was found. There was no evidence of a benefit on PFS (HR = 0.94; 95% CI, 0.86 to 1.03; P = .19). Modified radiotherapy reduced deaths resulting from lung cancer (HR ₌ 0.89; 95% CI, 0.81 to 0.98; P = .02), and there was a nonsignificant reduction of non-lung cancer deaths (HR = 0.87; 95% CI, 0.66 to 1.15; P = .33). In small-cell lung cancer (SCLC; two trials, 685 patients), similar results were found: OS, HR = 0.87, 95% CI, 0.74 to 1.02, P = .08; PFS, HR = 0.88, 95% CI, 0.75 to 1.03, P = .11. In both NSCLC and SCLC, the use of modified radiotherapy increased the risk of acute esophageal toxicity (odds ratio [OR] = 2.44 in NSCLC and OR = 2.41 in SCLC; P < .001) but did not have an impact on the risk of other acute toxicities. Conclusion Patients with nonmetastatic NSCLC derived a significant OS benefit from accelerated or hyperfractionated radiotherapy; a similar but nonsignificant trend was observed for SCLC. As expected, there was increased acute esophageal toxicity.
CC :	002B04; 002B11A
FD :	Radiothérapie; Traitement; Cancer du poumon; Homme; Analyse donnée; Métaanalyse; Cancérologie
FG :	Pathologie de l'appareil respiratoire; Pathologie des bronches; Pathologie des poumons; Tumeur maligne; Cancer
ED :	Radiotherapy; Treatment; Lung cancer; Human; Data analysis; Metaanalysis; Cancerology
EG :	Respiratory disease; Bronchus disease; Lung disease; Malignant tumor; Cancer
SD :	Radioterapia; Tratamiento; Cáncer del pulmón; Hombre; Análisis datos; Meta-análisis; Cancerología
LO :	INIST-20094.354000506689960150
ID :	12-0331397

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Le document en format XML

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<author><name sortKey="Dahlberg, Suzanne E" sort="Dahlberg, Suzanne E" uniqKey="Dahlberg S" first="Suzanne E." last="Dahlberg">Suzanne E. Dahlberg</name>
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<author><name sortKey="Bishop, James F" sort="Bishop, James F" uniqKey="Bishop J" first="James F." last="Bishop">James F. Bishop</name>
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<author><name sortKey="Dische, Stanley" sort="Dische, Stanley" uniqKey="Dische S" first="Stanley" last="Dische">Stanley Dische</name>
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<author><name sortKey="Arriagada, Rodrigo" sort="Arriagada, Rodrigo" uniqKey="Arriagada R" first="Rodrigo" last="Arriagada">Rodrigo Arriagada</name>
<affiliation><inist:fA14 i1="01"><s1>Institut de Cancérologie Gustave-Roussy</s1>
<s2>Villejuif</s2>
<s3>FRA</s3>
<sZ>1 aut.</sZ>
<sZ>2 aut.</sZ>
<sZ>20 aut.</sZ>
<sZ>22 aut.</sZ>
</inist:fA14>
</affiliation>
<affiliation><inist:fA14 i1="16"><s1>Karolinska Institutet</s1>
<s2>Stockholm</s2>
<s3>SWE</s3>
<sZ>20 aut.</sZ>
</inist:fA14>
</affiliation>
</author>
<author><name sortKey="Ruysscher, Dirk De" sort="Ruysscher, Dirk De" uniqKey="Ruysscher D" first="Dirk De" last="Ruysscher">Dirk De Ruysscher</name>
<affiliation><inist:fA14 i1="17"><s1>Maastricht University Medical Center</s1>
<s2>Maastricht</s2>
<s3>NLD</s3>
<sZ>21 aut.</sZ>
</inist:fA14>
</affiliation>
</author>
<author><name sortKey="Pignon, Jean Pierre" sort="Pignon, Jean Pierre" uniqKey="Pignon J" first="Jean-Pierre" last="Pignon">Jean-Pierre Pignon</name>
<affiliation><inist:fA14 i1="01"><s1>Institut de Cancérologie Gustave-Roussy</s1>
<s2>Villejuif</s2>
<s3>FRA</s3>
<sZ>1 aut.</sZ>
<sZ>2 aut.</sZ>
<sZ>20 aut.</sZ>
<sZ>22 aut.</sZ>
</inist:fA14>
</affiliation>
</author>
</titleStmt>
<publicationStmt><idno type="wicri:source">INIST</idno>
<idno type="inist">12-0331397</idno>
<date when="2012">2012</date>
<idno type="stanalyst">PASCAL 12-0331397 INIST</idno>
<idno type="RBID">Pascal:12-0331397</idno>
<idno type="wicri:Area/PascalFrancis/Corpus">001111</idno>
</publicationStmt>
<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a">Hyperfractionated or Accelerated Radiotherapy in Lung Cancer: An Individual Patient Data Meta-Analysis</title>
<author><name sortKey="Mauguen, Audrey" sort="Mauguen, Audrey" uniqKey="Mauguen A" first="Audrey" last="Mauguen">Audrey Mauguen</name>
<affiliation><inist:fA14 i1="01"><s1>Institut de Cancérologie Gustave-Roussy</s1>
<s2>Villejuif</s2>
<s3>FRA</s3>
<sZ>1 aut.</sZ>
<sZ>2 aut.</sZ>
<sZ>20 aut.</sZ>
<sZ>22 aut.</sZ>
</inist:fA14>
</affiliation>
</author>
<author><name sortKey="Le Pechoux, Cecile" sort="Le Pechoux, Cecile" uniqKey="Le Pechoux C" first="Cécile" last="Le Pechoux">Cécile Le Pechoux</name>
<affiliation><inist:fA14 i1="01"><s1>Institut de Cancérologie Gustave-Roussy</s1>
<s2>Villejuif</s2>
<s3>FRA</s3>
<sZ>1 aut.</sZ>
<sZ>2 aut.</sZ>
<sZ>20 aut.</sZ>
<sZ>22 aut.</sZ>
</inist:fA14>
</affiliation>
</author>
<author><name sortKey="Saunders, Michele I" sort="Saunders, Michele I" uniqKey="Saunders M" first="Michele I." last="Saunders">Michele I. Saunders</name>
<affiliation><inist:fA14 i1="02"><s1>Stanley Dische, University College London and Marie Curie Research Wing, Mount Vernon Hospital</s1>
<s2>Northwood Middlesex</s2>
<s3>GBR</s3>
<sZ>3 aut.</sZ>
</inist:fA14>
</affiliation>
</author>
<author><name sortKey="Schild, Steven E" sort="Schild, Steven E" uniqKey="Schild S" first="Steven E." last="Schild">Steven E. Schild</name>
<affiliation><inist:fA14 i1="04"><s1>Mayo Clinic</s1>
<s2>Phoenix, AZ</s2>
<s3>USA</s3>
<sZ>4 aut.</sZ>
</inist:fA14>
</affiliation>
</author>
<author><name sortKey="Turrisi, Andrew T" sort="Turrisi, Andrew T" uniqKey="Turrisi A" first="Andrew T." last="Turrisi">Andrew T. Turrisi</name>
<affiliation><inist:fA14 i1="05"><s1>Sinai Grace Hospital</s1>
<s2>Detroit, MI</s2>
<s3>USA</s3>
<sZ>5 aut.</sZ>
</inist:fA14>
</affiliation>
</author>
<author><name sortKey="Baumann, Michael" sort="Baumann, Michael" uniqKey="Baumann M" first="Michael" last="Baumann">Michael Baumann</name>
<affiliation><inist:fA14 i1="06"><s1>University Hospital and Medical Faculty Carl Gustav Carus</s1>
<s2>Dresden</s2>
<s3>DEU</s3>
<sZ>6 aut.</sZ>
<sZ>17 aut.</sZ>
</inist:fA14>
</affiliation>
</author>
<author><name sortKey="Sause, William T" sort="Sause, William T" uniqKey="Sause W" first="William T." last="Sause">William T. Sause</name>
<affiliation><inist:fA14 i1="07"><s1>Intermountain Medical Center</s1>
<s2>Murray, UT</s2>
<s3>AUS</s3>
<sZ>7 aut.</sZ>
</inist:fA14>
</affiliation>
</author>
<author><name sortKey="Ball, David" sort="Ball, David" uniqKey="Ball D" first="David" last="Ball">David Ball</name>
<affiliation><inist:fA14 i1="08"><s1>University of Melbourne, East Melbourne</s1>
<s2>Victoria</s2>
<s3>AUS</s3>
<sZ>8 aut.</sZ>
</inist:fA14>
</affiliation>
</author>
<author><name sortKey="Belani, Chandra P" sort="Belani, Chandra P" uniqKey="Belani C" first="Chandra P." last="Belani">Chandra P. Belani</name>
<affiliation><inist:fA14 i1="10"><s1>Penn State Milton S. Hershey Medical Center</s1>
<s2>Hershey</s2>
<s3>USA</s3>
<sZ>9 aut.</sZ>
</inist:fA14>
</affiliation>
</author>
<author><name sortKey="Bonner, James A" sort="Bonner, James A" uniqKey="Bonner J" first="James A." last="Bonner">James A. Bonner</name>
<affiliation><inist:fA14 i1="12"><s1>University of Alabama-Birmingham</s1>
<s2>Birmingham, AL</s2>
<s3>USA</s3>
<sZ>10 aut.</sZ>
</inist:fA14>
</affiliation>
</author>
<author><name sortKey="Zajusz, Aleksander" sort="Zajusz, Aleksander" uniqKey="Zajusz A" first="Aleksander" last="Zajusz">Aleksander Zajusz</name>
<affiliation><inist:fA14 i1="13"><s1>Maria Sklodowska-Curie Memorial Cancer Center, Gliwice Branch</s1>
<s3>POL</s3>
<sZ>11 aut.</sZ>
<sZ>16 aut.</sZ>
</inist:fA14>
</affiliation>
</author>
<author><name sortKey="Dahlberg, Suzanne E" sort="Dahlberg, Suzanne E" uniqKey="Dahlberg S" first="Suzanne E." last="Dahlberg">Suzanne E. Dahlberg</name>
<affiliation><inist:fA14 i1="14"><s1>Dana-Farber Cancer Institute</s1>
<s2>Boston, MA</s2>
<s3>USA</s3>
<sZ>12 aut.</sZ>
</inist:fA14>
</affiliation>
</author>
<author><name sortKey="Nankivell, Matthew" sort="Nankivell, Matthew" uniqKey="Nankivell M" first="Matthew" last="Nankivell">Matthew Nankivell</name>
<affiliation><inist:fA14 i1="03"><s1>Medical Research Council Clinical Trials Unit</s1>
<s2>London</s2>
<s3>GBR</s3>
<sZ>13 aut.</sZ>
</inist:fA14>
</affiliation>
</author>
<author><name sortKey="Mandrekar, Sumithra J" sort="Mandrekar, Sumithra J" uniqKey="Mandrekar S" first="Sumithra J." last="Mandrekar">Sumithra J. Mandrekar</name>
<affiliation><inist:fA14 i1="15"><s1>Mayo Clinic and North Central Cancer Treatment Group</s1>
<s2>Rochester, MN</s2>
<s3>USA</s3>
<sZ>14 aut.</sZ>
</inist:fA14>
</affiliation>
</author>
<author><name sortKey="Paulus, Rebecca" sort="Paulus, Rebecca" uniqKey="Paulus R" first="Rebecca" last="Paulus">Rebecca Paulus</name>
<affiliation><inist:fA14 i1="11"><s1>Radiation Therapy Oncology Group</s1>
<s2>Philadelphia, PA</s2>
<s3>USA</s3>
<sZ>15 aut.</sZ>
</inist:fA14>
</affiliation>
</author>
<author><name sortKey="Behrendt, Katarzyna" sort="Behrendt, Katarzyna" uniqKey="Behrendt K" first="Katarzyna" last="Behrendt">Katarzyna Behrendt</name>
<affiliation><inist:fA14 i1="13"><s1>Maria Sklodowska-Curie Memorial Cancer Center, Gliwice Branch</s1>
<s3>POL</s3>
<sZ>11 aut.</sZ>
<sZ>16 aut.</sZ>
</inist:fA14>
</affiliation>
</author>
<author><name sortKey="Koch, Rainer" sort="Koch, Rainer" uniqKey="Koch R" first="Rainer" last="Koch">Rainer Koch</name>
<affiliation><inist:fA14 i1="06"><s1>University Hospital and Medical Faculty Carl Gustav Carus</s1>
<s2>Dresden</s2>
<s3>DEU</s3>
<sZ>6 aut.</sZ>
<sZ>17 aut.</sZ>
</inist:fA14>
</affiliation>
</author>
<author><name sortKey="Bishop, James F" sort="Bishop, James F" uniqKey="Bishop J" first="James F." last="Bishop">James F. Bishop</name>
<affiliation><inist:fA14 i1="09"><s1>Victorian Comprehensive Cancer Centre</s1>
<s2>Melbourne</s2>
<s3>AUS</s3>
<sZ>18 aut.</sZ>
</inist:fA14>
</affiliation>
</author>
<author><name sortKey="Dische, Stanley" sort="Dische, Stanley" uniqKey="Dische S" first="Stanley" last="Dische">Stanley Dische</name>
</author>
<author><name sortKey="Arriagada, Rodrigo" sort="Arriagada, Rodrigo" uniqKey="Arriagada R" first="Rodrigo" last="Arriagada">Rodrigo Arriagada</name>
<affiliation><inist:fA14 i1="01"><s1>Institut de Cancérologie Gustave-Roussy</s1>
<s2>Villejuif</s2>
<s3>FRA</s3>
<sZ>1 aut.</sZ>
<sZ>2 aut.</sZ>
<sZ>20 aut.</sZ>
<sZ>22 aut.</sZ>
</inist:fA14>
</affiliation>
<affiliation><inist:fA14 i1="16"><s1>Karolinska Institutet</s1>
<s2>Stockholm</s2>
<s3>SWE</s3>
<sZ>20 aut.</sZ>
</inist:fA14>
</affiliation>
</author>
<author><name sortKey="Ruysscher, Dirk De" sort="Ruysscher, Dirk De" uniqKey="Ruysscher D" first="Dirk De" last="Ruysscher">Dirk De Ruysscher</name>
<affiliation><inist:fA14 i1="17"><s1>Maastricht University Medical Center</s1>
<s2>Maastricht</s2>
<s3>NLD</s3>
<sZ>21 aut.</sZ>
</inist:fA14>
</affiliation>
</author>
<author><name sortKey="Pignon, Jean Pierre" sort="Pignon, Jean Pierre" uniqKey="Pignon J" first="Jean-Pierre" last="Pignon">Jean-Pierre Pignon</name>
<affiliation><inist:fA14 i1="01"><s1>Institut de Cancérologie Gustave-Roussy</s1>
<s2>Villejuif</s2>
<s3>FRA</s3>
<sZ>1 aut.</sZ>
<sZ>2 aut.</sZ>
<sZ>20 aut.</sZ>
<sZ>22 aut.</sZ>
</inist:fA14>
</affiliation>
</author>
</analytic>
<series><title level="j" type="main">Journal of clinical oncology</title>
<title level="j" type="abbreviated">J. clin. oncol.</title>
<idno type="ISSN">0732-183X</idno>
<imprint><date when="2012">2012</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
<seriesStmt><title level="j" type="main">Journal of clinical oncology</title>
<title level="j" type="abbreviated">J. clin. oncol.</title>
<idno type="ISSN">0732-183X</idno>
</seriesStmt>
</fileDesc>
<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Cancerology</term>
<term>Data analysis</term>
<term>Human</term>
<term>Lung cancer</term>
<term>Metaanalysis</term>
<term>Radiotherapy</term>
<term>Treatment</term>
</keywords>
<keywords scheme="Pascal" xml:lang="fr"><term>Radiothérapie</term>
<term>Traitement</term>
<term>Cancer du poumon</term>
<term>Homme</term>
<term>Analyse donnée</term>
<term>Métaanalyse</term>
<term>Cancérologie</term>
</keywords>
</textClass>
</profileDesc>
</teiHeader>
<front><div type="abstract" xml:lang="en">Purpose In lung cancer, randomized trials assessing hyperfractionated or accelerated radiotherapy seem to yield conflicting results regarding the effects on overall (OS) or progression-free survival (PFS). The Meta-Analysis of Radiotherapy in Lung Cancer Collaborative Group decided to address the role of modified radiotherapy fractionation. Material and Methods We performed an individual patient data meta-analysis in patients with nonmetastatic lung cancer, which included trials comparing modified radiotherapy with conventional radiotherapy. Results In non-small-cell lung cancer (NSCLC; 10 trials, 2,000 patients), modified fractionation improved OS as compared with conventional schedules (hazard ratio [HR] = 0.88, 95% CI, 0.80 to 0.97; P = .009), resulting in an absolute benefit of 2.5% (8.3% to 10.8%) at 5 years. No evidence of heterogeneity between trials was found. There was no evidence of a benefit on PFS (HR = 0.94; 95% CI, 0.86 to 1.03; P = .19). Modified radiotherapy reduced deaths resulting from lung cancer (HR <sub>=</sub>
 0.89; 95% CI, 0.81 to 0.98; P = .02), and there was a nonsignificant reduction of non-lung cancer deaths (HR = 0.87; 95% CI, 0.66 to 1.15; P = .33). In small-cell lung cancer (SCLC; two trials, 685 patients), similar results were found: OS, HR = 0.87, 95% CI, 0.74 to 1.02, P = .08; PFS, HR = 0.88, 95% CI, 0.75 to 1.03, P = .11. In both NSCLC and SCLC, the use of modified radiotherapy increased the risk of acute esophageal toxicity (odds ratio [OR] = 2.44 in NSCLC and OR = 2.41 in SCLC; P < .001) but did not have an impact on the risk of other acute toxicities. Conclusion Patients with nonmetastatic NSCLC derived a significant OS benefit from accelerated or hyperfractionated radiotherapy; a similar but nonsignificant trend was observed for SCLC. As expected, there was increased acute esophageal toxicity.</div>
</front>
</TEI>
<inist><standard h6="B"><pA><fA01 i1="01" i2="1"><s0>0732-183X</s0>
</fA01>
<fA03 i2="1"><s0>J. clin. oncol.</s0>
</fA03>
<fA05><s2>30</s2>
</fA05>
<fA06><s2>22</s2>
</fA06>
<fA08 i1="01" i2="1" l="ENG"><s1>Hyperfractionated or Accelerated Radiotherapy in Lung Cancer: An Individual Patient Data Meta-Analysis</s1>
</fA08>
<fA11 i1="01" i2="1"><s1>MAUGUEN (Audrey)</s1>
</fA11>
<fA11 i1="02" i2="1"><s1>LE PECHOUX (Cécile)</s1>
</fA11>
<fA11 i1="03" i2="1"><s1>SAUNDERS (Michele I.)</s1>
</fA11>
<fA11 i1="04" i2="1"><s1>SCHILD (Steven E.)</s1>
</fA11>
<fA11 i1="05" i2="1"><s1>TURRISI (Andrew T.)</s1>
</fA11>
<fA11 i1="06" i2="1"><s1>BAUMANN (Michael)</s1>
</fA11>
<fA11 i1="07" i2="1"><s1>SAUSE (William T.)</s1>
</fA11>
<fA11 i1="08" i2="1"><s1>BALL (David)</s1>
</fA11>
<fA11 i1="09" i2="1"><s1>BELANI (Chandra P.)</s1>
</fA11>
<fA11 i1="10" i2="1"><s1>BONNER (James A.)</s1>
</fA11>
<fA11 i1="11" i2="1"><s1>ZAJUSZ (Aleksander)</s1>
</fA11>
<fA11 i1="12" i2="1"><s1>DAHLBERG (Suzanne E.)</s1>
</fA11>
<fA11 i1="13" i2="1"><s1>NANKIVELL (Matthew)</s1>
</fA11>
<fA11 i1="14" i2="1"><s1>MANDREKAR (Sumithra J.)</s1>
</fA11>
<fA11 i1="15" i2="1"><s1>PAULUS (Rebecca)</s1>
</fA11>
<fA11 i1="16" i2="1"><s1>BEHRENDT (Katarzyna)</s1>
</fA11>
<fA11 i1="17" i2="1"><s1>KOCH (Rainer)</s1>
</fA11>
<fA11 i1="18" i2="1"><s1>BISHOP (James F.)</s1>
</fA11>
<fA11 i1="19" i2="1"><s1>DISCHE (Stanley)</s1>
</fA11>
<fA11 i1="20" i2="1"><s1>ARRIAGADA (Rodrigo)</s1>
</fA11>
<fA11 i1="21" i2="1"><s1>RUYSSCHER (Dirk De)</s1>
</fA11>
<fA11 i1="22" i2="1"><s1>PIGNON (Jean-Pierre)</s1>
</fA11>
<fA14 i1="01"><s1>Institut de Cancérologie Gustave-Roussy</s1>
<s2>Villejuif</s2>
<s3>FRA</s3>
<sZ>1 aut.</sZ>
<sZ>2 aut.</sZ>
<sZ>20 aut.</sZ>
<sZ>22 aut.</sZ>
</fA14>
<fA14 i1="02"><s1>Stanley Dische, University College London and Marie Curie Research Wing, Mount Vernon Hospital</s1>
<s2>Northwood Middlesex</s2>
<s3>GBR</s3>
<sZ>3 aut.</sZ>
</fA14>
<fA14 i1="03"><s1>Medical Research Council Clinical Trials Unit</s1>
<s2>London</s2>
<s3>GBR</s3>
<sZ>13 aut.</sZ>
</fA14>
<fA14 i1="04"><s1>Mayo Clinic</s1>
<s2>Phoenix, AZ</s2>
<s3>USA</s3>
<sZ>4 aut.</sZ>
</fA14>
<fA14 i1="05"><s1>Sinai Grace Hospital</s1>
<s2>Detroit, MI</s2>
<s3>USA</s3>
<sZ>5 aut.</sZ>
</fA14>
<fA14 i1="06"><s1>University Hospital and Medical Faculty Carl Gustav Carus</s1>
<s2>Dresden</s2>
<s3>DEU</s3>
<sZ>6 aut.</sZ>
<sZ>17 aut.</sZ>
</fA14>
<fA14 i1="07"><s1>Intermountain Medical Center</s1>
<s2>Murray, UT</s2>
<s3>AUS</s3>
<sZ>7 aut.</sZ>
</fA14>
<fA14 i1="08"><s1>University of Melbourne, East Melbourne</s1>
<s2>Victoria</s2>
<s3>AUS</s3>
<sZ>8 aut.</sZ>
</fA14>
<fA14 i1="09"><s1>Victorian Comprehensive Cancer Centre</s1>
<s2>Melbourne</s2>
<s3>AUS</s3>
<sZ>18 aut.</sZ>
</fA14>
<fA14 i1="10"><s1>Penn State Milton S. Hershey Medical Center</s1>
<s2>Hershey</s2>
<s3>USA</s3>
<sZ>9 aut.</sZ>
</fA14>
<fA14 i1="11"><s1>Radiation Therapy Oncology Group</s1>
<s2>Philadelphia, PA</s2>
<s3>USA</s3>
<sZ>15 aut.</sZ>
</fA14>
<fA14 i1="12"><s1>University of Alabama-Birmingham</s1>
<s2>Birmingham, AL</s2>
<s3>USA</s3>
<sZ>10 aut.</sZ>
</fA14>
<fA14 i1="13"><s1>Maria Sklodowska-Curie Memorial Cancer Center, Gliwice Branch</s1>
<s3>POL</s3>
<sZ>11 aut.</sZ>
<sZ>16 aut.</sZ>
</fA14>
<fA14 i1="14"><s1>Dana-Farber Cancer Institute</s1>
<s2>Boston, MA</s2>
<s3>USA</s3>
<sZ>12 aut.</sZ>
</fA14>
<fA14 i1="15"><s1>Mayo Clinic and North Central Cancer Treatment Group</s1>
<s2>Rochester, MN</s2>
<s3>USA</s3>
<sZ>14 aut.</sZ>
</fA14>
<fA14 i1="16"><s1>Karolinska Institutet</s1>
<s2>Stockholm</s2>
<s3>SWE</s3>
<sZ>20 aut.</sZ>
</fA14>
<fA14 i1="17"><s1>Maastricht University Medical Center</s1>
<s2>Maastricht</s2>
<s3>NLD</s3>
<sZ>21 aut.</sZ>
</fA14>
<fA20><s1>2788-2797</s1>
</fA20>
<fA21><s1>2012</s1>
</fA21>
<fA23 i1="01"><s0>ENG</s0>
</fA23>
<fA43 i1="01"><s1>INIST</s1>
<s2>20094</s2>
<s5>354000506689960150</s5>
</fA43>
<fA44><s0>0000</s0>
<s1>© 2012 INIST-CNRS. All rights reserved.</s1>
</fA44>
<fA45><s0>40 ref.</s0>
</fA45>
<fA47 i1="01" i2="1"><s0>12-0331397</s0>
</fA47>
<fA60><s1>P</s1>
</fA60>
<fA61><s0>A</s0>
</fA61>
<fA64 i1="01" i2="1"><s0>Journal of clinical oncology</s0>
</fA64>
<fA66 i1="01"><s0>USA</s0>
</fA66>
<fC01 i1="01" l="ENG"><s0>Purpose In lung cancer, randomized trials assessing hyperfractionated or accelerated radiotherapy seem to yield conflicting results regarding the effects on overall (OS) or progression-free survival (PFS). The Meta-Analysis of Radiotherapy in Lung Cancer Collaborative Group decided to address the role of modified radiotherapy fractionation. Material and Methods We performed an individual patient data meta-analysis in patients with nonmetastatic lung cancer, which included trials comparing modified radiotherapy with conventional radiotherapy. Results In non-small-cell lung cancer (NSCLC; 10 trials, 2,000 patients), modified fractionation improved OS as compared with conventional schedules (hazard ratio [HR] = 0.88, 95% CI, 0.80 to 0.97; P = .009), resulting in an absolute benefit of 2.5% (8.3% to 10.8%) at 5 years. No evidence of heterogeneity between trials was found. There was no evidence of a benefit on PFS (HR = 0.94; 95% CI, 0.86 to 1.03; P = .19). Modified radiotherapy reduced deaths resulting from lung cancer (HR <sub>=</sub>
 0.89; 95% CI, 0.81 to 0.98; P = .02), and there was a nonsignificant reduction of non-lung cancer deaths (HR = 0.87; 95% CI, 0.66 to 1.15; P = .33). In small-cell lung cancer (SCLC; two trials, 685 patients), similar results were found: OS, HR = 0.87, 95% CI, 0.74 to 1.02, P = .08; PFS, HR = 0.88, 95% CI, 0.75 to 1.03, P = .11. In both NSCLC and SCLC, the use of modified radiotherapy increased the risk of acute esophageal toxicity (odds ratio [OR] = 2.44 in NSCLC and OR = 2.41 in SCLC; P < .001) but did not have an impact on the risk of other acute toxicities. Conclusion Patients with nonmetastatic NSCLC derived a significant OS benefit from accelerated or hyperfractionated radiotherapy; a similar but nonsignificant trend was observed for SCLC. As expected, there was increased acute esophageal toxicity.</s0>
</fC01>
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<fC03 i1="01" i2="X" l="FRE"><s0>Radiothérapie</s0>
<s5>01</s5>
</fC03>
<fC03 i1="01" i2="X" l="ENG"><s0>Radiotherapy</s0>
<s5>01</s5>
</fC03>
<fC03 i1="01" i2="X" l="SPA"><s0>Radioterapia</s0>
<s5>01</s5>
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<s5>02</s5>
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<s5>02</s5>
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<s2>NM</s2>
<s5>03</s5>
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<s5>03</s5>
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<s5>03</s5>
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<s5>05</s5>
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<fC03 i1="05" i2="X" l="FRE"><s0>Analyse donnée</s0>
<s5>06</s5>
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<s5>06</s5>
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<fC03 i1="05" i2="X" l="SPA"><s0>Análisis datos</s0>
<s5>06</s5>
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<fC03 i1="06" i2="X" l="FRE"><s0>Métaanalyse</s0>
<s5>08</s5>
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<fC03 i1="06" i2="X" l="ENG"><s0>Metaanalysis</s0>
<s5>08</s5>
</fC03>
<fC03 i1="06" i2="X" l="SPA"><s0>Meta-análisis</s0>
<s5>08</s5>
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<fC03 i1="07" i2="X" l="FRE"><s0>Cancérologie</s0>
<s5>09</s5>
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<fC03 i1="07" i2="X" l="ENG"><s0>Cancerology</s0>
<s5>09</s5>
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<fC03 i1="07" i2="X" l="SPA"><s0>Cancerología</s0>
<s5>09</s5>
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<fC07 i1="01" i2="X" l="FRE"><s0>Pathologie de l'appareil respiratoire</s0>
<s5>37</s5>
</fC07>
<fC07 i1="01" i2="X" l="ENG"><s0>Respiratory disease</s0>
<s5>37</s5>
</fC07>
<fC07 i1="01" i2="X" l="SPA"><s0>Aparato respiratorio patología</s0>
<s5>37</s5>
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<fC07 i1="02" i2="X" l="FRE"><s0>Pathologie des bronches</s0>
<s5>38</s5>
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<fC07 i1="02" i2="X" l="ENG"><s0>Bronchus disease</s0>
<s5>38</s5>
</fC07>
<fC07 i1="02" i2="X" l="SPA"><s0>Bronquio patología</s0>
<s5>38</s5>
</fC07>
<fC07 i1="03" i2="X" l="FRE"><s0>Pathologie des poumons</s0>
<s5>39</s5>
</fC07>
<fC07 i1="03" i2="X" l="ENG"><s0>Lung disease</s0>
<s5>39</s5>
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<fC07 i1="03" i2="X" l="SPA"><s0>Pulmón patología</s0>
<s5>39</s5>
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<s5>40</s5>
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<s2>NM</s2>
<s5>40</s5>
</fC07>
<fC07 i1="04" i2="X" l="SPA"><s0>Tumor maligno</s0>
<s2>NM</s2>
<s5>40</s5>
</fC07>
<fC07 i1="05" i2="X" l="FRE"><s0>Cancer</s0>
<s2>NM</s2>
</fC07>
<fC07 i1="05" i2="X" l="ENG"><s0>Cancer</s0>
<s2>NM</s2>
</fC07>
<fC07 i1="05" i2="X" l="SPA"><s0>Cáncer</s0>
<s2>NM</s2>
</fC07>
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<server><NO>PASCAL 12-0331397 INIST</NO>
<ET>Hyperfractionated or Accelerated Radiotherapy in Lung Cancer: An Individual Patient Data Meta-Analysis</ET>
<AU>MAUGUEN (Audrey); LE PECHOUX (Cécile); SAUNDERS (Michele I.); SCHILD (Steven E.); TURRISI (Andrew T.); BAUMANN (Michael); SAUSE (William T.); BALL (David); BELANI (Chandra P.); BONNER (James A.); ZAJUSZ (Aleksander); DAHLBERG (Suzanne E.); NANKIVELL (Matthew); MANDREKAR (Sumithra J.); PAULUS (Rebecca); BEHRENDT (Katarzyna); KOCH (Rainer); BISHOP (James F.); DISCHE (Stanley); ARRIAGADA (Rodrigo); RUYSSCHER (Dirk De); PIGNON (Jean-Pierre)</AU>
<AF>Institut de Cancérologie Gustave-Roussy/Villejuif/France (1 aut., 2 aut., 20 aut., 22 aut.); Stanley Dische, University College London and Marie Curie Research Wing, Mount Vernon Hospital/Northwood Middlesex/Royaume-Uni (3 aut.); Medical Research Council Clinical Trials Unit/London/Royaume-Uni (13 aut.); Mayo Clinic/Phoenix, AZ/Etats-Unis (4 aut.); Sinai Grace Hospital/Detroit, MI/Etats-Unis (5 aut.); University Hospital and Medical Faculty Carl Gustav Carus/Dresden/Allemagne (6 aut., 17 aut.); Intermountain Medical Center/Murray, UT/Australie (7 aut.); University of Melbourne, East Melbourne/Victoria/Australie (8 aut.); Victorian Comprehensive Cancer Centre/Melbourne/Australie (18 aut.); Penn State Milton S. Hershey Medical Center/Hershey/Etats-Unis (9 aut.); Radiation Therapy Oncology Group/Philadelphia, PA/Etats-Unis (15 aut.); University of Alabama-Birmingham/Birmingham, AL/Etats-Unis (10 aut.); Maria Sklodowska-Curie Memorial Cancer Center, Gliwice Branch/Pologne (11 aut., 16 aut.); Dana-Farber Cancer Institute/Boston, MA/Etats-Unis (12 aut.); Mayo Clinic and North Central Cancer Treatment Group/Rochester, MN/Etats-Unis (14 aut.); Karolinska Institutet/Stockholm/Suède (20 aut.); Maastricht University Medical Center/Maastricht/Pays-Bas (21 aut.)</AF>
<DT>Publication en série; Niveau analytique</DT>
<SO>Journal of clinical oncology; ISSN 0732-183X; Etats-Unis; Da. 2012; Vol. 30; No. 22; Pp. 2788-2797; Bibl. 40 ref.</SO>
<LA>Anglais</LA>
<EA>Purpose In lung cancer, randomized trials assessing hyperfractionated or accelerated radiotherapy seem to yield conflicting results regarding the effects on overall (OS) or progression-free survival (PFS). The Meta-Analysis of Radiotherapy in Lung Cancer Collaborative Group decided to address the role of modified radiotherapy fractionation. Material and Methods We performed an individual patient data meta-analysis in patients with nonmetastatic lung cancer, which included trials comparing modified radiotherapy with conventional radiotherapy. Results In non-small-cell lung cancer (NSCLC; 10 trials, 2,000 patients), modified fractionation improved OS as compared with conventional schedules (hazard ratio [HR] = 0.88, 95% CI, 0.80 to 0.97; P = .009), resulting in an absolute benefit of 2.5% (8.3% to 10.8%) at 5 years. No evidence of heterogeneity between trials was found. There was no evidence of a benefit on PFS (HR = 0.94; 95% CI, 0.86 to 1.03; P = .19). Modified radiotherapy reduced deaths resulting from lung cancer (HR <sub>=</sub>
 0.89; 95% CI, 0.81 to 0.98; P = .02), and there was a nonsignificant reduction of non-lung cancer deaths (HR = 0.87; 95% CI, 0.66 to 1.15; P = .33). In small-cell lung cancer (SCLC; two trials, 685 patients), similar results were found: OS, HR = 0.87, 95% CI, 0.74 to 1.02, P = .08; PFS, HR = 0.88, 95% CI, 0.75 to 1.03, P = .11. In both NSCLC and SCLC, the use of modified radiotherapy increased the risk of acute esophageal toxicity (odds ratio [OR] = 2.44 in NSCLC and OR = 2.41 in SCLC; P < .001) but did not have an impact on the risk of other acute toxicities. Conclusion Patients with nonmetastatic NSCLC derived a significant OS benefit from accelerated or hyperfractionated radiotherapy; a similar but nonsignificant trend was observed for SCLC. As expected, there was increased acute esophageal toxicity.</EA>
<CC>002B04; 002B11A</CC>
<FD>Radiothérapie; Traitement; Cancer du poumon; Homme; Analyse donnée; Métaanalyse; Cancérologie</FD>
<FG>Pathologie de l'appareil respiratoire; Pathologie des bronches; Pathologie des poumons; Tumeur maligne; Cancer</FG>
<ED>Radiotherapy; Treatment; Lung cancer; Human; Data analysis; Metaanalysis; Cancerology</ED>
<EG>Respiratory disease; Bronchus disease; Lung disease; Malignant tumor; Cancer</EG>
<SD>Radioterapia; Tratamiento; Cáncer del pulmón; Hombre; Análisis datos; Meta-análisis; Cancerología</SD>
<LO>INIST-20094.354000506689960150</LO>
<ID>12-0331397</ID>
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Hyperfractionated or Accelerated Radiotherapy in Lung Cancer: An Individual Patient Data Meta-Analysis

Hyperfractionated or Accelerated Radiotherapy in Lung Cancer: An Individual Patient Data Meta-Analysis

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