Role of radiotherapy fractionation in head and neck cancers (MARCH): an updated meta-analysis.
Identifieur interne : 000526 ( PubMed/Curation ); précédent : 000525; suivant : 000527Role of radiotherapy fractionation in head and neck cancers (MARCH): an updated meta-analysis.
Auteurs : Benjamin Lacas [France] ; Jean Bourhis [Suisse] ; Jens Overgaard [Danemark] ; Qiang Zhang [États-Unis] ; Vincent Grégoire [Belgique] ; Matthew Nankivell [Royaume-Uni] ; Björn Zackrisson [Suède] ; Zbigniew Szutkowski [Pologne] ; Rafał Suwi Ski [Pologne] ; Michael Poulsen [Australie] ; Brian O'Sullivan [Canada] ; Renzo Corv [Italie] ; Sarbani Ghosh Laskar [Inde] ; Carlo Fallai [Italie] ; Hideya Yamazaki [Japon] ; Werner Dobrowsky [Royaume-Uni] ; Kwan Ho Cho [Corée du Sud] ; Adam S. Garden [États-Unis] ; Johannes A. Langendijk [Pays-Bas] ; Celia Maria Pais Viegas [Brésil] ; John Hay [Canada] ; Mohamed Lotayef [Égypte] ; Mahesh K B. Parmar [Royaume-Uni] ; Anne Aupérin [France] ; Carla Van Herpen [Pays-Bas] ; Philippe Maingon [France] ; Andy M. Trotti [États-Unis] ; Cai Grau [Danemark] ; Jean-Pierre Pignon [France] ; Pierre Blanchard [France]Source :
- The Lancet. Oncology [ 1474-5488 ] ; 2017.
Descripteurs français
- KwdFr :
- Carcinome épidermoïde (anatomopathologie), Carcinome épidermoïde (mortalité), Carcinome épidermoïde (radiothérapie), Fractionnement de la dose d'irradiation, Humains, Tumeurs de la tête et du cou (anatomopathologie), Tumeurs de la tête et du cou (mortalité), Tumeurs de la tête et du cou (radiothérapie).
- MESH :
- anatomopathologie : Carcinome épidermoïde, Tumeurs de la tête et du cou.
- mortalité : Carcinome épidermoïde, Tumeurs de la tête et du cou.
- radiothérapie : Carcinome épidermoïde, Tumeurs de la tête et du cou.
- Fractionnement de la dose d'irradiation, Humains.
English descriptors
- KwdEn :
- MESH :
- mortality : Carcinoma, Squamous Cell, Head and Neck Neoplasms.
- pathology : Carcinoma, Squamous Cell, Head and Neck Neoplasms.
- radiotherapy : Carcinoma, Squamous Cell, Head and Neck Neoplasms.
- Dose Fractionation, Humans.
Abstract
The Meta-Analysis of Radiotherapy in squamous cell Carcinomas of Head and neck (MARCH) showed that altered fractionation radiotherapy is associated with improved overall and progression-free survival compared with conventional radiotherapy, with hyperfractionated radiotherapy showing the greatest benefit. This update aims to confirm and explain the superiority of hyperfractionated radiotherapy over other altered fractionation radiotherapy regimens and to assess the benefit of altered fractionation within the context of concomitant chemotherapy with the inclusion of new trials.
DOI: 10.1016/S1470-2045(17)30458-8
PubMed: 28757375
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Langendijk</name><affiliation wicri:level="1"><nlm:affiliation>Department of Radiation Oncology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands.</nlm:affiliation><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Department of Radiation Oncology, University Medical Center Groningen, University of Groningen, Groningen</wicri:regionArea></affiliation></author><author><name sortKey="Viegas, Celia Maria Pais" sort="Viegas, Celia Maria Pais" uniqKey="Viegas C" first="Celia Maria Pais" last="Viegas">Celia Maria Pais Viegas</name><affiliation wicri:level="1"><nlm:affiliation>Radiation Oncology Department, Instituto Nacional de Cancer, Brasil National Cancer Institute, Rio de Janeiro, Brazil.</nlm:affiliation><country xml:lang="fr">Brésil</country><wicri:regionArea>Radiation Oncology Department, Instituto Nacional de Cancer, Brasil National Cancer Institute, Rio de Janeiro</wicri:regionArea></affiliation></author><author><name sortKey="Hay, John" sort="Hay, John" uniqKey="Hay J" first="John" last="Hay">John Hay</name><affiliation wicri:level="1"><nlm:affiliation>Division of Radiation Oncology, British Columbia Cancer Agency, Vancouver, BC, Canada.</nlm:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>Division of Radiation Oncology, British Columbia Cancer Agency, Vancouver, BC</wicri:regionArea></affiliation></author><author><name sortKey="Lotayef, Mohamed" sort="Lotayef, Mohamed" uniqKey="Lotayef M" first="Mohamed" last="Lotayef">Mohamed Lotayef</name><affiliation wicri:level="1"><nlm:affiliation>Radiation Oncology Department, National Cancer Institute, Cairo University, Cairo, Egypt.</nlm:affiliation><country xml:lang="fr">Égypte</country><wicri:regionArea>Radiation Oncology Department, National Cancer Institute, Cairo University, Cairo</wicri:regionArea></affiliation></author><author><name sortKey="Parmar, Mahesh K B" sort="Parmar, Mahesh K B" uniqKey="Parmar M" first="Mahesh K B" last="Parmar">Mahesh K B. Parmar</name><affiliation wicri:level="1"><nlm:affiliation>Medical Research Council Clinical Trials Unit, University College London, London, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Medical Research Council Clinical Trials Unit, University College London, London</wicri:regionArea></affiliation></author><author><name sortKey="Auperin, Anne" sort="Auperin, Anne" uniqKey="Auperin A" first="Anne" last="Aupérin">Anne Aupérin</name><affiliation wicri:level="1"><nlm:affiliation>Ligue Nationale Contre le Cancer Meta-Analysis Platform, Service de Biostatistique et d'Epidémiologie, Gustave Roussy Cancer Campus, INSERM U1018, CESP, Université Paris-Sud, Université Paris-Saclay, Villejuif, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Ligue Nationale Contre le Cancer Meta-Analysis Platform, Service de Biostatistique et d'Epidémiologie, Gustave Roussy Cancer Campus, INSERM U1018, CESP, Université Paris-Sud, Université Paris-Saclay, Villejuif</wicri:regionArea></affiliation></author><author><name sortKey="Van Herpen, Carla" sort="Van Herpen, Carla" uniqKey="Van Herpen C" first="Carla" last="Van Herpen">Carla Van Herpen</name><affiliation wicri:level="1"><nlm:affiliation>Department of Medical Oncology, Radboud University Medical Center, Nijmegen, Netherlands.</nlm:affiliation><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Department of Medical Oncology, Radboud University Medical Center, Nijmegen</wicri:regionArea></affiliation></author><author><name sortKey="Maingon, Philippe" sort="Maingon, Philippe" uniqKey="Maingon P" first="Philippe" last="Maingon">Philippe Maingon</name><affiliation wicri:level="1"><nlm:affiliation>European Organisation for Research and Treatment of Cancer, Radiation Oncology Group, Brussels, Belgium; Service d'Oncologie, Radiothérapie, Hôpitaux Universitaires Pitié Salpêtrière, Charles Foix, Paris, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>European Organisation for Research and Treatment of Cancer, Radiation Oncology Group, Brussels, Belgium; Service d'Oncologie, Radiothérapie, Hôpitaux Universitaires Pitié Salpêtrière, Charles Foix, Paris</wicri:regionArea></affiliation></author><author><name sortKey="Trotti, Andy M" sort="Trotti, Andy M" uniqKey="Trotti A" first="Andy M" last="Trotti">Andy M. Trotti</name><affiliation wicri:level="1"><nlm:affiliation>Moffitt Cancer Center, Department of Radiation Oncology, Tampa, FL, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Moffitt Cancer Center, Department of Radiation Oncology, Tampa, FL</wicri:regionArea></affiliation></author><author><name sortKey="Grau, Cai" sort="Grau, Cai" uniqKey="Grau C" first="Cai" last="Grau">Cai Grau</name><affiliation wicri:level="1"><nlm:affiliation>Department of Experimental Clinical Oncology, Aarhus, Denmark.</nlm:affiliation><country xml:lang="fr">Danemark</country><wicri:regionArea>Department of Experimental Clinical Oncology, Aarhus</wicri:regionArea></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 wicri:level="1"><nlm:affiliation>Ligue Nationale Contre le Cancer Meta-Analysis Platform, Service de Biostatistique et d'Epidémiologie, Gustave Roussy Cancer Campus, INSERM U1018, CESP, Université Paris-Sud, Université Paris-Saclay, Villejuif, France. Electronic address: jean-pierre.pignon@gustaveroussy.fr.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Ligue Nationale Contre le Cancer Meta-Analysis Platform, Service de Biostatistique et d'Epidémiologie, Gustave Roussy Cancer Campus, INSERM U1018, CESP, Université Paris-Sud, Université Paris-Saclay, Villejuif</wicri:regionArea></affiliation></author><author><name sortKey="Blanchard, Pierre" sort="Blanchard, Pierre" uniqKey="Blanchard P" first="Pierre" last="Blanchard">Pierre Blanchard</name><affiliation wicri:level="1"><nlm:affiliation>Department of Radiation Therapy, Gustave Roussy Cancer Campus, INSERM U1018, CESP, Université Paris-Sud, Université Paris-Saclay, Villejuif, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Department of Radiation Therapy, Gustave Roussy Cancer Campus, INSERM U1018, CESP, Université Paris-Sud, Université Paris-Saclay, Villejuif</wicri:regionArea></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2017">2017</date><idno type="RBID">pubmed:28757375</idno><idno type="pmid">28757375</idno><idno type="doi">10.1016/S1470-2045(17)30458-8</idno><idno type="wicri:Area/PubMed/Corpus">000528</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Corpus" wicri:corpus="PubMed">000528</idno><idno type="wicri:Area/PubMed/Curation">000526</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Curation">000526</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Role of radiotherapy fractionation in head and neck cancers (MARCH): an updated meta-analysis.</title><author><name sortKey="Lacas, Benjamin" sort="Lacas, Benjamin" uniqKey="Lacas B" first="Benjamin" last="Lacas">Benjamin Lacas</name><affiliation wicri:level="1"><nlm:affiliation>Ligue Nationale Contre le Cancer Meta-Analysis Platform, Service de Biostatistique et d'Epidémiologie, Gustave Roussy Cancer Campus, INSERM U1018, CESP, Université Paris-Sud, Université Paris-Saclay, Villejuif, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Ligue Nationale Contre le Cancer Meta-Analysis Platform, Service de Biostatistique et d'Epidémiologie, Gustave Roussy Cancer Campus, INSERM U1018, CESP, Université Paris-Sud, Université Paris-Saclay, Villejuif</wicri:regionArea></affiliation></author><author><name sortKey="Bourhis, Jean" sort="Bourhis, Jean" uniqKey="Bourhis J" first="Jean" last="Bourhis">Jean Bourhis</name><affiliation wicri:level="1"><nlm:affiliation>Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.</nlm:affiliation><country xml:lang="fr">Suisse</country><wicri:regionArea>Centre Hospitalier Universitaire Vaudois, Lausanne</wicri:regionArea></affiliation></author><author><name sortKey="Overgaard, Jens" sort="Overgaard, Jens" uniqKey="Overgaard J" first="Jens" last="Overgaard">Jens Overgaard</name><affiliation wicri:level="1"><nlm:affiliation>Department of Experimental Clinical Oncology, Aarhus, Denmark.</nlm:affiliation><country xml:lang="fr">Danemark</country><wicri:regionArea>Department of Experimental Clinical Oncology, Aarhus</wicri:regionArea></affiliation></author><author><name sortKey="Zhang, Qiang" sort="Zhang, Qiang" uniqKey="Zhang Q" first="Qiang" last="Zhang">Qiang Zhang</name><affiliation wicri:level="1"><nlm:affiliation>NRG Oncology Statistics and Data Management Center (formerly RTOG), Philadelphia, PA, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>NRG Oncology Statistics and Data Management Center (formerly RTOG), Philadelphia, PA</wicri:regionArea></affiliation></author><author><name sortKey="Gregoire, Vincent" sort="Gregoire, Vincent" uniqKey="Gregoire V" first="Vincent" last="Grégoire">Vincent Grégoire</name><affiliation wicri:level="1"><nlm:affiliation>Radiation Oncology Department, UCL-Cliniques Universitaires St-Luc, Brussels, Belgium.</nlm:affiliation><country xml:lang="fr">Belgique</country><wicri:regionArea>Radiation Oncology Department, UCL-Cliniques Universitaires St-Luc, Brussels</wicri:regionArea></affiliation></author><author><name sortKey="Nankivell, Matthew" sort="Nankivell, Matthew" uniqKey="Nankivell M" first="Matthew" last="Nankivell">Matthew Nankivell</name><affiliation wicri:level="1"><nlm:affiliation>Medical Research Council Clinical Trials Unit, University College London, London, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Medical Research Council Clinical Trials Unit, University College London, London</wicri:regionArea></affiliation></author><author><name sortKey="Zackrisson, Bjorn" sort="Zackrisson, Bjorn" uniqKey="Zackrisson B" first="Björn" last="Zackrisson">Björn Zackrisson</name><affiliation wicri:level="1"><nlm:affiliation>Department of Radiation Sciences, Oncology, Umeå University, Umeå, Sweden.</nlm:affiliation><country xml:lang="fr">Suède</country><wicri:regionArea>Department of Radiation Sciences, Oncology, Umeå University, Umeå</wicri:regionArea></affiliation></author><author><name sortKey="Szutkowski, Zbigniew" sort="Szutkowski, Zbigniew" uniqKey="Szutkowski Z" first="Zbigniew" last="Szutkowski">Zbigniew Szutkowski</name><affiliation wicri:level="1"><nlm:affiliation>Department of Radiotherapy, Cancer Center, Marie Curie-Sklodowska Memorial Institute, Warsaw, Poland.</nlm:affiliation><country xml:lang="fr">Pologne</country><wicri:regionArea>Department of Radiotherapy, Cancer Center, Marie Curie-Sklodowska Memorial Institute, Warsaw</wicri:regionArea></affiliation></author><author><name sortKey="Suwi Ski, Rafal" sort="Suwi Ski, Rafal" uniqKey="Suwi Ski R" first="Rafał" last="Suwi Ski">Rafał Suwi Ski</name><affiliation wicri:level="1"><nlm:affiliation>Radiotherapy and Chemotherapy Clinic and Teaching Hospital, Marie Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice, Poland.</nlm:affiliation><country xml:lang="fr">Pologne</country><wicri:regionArea>Radiotherapy and Chemotherapy Clinic and Teaching Hospital, Marie Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice</wicri:regionArea></affiliation></author><author><name sortKey="Poulsen, Michael" sort="Poulsen, Michael" uniqKey="Poulsen M" first="Michael" last="Poulsen">Michael Poulsen</name><affiliation wicri:level="1"><nlm:affiliation>Radiation Oncology Services, Mater Centre, Brisbane, QLD, Australia.</nlm:affiliation><country xml:lang="fr">Australie</country><wicri:regionArea>Radiation Oncology Services, Mater Centre, Brisbane, QLD</wicri:regionArea></affiliation></author><author><name sortKey="O Sullivan, Brian" sort="O Sullivan, Brian" uniqKey="O Sullivan B" first="Brian" last="O'Sullivan">Brian O'Sullivan</name><affiliation wicri:level="1"><nlm:affiliation>Department of Radiation Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada.</nlm:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>Department of Radiation Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON</wicri:regionArea></affiliation></author><author><name sortKey="Corv, Renzo" sort="Corv, Renzo" uniqKey="Corv R" first="Renzo" last="Corv">Renzo Corv</name><affiliation wicri:level="1"><nlm:affiliation>IRCCS San Martino-IST, Genoa, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>IRCCS San Martino-IST, Genoa</wicri:regionArea></affiliation></author><author><name sortKey="Laskar, Sarbani Ghosh" sort="Laskar, Sarbani Ghosh" uniqKey="Laskar S" first="Sarbani Ghosh" last="Laskar">Sarbani Ghosh Laskar</name><affiliation wicri:level="1"><nlm:affiliation>Department of Radiation Oncology, Tata Memorial Hospital, Mumbai, India.</nlm:affiliation><country xml:lang="fr">Inde</country><wicri:regionArea>Department of Radiation Oncology, Tata Memorial Hospital, Mumbai</wicri:regionArea></affiliation></author><author><name sortKey="Fallai, Carlo" sort="Fallai, Carlo" uniqKey="Fallai C" first="Carlo" last="Fallai">Carlo Fallai</name><affiliation wicri:level="1"><nlm:affiliation>Department of Radiotherapy, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Radiotherapy, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan</wicri:regionArea></affiliation></author><author><name sortKey="Yamazaki, Hideya" sort="Yamazaki, Hideya" uniqKey="Yamazaki H" first="Hideya" last="Yamazaki">Hideya Yamazaki</name><affiliation wicri:level="1"><nlm:affiliation>Department of Radiation Oncology, Osaka Medical Center for Cancer and Cardiovascular Disease, Osaka, Japan.</nlm:affiliation><country xml:lang="fr">Japon</country><wicri:regionArea>Department of Radiation Oncology, Osaka Medical Center for Cancer and Cardiovascular Disease, Osaka</wicri:regionArea></affiliation></author><author><name sortKey="Dobrowsky, Werner" sort="Dobrowsky, Werner" uniqKey="Dobrowsky W" first="Werner" last="Dobrowsky">Werner Dobrowsky</name><affiliation wicri:level="1"><nlm:affiliation>Department of Clinical Oncology, Freeman Hospital, Newcastle, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Clinical Oncology, Freeman Hospital, Newcastle</wicri:regionArea></affiliation></author><author><name sortKey="Cho, Kwan Ho" sort="Cho, Kwan Ho" uniqKey="Cho K" first="Kwan Ho" last="Cho">Kwan Ho Cho</name><affiliation wicri:level="1"><nlm:affiliation>Proton Therapy Center, Research Institute and Hospital, National Cancer Center, Goyang, South Korea.</nlm:affiliation><country xml:lang="fr">Corée du Sud</country><wicri:regionArea>Proton Therapy Center, Research Institute and Hospital, National Cancer Center, Goyang</wicri:regionArea></affiliation></author><author><name sortKey="Garden, Adam S" sort="Garden, Adam S" uniqKey="Garden A" first="Adam S" last="Garden">Adam S. Garden</name><affiliation wicri:level="1"><nlm:affiliation>Division of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Division of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX</wicri:regionArea></affiliation></author><author><name sortKey="Langendijk, Johannes A" sort="Langendijk, Johannes A" uniqKey="Langendijk J" first="Johannes A" last="Langendijk">Johannes A. Langendijk</name><affiliation wicri:level="1"><nlm:affiliation>Department of Radiation Oncology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands.</nlm:affiliation><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Department of Radiation Oncology, University Medical Center Groningen, University of Groningen, Groningen</wicri:regionArea></affiliation></author><author><name sortKey="Viegas, Celia Maria Pais" sort="Viegas, Celia Maria Pais" uniqKey="Viegas C" first="Celia Maria Pais" last="Viegas">Celia Maria Pais Viegas</name><affiliation wicri:level="1"><nlm:affiliation>Radiation Oncology Department, Instituto Nacional de Cancer, Brasil National Cancer Institute, Rio de Janeiro, Brazil.</nlm:affiliation><country xml:lang="fr">Brésil</country><wicri:regionArea>Radiation Oncology Department, Instituto Nacional de Cancer, Brasil National Cancer Institute, Rio de Janeiro</wicri:regionArea></affiliation></author><author><name sortKey="Hay, John" sort="Hay, John" uniqKey="Hay J" first="John" last="Hay">John Hay</name><affiliation wicri:level="1"><nlm:affiliation>Division of Radiation Oncology, British Columbia Cancer Agency, Vancouver, BC, Canada.</nlm:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>Division of Radiation Oncology, British Columbia Cancer Agency, Vancouver, BC</wicri:regionArea></affiliation></author><author><name sortKey="Lotayef, Mohamed" sort="Lotayef, Mohamed" uniqKey="Lotayef M" first="Mohamed" last="Lotayef">Mohamed Lotayef</name><affiliation wicri:level="1"><nlm:affiliation>Radiation Oncology Department, National Cancer Institute, Cairo University, Cairo, Egypt.</nlm:affiliation><country xml:lang="fr">Égypte</country><wicri:regionArea>Radiation Oncology Department, National Cancer Institute, Cairo University, Cairo</wicri:regionArea></affiliation></author><author><name sortKey="Parmar, Mahesh K B" sort="Parmar, Mahesh K B" uniqKey="Parmar M" first="Mahesh K B" last="Parmar">Mahesh K B. Parmar</name><affiliation wicri:level="1"><nlm:affiliation>Medical Research Council Clinical Trials Unit, University College London, London, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Medical Research Council Clinical Trials Unit, University College London, London</wicri:regionArea></affiliation></author><author><name sortKey="Auperin, Anne" sort="Auperin, Anne" uniqKey="Auperin A" first="Anne" last="Aupérin">Anne Aupérin</name><affiliation wicri:level="1"><nlm:affiliation>Ligue Nationale Contre le Cancer Meta-Analysis Platform, Service de Biostatistique et d'Epidémiologie, Gustave Roussy Cancer Campus, INSERM U1018, CESP, Université Paris-Sud, Université Paris-Saclay, Villejuif, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Ligue Nationale Contre le Cancer Meta-Analysis Platform, Service de Biostatistique et d'Epidémiologie, Gustave Roussy Cancer Campus, INSERM U1018, CESP, Université Paris-Sud, Université Paris-Saclay, Villejuif</wicri:regionArea></affiliation></author><author><name sortKey="Van Herpen, Carla" sort="Van Herpen, Carla" uniqKey="Van Herpen C" first="Carla" last="Van Herpen">Carla Van Herpen</name><affiliation wicri:level="1"><nlm:affiliation>Department of Medical Oncology, Radboud University Medical Center, Nijmegen, Netherlands.</nlm:affiliation><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Department of Medical Oncology, Radboud University Medical Center, Nijmegen</wicri:regionArea></affiliation></author><author><name sortKey="Maingon, Philippe" sort="Maingon, Philippe" uniqKey="Maingon P" first="Philippe" last="Maingon">Philippe Maingon</name><affiliation wicri:level="1"><nlm:affiliation>European Organisation for Research and Treatment of Cancer, Radiation Oncology Group, Brussels, Belgium; Service d'Oncologie, Radiothérapie, Hôpitaux Universitaires Pitié Salpêtrière, Charles Foix, Paris, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>European Organisation for Research and Treatment of Cancer, Radiation Oncology Group, Brussels, Belgium; Service d'Oncologie, Radiothérapie, Hôpitaux Universitaires Pitié Salpêtrière, Charles Foix, Paris</wicri:regionArea></affiliation></author><author><name sortKey="Trotti, Andy M" sort="Trotti, Andy M" uniqKey="Trotti A" first="Andy M" last="Trotti">Andy M. Trotti</name><affiliation wicri:level="1"><nlm:affiliation>Moffitt Cancer Center, Department of Radiation Oncology, Tampa, FL, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Moffitt Cancer Center, Department of Radiation Oncology, Tampa, FL</wicri:regionArea></affiliation></author><author><name sortKey="Grau, Cai" sort="Grau, Cai" uniqKey="Grau C" first="Cai" last="Grau">Cai Grau</name><affiliation wicri:level="1"><nlm:affiliation>Department of Experimental Clinical Oncology, Aarhus, Denmark.</nlm:affiliation><country xml:lang="fr">Danemark</country><wicri:regionArea>Department of Experimental Clinical Oncology, Aarhus</wicri:regionArea></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 wicri:level="1"><nlm:affiliation>Ligue Nationale Contre le Cancer Meta-Analysis Platform, Service de Biostatistique et d'Epidémiologie, Gustave Roussy Cancer Campus, INSERM U1018, CESP, Université Paris-Sud, Université Paris-Saclay, Villejuif, France. Electronic address: jean-pierre.pignon@gustaveroussy.fr.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Ligue Nationale Contre le Cancer Meta-Analysis Platform, Service de Biostatistique et d'Epidémiologie, Gustave Roussy Cancer Campus, INSERM U1018, CESP, Université Paris-Sud, Université Paris-Saclay, Villejuif</wicri:regionArea></affiliation></author><author><name sortKey="Blanchard, Pierre" sort="Blanchard, Pierre" uniqKey="Blanchard P" first="Pierre" last="Blanchard">Pierre Blanchard</name><affiliation wicri:level="1"><nlm:affiliation>Department of Radiation Therapy, Gustave Roussy Cancer Campus, INSERM U1018, CESP, Université Paris-Sud, Université Paris-Saclay, Villejuif, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Department of Radiation Therapy, Gustave Roussy Cancer Campus, INSERM U1018, CESP, Université Paris-Sud, Université Paris-Saclay, Villejuif</wicri:regionArea></affiliation></author></analytic><series><title level="j">The Lancet. Oncology</title><idno type="eISSN">1474-5488</idno><imprint><date when="2017" type="published">2017</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Carcinoma, Squamous Cell (mortality)</term><term>Carcinoma, Squamous Cell (pathology)</term><term>Carcinoma, Squamous Cell (radiotherapy)</term><term>Dose Fractionation</term><term>Head and Neck Neoplasms (mortality)</term><term>Head and Neck Neoplasms (pathology)</term><term>Head and Neck Neoplasms (radiotherapy)</term><term>Humans</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Carcinome épidermoïde (anatomopathologie)</term><term>Carcinome épidermoïde (mortalité)</term><term>Carcinome épidermoïde (radiothérapie)</term><term>Fractionnement de la dose d'irradiation</term><term>Humains</term><term>Tumeurs de la tête et du cou (anatomopathologie)</term><term>Tumeurs de la tête et du cou (mortalité)</term><term>Tumeurs de la tête et du cou (radiothérapie)</term></keywords><keywords scheme="MESH" qualifier="anatomopathologie" xml:lang="fr"><term>Carcinome épidermoïde</term><term>Tumeurs de la tête et du cou</term></keywords><keywords scheme="MESH" qualifier="mortality" xml:lang="en"><term>Carcinoma, Squamous Cell</term><term>Head and Neck Neoplasms</term></keywords><keywords scheme="MESH" qualifier="mortalité" xml:lang="fr"><term>Carcinome épidermoïde</term><term>Tumeurs de la tête et du cou</term></keywords><keywords scheme="MESH" qualifier="pathology" xml:lang="en"><term>Carcinoma, Squamous Cell</term><term>Head and Neck Neoplasms</term></keywords><keywords scheme="MESH" qualifier="radiotherapy" xml:lang="en"><term>Carcinoma, Squamous Cell</term><term>Head and Neck Neoplasms</term></keywords><keywords scheme="MESH" qualifier="radiothérapie" xml:lang="fr"><term>Carcinome épidermoïde</term><term>Tumeurs de la tête et du cou</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Dose Fractionation</term><term>Humans</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Fractionnement de la dose d'irradiation</term><term>Humains</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">The Meta-Analysis of Radiotherapy in squamous cell Carcinomas of Head and neck (MARCH) showed that altered fractionation radiotherapy is associated with improved overall and progression-free survival compared with conventional radiotherapy, with hyperfractionated radiotherapy showing the greatest benefit. This update aims to confirm and explain the superiority of hyperfractionated radiotherapy over other altered fractionation radiotherapy regimens and to assess the benefit of altered fractionation within the context of concomitant chemotherapy with the inclusion of new trials.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">28757375</PMID><DateCreated><Year>2017</Year><Month>07</Month><Day>31</Day></DateCreated><DateCompleted><Year>2017</Year><Month>09</Month><Day>25</Day></DateCompleted><DateRevised><Year>2017</Year><Month>09</Month><Day>25</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1474-5488</ISSN><JournalIssue CitedMedium="Internet"><Volume>18</Volume><Issue>9</Issue><PubDate><Year>2017</Year><Month>Sep</Month></PubDate></JournalIssue><Title>The Lancet. Oncology</Title><ISOAbbreviation>Lancet Oncol.</ISOAbbreviation></Journal><ArticleTitle>Role of radiotherapy fractionation in head and neck cancers (MARCH): an updated meta-analysis.</ArticleTitle><Pagination><MedlinePgn>1221-1237</MedlinePgn></Pagination><ELocationID EIdType="pii" ValidYN="Y">S1470-2045(17)30458-8</ELocationID><ELocationID EIdType="doi" ValidYN="Y">10.1016/S1470-2045(17)30458-8</ELocationID><Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">The Meta-Analysis of Radiotherapy in squamous cell Carcinomas of Head and neck (MARCH) showed that altered fractionation radiotherapy is associated with improved overall and progression-free survival compared with conventional radiotherapy, with hyperfractionated radiotherapy showing the greatest benefit. This update aims to confirm and explain the superiority of hyperfractionated radiotherapy over other altered fractionation radiotherapy regimens and to assess the benefit of altered fractionation within the context of concomitant chemotherapy with the inclusion of new trials.</AbstractText><AbstractText Label="METHODS" NlmCategory="METHODS">For this updated meta-analysis, we searched bibliography databases, trials registries, and meeting proceedings for published or unpublished randomised trials done between Jan 1, 2009, and July 15, 2015, comparing primary or postoperative conventional fractionation radiotherapy versus altered fractionation radiotherapy (comparison 1) or conventional fractionation radiotherapy plus concomitant chemotherapy versus altered fractionation radiotherapy alone (comparison 2). Eligible trials had to start randomisation on or after Jan 1, 1970, and completed accrual before Dec 31, 2010; had to have been randomised in a way that precluded prior knowledge of treatment assignment; and had to include patients with non-metastatic squamous cell carcinoma of the oral cavity, oropharynx, hypopharynx, or larynx undergoing first-line curative treatment. Trials including a non-conventional radiotherapy control group, investigating hypofractionated radiotherapy, or including mostly nasopharyngeal carcinomas were excluded. Trials were grouped in three types of altered fractionation: hyperfractionated, moderately accelerated, and very accelerated. Individual patient data were collected and combined with a fixed-effects model based on the intention-to-treat principle. The primary endpoint was overall survival.</AbstractText><AbstractText Label="FINDINGS" NlmCategory="RESULTS">Comparison 1 (conventional fractionation radiotherapy vs altered fractionation radiotherapy) included 33 trials and 11 423 patients. Altered fractionation radiotherapy was associated with a significant benefit on overall survival (hazard ratio [HR] 0·94, 95% CI 0·90-0·98; p=0·0033), with an absolute difference at 5 years of 3·1% (95% CI 1·3-4·9) and at 10 years of 1·2% (-0·8 to 3·2). We found a significant interaction (p=0·051) between type of fractionation and treatment effect, the overall survival benefit being restricted to the hyperfractionated group (HR 0·83, 0·74-0·92), with absolute differences at 5 years of 8·1% (3·4 to 12·8) and at 10 years of 3·9% (-0·6 to 8·4). Comparison 2 (conventional fractionation radiotherapy plus concomitant chemotherapy versus altered fractionation radiotherapy alone) included five trials and 986 patients. Overall survival was significantly worse with altered fractionation radiotherapy compared with concomitant chemoradiotherapy (HR 1·22, 1·05-1·42; p=0·0098), with absolute differences at 5 years of -5·8% (-11·9 to 0·3) and at 10 years of -5·1% (-13·0 to 2·8).</AbstractText><AbstractText Label="INTERPRETATION" NlmCategory="CONCLUSIONS">This update confirms, with more patients and a longer follow-up than the first version of MARCH, that hyperfractionated radiotherapy is, along with concomitant chemoradiotherapy, a standard of care for the treatment of locally advanced head and neck squamous cell cancers. The comparison between hyperfractionated radiotherapy and concomitant chemoradiotherapy remains to be specifically tested.</AbstractText><AbstractText Label="FUNDING" NlmCategory="BACKGROUND">Institut National du Cancer; and Ligue Nationale Contre le Cancer.</AbstractText><CopyrightInformation>Copyright © 2017 Elsevier Ltd. All rights reserved.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Lacas</LastName><ForeName>Benjamin</ForeName><Initials>B</Initials><AffiliationInfo><Affiliation>Ligue Nationale Contre le Cancer Meta-Analysis Platform, Service de Biostatistique et d'Epidémiologie, Gustave Roussy Cancer Campus, INSERM U1018, CESP, Université Paris-Sud, Université Paris-Saclay, Villejuif, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Bourhis</LastName><ForeName>Jean</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Overgaard</LastName><ForeName>Jens</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Department of Experimental Clinical Oncology, Aarhus, Denmark.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Zhang</LastName><ForeName>Qiang</ForeName><Initials>Q</Initials><AffiliationInfo><Affiliation>NRG Oncology Statistics and Data Management Center (formerly RTOG), Philadelphia, PA, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Grégoire</LastName><ForeName>Vincent</ForeName><Initials>V</Initials><AffiliationInfo><Affiliation>Radiation Oncology Department, UCL-Cliniques Universitaires St-Luc, Brussels, Belgium.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Nankivell</LastName><ForeName>Matthew</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Medical Research Council Clinical Trials Unit, University College London, London, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Zackrisson</LastName><ForeName>Björn</ForeName><Initials>B</Initials><AffiliationInfo><Affiliation>Department of Radiation Sciences, Oncology, Umeå University, Umeå, Sweden.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Szutkowski</LastName><ForeName>Zbigniew</ForeName><Initials>Z</Initials><AffiliationInfo><Affiliation>Department of Radiotherapy, Cancer Center, Marie Curie-Sklodowska Memorial Institute, Warsaw, Poland.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Suwiński</LastName><ForeName>Rafał</ForeName><Initials>R</Initials><AffiliationInfo><Affiliation>Radiotherapy and Chemotherapy Clinic and Teaching Hospital, Marie Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice, Poland.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Poulsen</LastName><ForeName>Michael</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Radiation Oncology Services, Mater Centre, Brisbane, QLD, Australia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>O'Sullivan</LastName><ForeName>Brian</ForeName><Initials>B</Initials><AffiliationInfo><Affiliation>Department of Radiation Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Corvò</LastName><ForeName>Renzo</ForeName><Initials>R</Initials><AffiliationInfo><Affiliation>IRCCS San Martino-IST, Genoa, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Laskar</LastName><ForeName>Sarbani Ghosh</ForeName><Initials>SG</Initials><AffiliationInfo><Affiliation>Department of Radiation Oncology, Tata Memorial Hospital, Mumbai, India.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Fallai</LastName><ForeName>Carlo</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>Department of Radiotherapy, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Yamazaki</LastName><ForeName>Hideya</ForeName><Initials>H</Initials><AffiliationInfo><Affiliation>Department of Radiation Oncology, Osaka Medical Center for Cancer and Cardiovascular Disease, Osaka, Japan.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Dobrowsky</LastName><ForeName>Werner</ForeName><Initials>W</Initials><AffiliationInfo><Affiliation>Department of Clinical Oncology, Freeman Hospital, Newcastle, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Cho</LastName><ForeName>Kwan Ho</ForeName><Initials>KH</Initials><AffiliationInfo><Affiliation>Proton Therapy Center, Research Institute and Hospital, National Cancer Center, Goyang, South Korea.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Garden</LastName><ForeName>Adam S</ForeName><Initials>AS</Initials><AffiliationInfo><Affiliation>Division of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Langendijk</LastName><ForeName>Johannes A</ForeName><Initials>JA</Initials><AffiliationInfo><Affiliation>Department of Radiation Oncology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Viegas</LastName><ForeName>Celia Maria Pais</ForeName><Initials>CMP</Initials><AffiliationInfo><Affiliation>Radiation Oncology Department, Instituto Nacional de Cancer, Brasil National Cancer Institute, Rio de Janeiro, Brazil.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Hay</LastName><ForeName>John</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Division of Radiation Oncology, British Columbia Cancer Agency, Vancouver, BC, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Lotayef</LastName><ForeName>Mohamed</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Radiation Oncology Department, National Cancer Institute, Cairo University, Cairo, Egypt.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Parmar</LastName><ForeName>Mahesh K B</ForeName><Initials>MKB</Initials><AffiliationInfo><Affiliation>Medical Research Council Clinical Trials Unit, University College London, London, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Aupérin</LastName><ForeName>Anne</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Ligue Nationale Contre le Cancer Meta-Analysis Platform, Service de Biostatistique et d'Epidémiologie, Gustave Roussy Cancer Campus, INSERM U1018, CESP, Université Paris-Sud, Université Paris-Saclay, Villejuif, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>van Herpen</LastName><ForeName>Carla</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>Department of Medical Oncology, Radboud University Medical Center, Nijmegen, Netherlands.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Maingon</LastName><ForeName>Philippe</ForeName><Initials>P</Initials><AffiliationInfo><Affiliation>European Organisation for Research and Treatment of Cancer, Radiation Oncology Group, Brussels, Belgium; Service d'Oncologie, Radiothérapie, Hôpitaux Universitaires Pitié Salpêtrière, Charles Foix, Paris, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Trotti</LastName><ForeName>Andy M</ForeName><Initials>AM</Initials><AffiliationInfo><Affiliation>Moffitt Cancer Center, Department of Radiation Oncology, Tampa, FL, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Grau</LastName><ForeName>Cai</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>Department of Experimental Clinical Oncology, Aarhus, Denmark.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Pignon</LastName><ForeName>Jean-Pierre</ForeName><Initials>JP</Initials><AffiliationInfo><Affiliation>Ligue Nationale Contre le Cancer Meta-Analysis Platform, Service de Biostatistique et d'Epidémiologie, Gustave Roussy Cancer Campus, INSERM U1018, CESP, Université Paris-Sud, Université Paris-Saclay, Villejuif, France. Electronic address: jean-pierre.pignon@gustaveroussy.fr.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Blanchard</LastName><ForeName>Pierre</ForeName><Initials>P</Initials><AffiliationInfo><Affiliation>Department of Radiation Therapy, Gustave Roussy Cancer Campus, INSERM U1018, CESP, Université Paris-Sud, Université Paris-Saclay, Villejuif, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><CollectiveName>MARCH Collaborative Group</CollectiveName></Author></AuthorList><Language>eng</Language><GrantList CompleteYN="Y"><Grant><GrantID>U10 CA180822</GrantID><Acronym>CA</Acronym><Agency>NCI NIH HHS</Agency><Country>United States</Country></Grant><Grant><GrantID>U10 CA180868</GrantID><Acronym>CA</Acronym><Agency>NCI NIH HHS</Agency><Country>United States</Country></Grant></GrantList><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D017418">Meta-Analysis</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2017</Year><Month>07</Month><Day>27</Day></ArticleDate></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>Lancet Oncol</MedlineTA><NlmUniqueID>100957246</NlmUniqueID><ISSNLinking>1470-2045</ISSNLinking></MedlineJournalInfo><SupplMeshList><SupplMeshName Type="Disease" UI="C535575">Carcinoma, squamous cell of head and neck</SupplMeshName></SupplMeshList><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D002294" MajorTopicYN="N">Carcinoma, Squamous Cell</DescriptorName><QualifierName UI="Q000401" MajorTopicYN="N">mortality</QualifierName><QualifierName UI="Q000473" MajorTopicYN="N">pathology</QualifierName><QualifierName UI="Q000532" MajorTopicYN="Y">radiotherapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D019583" MajorTopicYN="Y">Dose Fractionation</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006258" MajorTopicYN="N">Head and Neck Neoplasms</DescriptorName><QualifierName UI="Q000401" MajorTopicYN="N">mortality</QualifierName><QualifierName UI="Q000473" MajorTopicYN="N">pathology</QualifierName><QualifierName UI="Q000532" MajorTopicYN="Y">radiotherapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading></MeshHeadingList><InvestigatorList><Investigator ValidYN="Y"><LastName>Blanchard</LastName><ForeName>Pierre</ForeName><Initials>P</Initials></Investigator><Investigator ValidYN="Y"><LastName>Bourhis</LastName><ForeName>Jean</ForeName><Initials>J</Initials></Investigator><Investigator ValidYN="Y"><LastName>Lacas</LastName><ForeName>Benjamin</ForeName><Initials>B</Initials></Investigator><Investigator ValidYN="Y"><LastName>Pignon</LastName><ForeName>Jean Pierre</ForeName><Initials>JP</Initials></Investigator><Investigator 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