Randomized trials of radiotherapy alone versus combined chemotherapy and radiotherapy in stages IIIa and IIIb nonsmall cell lung cancer. A meta-analysis

✍ Scribed by Pietro Marino; Armando Preatoni; Alessandra Cantoni

• Publisher: John Wiley and Sons
• Year: 1995
• Tongue: English
• Weight: 612 KB
• Volume: 76
• Category: Article
• ISSN: 0008-543X
• DOI: 10.1002/1097-0142(19950815)76:4<593::aid-cncr2820760409>3.0.co;2-n

✦ Synopsis

Background. For patients with Stage I11 nonsmall cell lung cancer (NSCLC), radiation is the standard treatment, but survival remains poor. The authors performed a meta-analysis study using clinical trials that evaluated combined radiotherapy plus chemotherapy versus radiotherapy alone in patients with Stages IIIa and IIIb NSCLC.

Methods. For the meta-analysis study and the point estimates, essential data were extracted directly from published reports.

Results, Survival probabilities at 1, 2, 3, and 5 years, as estimated from published survival curves, were considered as the endpoints of interest. For survival at 3 and 5 years, the point estimates and the confidence intervals were used. Quality scoring of the studies also was performed. Fourteen trials were selected, comprising 1887 patients in the meta-analysis. For the cisplatin-based group, the estimated pooled odds ratio of death at 1 and 2 years was 0.76 (0.6-0.9 CI) and 0.70 (0.5-0.9 CI), with a reduction in mortality of 214% and 30%, respectively. For the noncisplatin-based group, the estimated pooled odds ratio at 1 and 2 years was 1.05 (0.7-1.5 CI) and 0.82 (0.5-1.3 CI), with a reduction in morality of 5% and 1870, respectively. However, no significant differences were found between the percentage of survival and the CI at 3 and 5 years using the point estimates.

Conclusions. These results favor combined cisplatinbased chemotherapy and radiotherapy, although it was not so at 3 and 5 years of survival. These data must, however, be considered in the light of their clinical relevance