Role of chemotherapy in 5000 patients with head and neck cancer treated by curative surgery: A subgroup analysis of the meta-analysis of chemotherapy in head and neck cancer.
Chemotherapy
Head and neck cancer
Individual patient data
Meta-analysis
Randomized trial
Squamous cell carcinoma
Surgery
Journal
Oral oncology
ISSN: 1879-0593
Titre abrégé: Oral Oncol
Pays: England
ID NLM: 9709118
Informations de publication
Date de publication:
08 2019
08 2019
Historique:
received:
26
02
2019
revised:
29
05
2019
accepted:
02
06
2019
entrez:
27
7
2019
pubmed:
28
7
2019
medline:
7
7
2020
Statut:
ppublish
Résumé
To evaluate the effect of chemotherapy added to a surgical locoregional treatment (LRT) for patients with locally advanced head and neck squamous cell carcinoma (HNSCC). We studied the sub-group of trials with surgical LRT included in the meta-analysis on chemotherapy in head and neck cancer (MACH-NC). Data from published and unpublished randomized trials comparing the addition of chemotherapy to LRT in HNSCC patients were sought using electronic database searching for the period 1965-2000, hand searching and by contacting experts in the field. Trials with less than 60 patients, or preoperative radiotherapy or where the type of LRT could not be individually determined were excluded. All individual patient data were checked for internal consistency, compared with published reports, and validated with trialists. Data were pooled using a fixed-effect model. Heterogeneity was assessed using Cochrane test and I Twenty-four trials were eligible (5000 patients). Chemotherapy improved overall survival (HR = 0.92 [95%CI: 0.85-0.99] p = 0.02). There was a significant interaction between treatment effect and timing of chemotherapy (p = 0.08 at pre-specified threshold of 0.10) with a greater effect for concomitant chemotherapy (HR = 0.79, 95%CI: 0.69-0.92). The benefit of chemotherapy was greater in women (HR This analysis confirmed the benefit of concomitant chemotherapy added to surgical LRT. The role of induction therapy as yet to be determined as it did not improve OS. Women may benefit more than men from chemotherapy.
Identifiants
pubmed: 31345376
pii: S1368-8375(19)30189-7
doi: 10.1016/j.oraloncology.2019.06.001
pmc: PMC7029787
mid: NIHMS1545143
pii:
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
106-114Subventions
Organisme : NCI NIH HHS
ID : U10 CA180822
Pays : United States
Organisme : NCI NIH HHS
ID : U10 CA180868
Pays : United States
Commentaires et corrections
Type : CommentIn
Informations de copyright
Copyright © 2019. Published by Elsevier Ltd.
Références
Control Clin Trials. 1986 Sep;7(3):177-88
pubmed: 3802833
Int J Radiat Oncol Biol Phys. 1989 Jul;17(1):3-9
pubmed: 2501243
Surgery. 1986 Jan;99(1):7-14
pubmed: 3942002
Prog Cardiovasc Dis. 1985 Mar-Apr;27(5):335-71
pubmed: 2858114
Radiother Oncol. 2011 Jul;100(1):33-40
pubmed: 21684027
Laryngoscope. 1988 Nov;98(11):1205-11
pubmed: 3054373
Cancer. 1987 Aug 1;60(3):301-11
pubmed: 2885080
Cancer Treat Rev. 2015 Mar;41(3):217-21
pubmed: 25687982
N Engl J Med. 2004 May 6;350(19):1937-44
pubmed: 15128893
Gan To Kagaku Ryoho. 1994 Jul;21(8):1169-77
pubmed: 8031158
Laryngoscope. 2008 Mar;118(3):444-9
pubmed: 18091334
J Clin Epidemiol. 2013 Jun;66(6):648-53
pubmed: 23415868
Int J Radiat Oncol Biol Phys. 2003 Jul 15;56(4):1055-62
pubmed: 12829141
Gan To Kagaku Ryoho. 1994 May;21(6):777-83
pubmed: 8185335
Head Neck. 1992 Mar-Apr;14(2):85-91
pubmed: 1376306
Int J Radiat Oncol Biol Phys. 1996 Dec 1;36(5):999-1004
pubmed: 8985019
Stat Med. 2002 Jun 15;21(11):1539-58
pubmed: 12111919
J Clin Oncol. 2018 Sep 10;36(26):2680-2683
pubmed: 30004815
Int J Radiat Oncol Biol Phys. 1992;23(4):705-13
pubmed: 1618662
Curr Opin Oncol. 2014 May;26(3):247-51
pubmed: 24651382
Clin Cancer Res. 2010 Oct 15;16(20):5019-27
pubmed: 20943762
Lancet Oncol. 2010 Jan;11(1):66-74
pubmed: 19875337
Int J Cancer. 2015 Mar 1;136(5):E359-86
pubmed: 25220842
Lancet Oncol. 2017 Sep;18(9):1221-1237
pubmed: 28757375
Eur J Cancer. 1991;27(7):821-7
pubmed: 1718348
Oral Oncol. 2012 Nov;48(11):1076-84
pubmed: 22800881
Recent Results Cancer Res. 1978;68:309-17
pubmed: 88754
Strahlenther Onkol. 2015 Aug;191(8):635-41
pubmed: 25782685
Control Clin Trials. 1996 Aug;17(4):343-6
pubmed: 8889347
Am J Surg. 1994 Sep;168(3):262-7
pubmed: 8080065
Int J Oncol. 1994 Apr;4(4):909-14
pubmed: 21567001
BMC Med Res Methodol. 2016 Mar 29;16:37
pubmed: 27025706
Cancer. 2014 May 15;120(10):1507-13
pubmed: 24863390
J Clin Oncol. 2013 Aug 10;31(23):2854-60
pubmed: 23835714
Ann Oncol. 2017 Sep 1;28(9):2206-2212
pubmed: 28911070
Stat Med. 2002 Sep 30;21(18):2641-52
pubmed: 12228882
Otolaryngol Clin North Am. 2013 Aug;46(4):681-710
pubmed: 23910478
Oral Oncol. 2017 Aug;71:129-137
pubmed: 28688680
Br J Cancer. 2000 Dec;83(12):1594-8
pubmed: 11189100
Cancer. 2017 May 1;123(9):1566-1575
pubmed: 28241096
Lancet Oncol. 2001 Aug;2(8):475-82
pubmed: 11905723
Stat Med. 1995 Oct 15;14(19):2057-79
pubmed: 8552887
Gan To Kagaku Ryoho. 1994 Jun;21(7):987-92
pubmed: 8002638
Radiother Oncol. 2008 May;87(2):164-72
pubmed: 18222010
J Natl Cancer Inst. 1994 Feb 16;86(4):265-72
pubmed: 8158680
Cancer. 2008 Nov 15;113(10):2797-806
pubmed: 18839393
Lancet Oncol. 2009 Apr;10(4):341-50
pubmed: 19246242
Acta Chir Belg. 1990 May-Jun;90(3):115-22
pubmed: 1695801
BMJ. 1995 Oct 7;311(7010):899-909
pubmed: 7580546
J Clin Oncol. 2013 Feb 20;31(6):744-51
pubmed: 23129742
N Engl J Med. 2004 May 6;350(19):1945-52
pubmed: 15128894
Radiother Oncol. 2009 Jul;92(1):4-14
pubmed: 19446902
Cancer Epidemiol Biomarkers Prev. 2011 Aug;20(8):1629-37
pubmed: 21750167