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Title: Chemotherapy in locally advanced nasopharyngeal carcinoma: An individual patient data meta-analysis of eight randomized trials and 1753 patients

Abstract

Objectives: To study the effect of adding chemotherapy to radiotherapy (RT) on overall survival and event-free survival for patients with nasopharyngeal carcinoma. Methods and Materials: This meta-analysis used updated individual patient data from randomized trials comparing chemotherapy plus RT with RT alone in locally advanced nasopharyngeal carcinoma. The log-rank test, stratified by trial, was used for comparisons, and the hazard ratios of death and failure were calculated. Results: Eight trials with 1753 patients were included. One trial with a 2 x 2 design was counted twice in the analysis. The analysis included 11 comparisons using the data from 1975 patients. The median follow-up was 6 years. The pooled hazard ratio of death was 0.82 (95% confidence interval, 0.71-0.94; p = 0.006), corresponding to an absolute survival benefit of 6% at 5 years from the addition of chemotherapy (from 56% to 62%). The pooled hazard ratio of tumor failure or death was 0.76 (95% confidence interval, 0.67-0.86; p < 0.0001), corresponding to an absolute event-free survival benefit of 10% at 5 years from the addition of chemotherapy (from 42% to 52%). A significant interaction was observed between the timing of chemotherapy and overall survival (p = 0.005), explaining the heterogeneity observedmore » in the treatment effect (p = 0.03), with the highest benefit resulting from concomitant chemotherapy. Conclusion: Chemotherapy led to a small, but significant, benefit for overall survival and event-free survival. This benefit was essentially observed when chemotherapy was administered concomitantly with RT.« less

Authors:
 [1];  [1];  [1];  [2];  [3];  [4];  [4];  [5];  [6];  [7];  [2];  [1];  [8]
  1. Institut Gustave-Roussy, Villejuif (France)
  2. Department of Clinical Oncology, Prince of Wales Hospital, Hong-Kong (China)
  3. Istanbul University, Institute of Oncology, Istanbul (Turkey)
  4. Department of Clinical Oncology, Queen Mary Hospital, Hong-Kong (China)
  5. Wayne State University, Detroit, MI (United States)
  6. Taiwan Cooperative Oncology Group, Taipei, Taiwan (China)
  7. Department of Radiology, Sapporo Medical University, Sapporo (Japan)
  8. Institut Gustave-Roussy, Villejuif (France). E-mail: jppignon@igr.fr
Publication Date:
OSTI Identifier:
20788265
Resource Type:
Journal Article
Resource Relation:
Journal Name: International Journal of Radiation Oncology, Biology and Physics; Journal Volume: 64; Journal Issue: 1; Other Information: DOI: 10.1016/j.ijrobp.2005.06.037; PII: S0360-3016(05)02221-2; Copyright (c) 2006 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; CARCINOMAS; CHEMOTHERAPY; DEATH; FAILURES; HEALTH HAZARDS; PATIENTS; RADIOTHERAPY

Citation Formats

Baujat, Bertrand, Audry, Helene, Bourhis, Jean, Chan, Anthony T.C., Onat, Haluk, Chua, Daniel T.T., Kwong, Dora L.W., Al-Sarraf, Muhyi, Chi, K.-H., Hareyama, Masato, Leung, Sing F., Thephamongkhol, Kullathorn, and Pignon, Jean-Pierre. Chemotherapy in locally advanced nasopharyngeal carcinoma: An individual patient data meta-analysis of eight randomized trials and 1753 patients. United States: N. p., 2006. Web. doi:10.1016/J.IJROBP.2005.0.
Baujat, Bertrand, Audry, Helene, Bourhis, Jean, Chan, Anthony T.C., Onat, Haluk, Chua, Daniel T.T., Kwong, Dora L.W., Al-Sarraf, Muhyi, Chi, K.-H., Hareyama, Masato, Leung, Sing F., Thephamongkhol, Kullathorn, & Pignon, Jean-Pierre. Chemotherapy in locally advanced nasopharyngeal carcinoma: An individual patient data meta-analysis of eight randomized trials and 1753 patients. United States. doi:10.1016/J.IJROBP.2005.0.
Baujat, Bertrand, Audry, Helene, Bourhis, Jean, Chan, Anthony T.C., Onat, Haluk, Chua, Daniel T.T., Kwong, Dora L.W., Al-Sarraf, Muhyi, Chi, K.-H., Hareyama, Masato, Leung, Sing F., Thephamongkhol, Kullathorn, and Pignon, Jean-Pierre. Sun . "Chemotherapy in locally advanced nasopharyngeal carcinoma: An individual patient data meta-analysis of eight randomized trials and 1753 patients". United States. doi:10.1016/J.IJROBP.2005.0.
@article{osti_20788265,
title = {Chemotherapy in locally advanced nasopharyngeal carcinoma: An individual patient data meta-analysis of eight randomized trials and 1753 patients},
author = {Baujat, Bertrand and Audry, Helene and Bourhis, Jean and Chan, Anthony T.C. and Onat, Haluk and Chua, Daniel T.T. and Kwong, Dora L.W. and Al-Sarraf, Muhyi and Chi, K.-H. and Hareyama, Masato and Leung, Sing F. and Thephamongkhol, Kullathorn and Pignon, Jean-Pierre},
abstractNote = {Objectives: To study the effect of adding chemotherapy to radiotherapy (RT) on overall survival and event-free survival for patients with nasopharyngeal carcinoma. Methods and Materials: This meta-analysis used updated individual patient data from randomized trials comparing chemotherapy plus RT with RT alone in locally advanced nasopharyngeal carcinoma. The log-rank test, stratified by trial, was used for comparisons, and the hazard ratios of death and failure were calculated. Results: Eight trials with 1753 patients were included. One trial with a 2 x 2 design was counted twice in the analysis. The analysis included 11 comparisons using the data from 1975 patients. The median follow-up was 6 years. The pooled hazard ratio of death was 0.82 (95% confidence interval, 0.71-0.94; p = 0.006), corresponding to an absolute survival benefit of 6% at 5 years from the addition of chemotherapy (from 56% to 62%). The pooled hazard ratio of tumor failure or death was 0.76 (95% confidence interval, 0.67-0.86; p < 0.0001), corresponding to an absolute event-free survival benefit of 10% at 5 years from the addition of chemotherapy (from 42% to 52%). A significant interaction was observed between the timing of chemotherapy and overall survival (p = 0.005), explaining the heterogeneity observed in the treatment effect (p = 0.03), with the highest benefit resulting from concomitant chemotherapy. Conclusion: Chemotherapy led to a small, but significant, benefit for overall survival and event-free survival. This benefit was essentially observed when chemotherapy was administered concomitantly with RT.},
doi = {10.1016/J.IJROBP.2005.0},
journal = {International Journal of Radiation Oncology, Biology and Physics},
number = 1,
volume = 64,
place = {United States},
year = {Sun Jan 01 00:00:00 EST 2006},
month = {Sun Jan 01 00:00:00 EST 2006}
}