BACKGROUND: Our previous individual patient data (IPD) meta-analysis showed that chemotherapy improved survival in patients curatively treated for non-metastatic head and neck squamous cell carcinoma (HNSCC), with a higher benefit with concomitant chemotherapy. However the heterogeneity of the results limited the conclusions and prompted us to confirm the results on a more complete database by adding the randomised trials conducted between 1994 and 2000. METHODS: The updated IPD meta-analysis included trials comparing loco-regional treatment to loco-regional treatment+chemotherapy in HNSCC patients and conducted between 1965 and 2000. The log-rank-test, stratified by trial, was used to compare treatments. The hazard ratios of death were calculated. RESULTS: Twenty-four new trials, most of them of concomitant chemotherapy, were included with a total of 87 trials and 16,485 patients. The hazard ratio of death was 0.88 (p<0.0001) with an absolute benefit for chemotherapy of 4.5% at 5 years, and a significant interaction (p<0.0001) between chemotherapy timing (adjuvant, induction or concomitant) and treatment. Both direct (6 trials) and indirect comparisons showed a more pronounced benefit of the concomitant chemotherapy as compared to induction chemotherapy. For the 50 concomitant trials, the hazard ratio was 0.81 (p<0.0001) and the absolute benefit 6.5% at 5 years. There was a decreasing effect of chemotherapy with age (p=0.003, test for trend). CONCLUSION: The benefit of concomitant chemotherapy was confirmed and was greater than the benefit of induction chemotherapy.
BACKGROUND: Our previous individual patient data (IPD) meta-analysis showed that chemotherapy improved survival in patients curatively treated for non-metastatic head and neck squamous cell carcinoma (HNSCC), with a higher benefit with concomitant chemotherapy. However the heterogeneity of the results limited the conclusions and prompted us to confirm the results on a more complete database by adding the randomised trials conducted between 1994 and 2000. METHODS: The updated IPD meta-analysis included trials comparing loco-regional treatment to loco-regional treatment+chemotherapy in HNSCC patients and conducted between 1965 and 2000. The log-rank-test, stratified by trial, was used to compare treatments. The hazard ratios of death were calculated. RESULTS: Twenty-four new trials, most of them of concomitant chemotherapy, were included with a total of 87 trials and 16,485 patients. The hazard ratio of death was 0.88 (p<0.0001) with an absolute benefit for chemotherapy of 4.5% at 5 years, and a significant interaction (p<0.0001) between chemotherapy timing (adjuvant, induction or concomitant) and treatment. Both direct (6 trials) and indirect comparisons showed a more pronounced benefit of the concomitant chemotherapy as compared to induction chemotherapy. For the 50 concomitant trials, the hazard ratio was 0.81 (p<0.0001) and the absolute benefit 6.5% at 5 years. There was a decreasing effect of chemotherapy with age (p=0.003, test for trend). CONCLUSION: The benefit of concomitant chemotherapy was confirmed and was greater than the benefit of induction chemotherapy.
Authors: Phuc Felix Nguyen-Tan; Qiang Zhang; K Kian Ang; Randal S Weber; David I Rosenthal; Denis Soulieres; Harold Kim; Craig Silverman; Adam Raben; Thomas J Galloway; André Fortin; Elizabeth Gore; William H Westra; Christine H Chung; Richard C Jordan; Maura L Gillison; Marcie List; Quynh-Thu Le Journal: J Clin Oncol Date: 2014-11-03 Impact factor: 44.544
Authors: K Kian Ang; Jonathan Harris; Richard Wheeler; Randal Weber; David I Rosenthal; Phuc Felix Nguyen-Tân; William H Westra; Christine H Chung; Richard C Jordan; Charles Lu; Harold Kim; Rita Axelrod; C Craig Silverman; Kevin P Redmond; Maura L Gillison Journal: N Engl J Med Date: 2010-06-07 Impact factor: 91.245
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Authors: Daan Nevens; Ann Goeleven; Fréderic Duprez; R Braeken; E Decabooter; M De Smet; L Lutters; Eddy Dejaeger; Wilfried De Neve; Sandra Nuyts Journal: Br J Radiol Date: 2018-01-02 Impact factor: 3.039
Authors: V Budach; E-T Becker; D Boehmer; H Badakhshi; U Jahn; K-D Wernecke; C Stromberger Journal: Strahlenther Onkol Date: 2013-12-11 Impact factor: 3.621
Authors: Michael M Fisher; Gopika SenthilKumar; Rong Hu; Steve Goldstein; Irene M Ong; Margot C Miller; Sean R Brennan; Saakshi Kaushik; Lindsey Abel; Kwangok P Nickel; Gopal Iyer; Paul M Harari; Randall J Kimple; Andrew M Baschnagel Journal: Int J Radiat Oncol Biol Phys Date: 2020-04-13 Impact factor: 7.038