Etienne Dauzier1, Benjamin Lacas1, Pierre Blanchard2, Quynh-Thu Le3, Christian Simon4, Gregory Wolf5, François Janot6, Masatoshi Horiuchi7, Jeffrey S Tobias8, James Moon9, John Simes10, Vinay Deshmane11, Jean-Jacques Mazeron12, Samir Mehta13, Branko Zaktonik14, Minoru Tamura15, Elizabeth Moyal16, Lisa Licitra17, Catherine Fortpied18, Bruce G Haffty19, Maria Grazia Ghi20, Vincent Gregoire21, Jonathan Harris22, Jean Bourhis23, Anne Aupérin24, Jean-Pierre Pignon1. 1. Meta-Analysis Unit, Service de Biostatistique et d'Epidémiologie, Gustave Roussy Cancer Campus, INSERM U1018, CESP, Université Paris-Sud, Université Paris-Saclay, Villejuif, France. 2. Meta-Analysis Unit, Service de Biostatistique et d'Epidémiologie, Gustave Roussy Cancer Campus, INSERM U1018, CESP, Université Paris-Sud, Université Paris-Saclay, Villejuif, France; Department of Radiation Therapy, Gustave Roussy Cancer Campus, Université Paris-Sud, Université Paris-Saclay, Villejuif, France. 3. Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA, USA. 4. Department of Otolaryngology and Head and Neck Surgery, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland. 5. Department of Otolaryngology, University of Michigan, Ann Arbor, USA. 6. Département de Cancérologie Cervico-faciale, Gustave Roussy Cancer Campus, Université Paris Sud, Villejuif, France. 7. Department of Otolaryngology, Tokai University School of Medicine, Kanagawa, Japan. 8. Department of Radiotherapy, University College London Hospital, London, UK. 9. SWOG Statistical Center, Seattle, WA, USA. 10. NHMRC Clinical Trials Center, Camperdown, Australia. 11. Surgical Oncology & Breast Diseases, P.D. Hinduja National Hospital & Medical Research Centre, Mumbai, India. 12. Département de radiothérapie, hôpital Pitié-Salpêtrière, Paris, France. 13. Department of Surgery, Sarla Hospital, Mumbai, India. 14. Department of Medical Oncology, Institute of Oncology, Ljubljana, Slovenia. 15. Dept. of Dentistry and Oral Surgery, Shinshu University School of Medicine, Japan. 16. Département de radiothérapie, IUCT Oncopole - CLCC Institut Claudius Regaud, Toulouse, France. 17. Department of Medical Oncology 3, Fondazione IRCCS-Istituto Nazionale dei Tumori, Milano and University of Milan, Italy. 18. EORTC Headquarters, Brussels, Belgium. 19. Dept. of Therapeutic Radiology, Rutgers Robert Wood Johnson and NJ Medical School, NJ, USA. 20. Oncology Unit 2, Veneto Oncology Institute-IRCCS, Padua, Italy. 21. Radiation Oncology Department, Centre Léon Bérard, Lyon, France. 22. NRG Oncology Statistics and Data Management Center, American College of Radiology, Philadelphia, USA. 23. Department of Radiotherapy, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland. 24. Meta-Analysis Unit, Service de Biostatistique et d'Epidémiologie, Gustave Roussy Cancer Campus, INSERM U1018, CESP, Université Paris-Sud, Université Paris-Saclay, Villejuif, France. Electronic address: anne.auperin@gustaveroussy.fr.
Abstract
OBJECTIVE: 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). MATERIALS AND METHODS: 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 I2 statistic. RESULTS: 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 (HRwomen = 0.63, 95%CI: 0.50-0.80) compared to men (HRmen = 0.96, 95%CI: 0.89-1.04; p for interaction = 0.001). CONCLUSIONS: 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.
OBJECTIVE: 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). MATERIALS AND METHODS: 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 HNSCCpatients 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 I2 statistic. RESULTS: 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 (HRwomen = 0.63, 95%CI: 0.50-0.80) compared to men (HRmen = 0.96, 95%CI: 0.89-1.04; p for interaction = 0.001). CONCLUSIONS: 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.
Authors: Jay S Cooper; Thomas F Pajak; Arlene A Forastiere; John Jacobs; Bruce H Campbell; Scott B Saxman; Julie A Kish; Harold E Kim; Anthony J Cmelak; Marvin Rotman; Mitchell Machtay; John F Ensley; K S Clifford Chao; Christopher J Schultz; Nancy Lee; Karen K Fu Journal: N Engl J Med Date: 2004-05-06 Impact factor: 91.245
Authors: J B Weissberg; Y H Son; R J Papac; C Sasaki; D B Fischer; R Lawrence; S Rockwell; A C Sartorelli; J J Fischer Journal: Int J Radiat Oncol Biol Phys Date: 1989-07 Impact factor: 7.038
Authors: M Tsukuda; H Ogasawara; S Kaneko; S Komiyama; M Horiuchi; Y Inuyama; T Uemura; M Uchida; S Kamata; M Okuda Journal: Gan To Kagaku Ryoho Date: 1994-07
Authors: Benjamin Lacas; Alexandra Carmel; Cécile Landais; Stuart J Wong; Lisa Licitra; Jeffrey S Tobias; Barbara Burtness; Maria Grazia Ghi; Ezra E W Cohen; Cai Grau; Gregory Wolf; Ricardo Hitt; Renzo Corvò; Volker Budach; Shaleen Kumar; Sarbani Ghosh Laskar; Jean-Jacques Mazeron; Lai-Ping Zhong; Werner Dobrowsky; Pirus Ghadjar; Carlo Fallai; Branko Zakotnik; Atul Sharma; René-Jean Bensadoun; Maria Grazia Ruo Redda; Séverine Racadot; George Fountzilas; David Brizel; Paolo Rovea; Athanassios Argiris; Zoltán Takácsi Nagy; Ju-Whei Lee; Catherine Fortpied; Jonathan Harris; Jean Bourhis; Anne Aupérin; Pierre Blanchard; Jean-Pierre Pignon Journal: Radiother Oncol Date: 2021-01-27 Impact factor: 6.280