1. Impact of thoracic radiotherapy timing in limited-stage small-cell lung cancer: usefulness of the individual patient data meta-analysis†
- Author
-
Béranger Lueza, Lesley Seymour, C. Le Pechoux, Minoru Takada, Allan Price, S. Spiro, M. Pijls-Johannesma, M. O'Brien, Anne-Sophie Veillard, N. Murray, Nevin Murray, M. Takada, Taro Shibata, James Lovato, H. Choy, David H. Johnson, W. Blackstock, Jeffrey Crawford, Cécile Le Péchoux, Donald H. Johnson, J.P. Pignon, D.V. Skarlos, Jean-Pierre Pignon, William Blackstock, Mary O’Brien, Anne Sophie Veillard, Dirk Karel Maria De Ruysscher, Hak Choy, Baktiar Hasan, X. Wang, Bernard Lebeau, Urania Dafni, E. Paris, Suzanne E. Dahlberg, B. Lebeau, Madelon Pijls-Johannesma, Sylvie Chevret, Xiaofei Wang, Dirk De Ruysscher, L. Seymour, R. Arriagada, Emmanuelle Paris, Dimosthenis Skarlos, Allan Hackshaw, P. Baas, A. Price, Stephen G. Spiro, Rodrigo Arriagada, Paul Baas, Maastricht Radiation Oncology Clinic (MAASTRO), Maastricht University [Maastricht], Service de biostatistique et d'épidémiologie (SBE), Direction de la recherche clinique [Gustave Roussy], Institut Gustave Roussy (IGR)-Institut Gustave Roussy (IGR), Plateforme Ligue nationale contre le cancer de méta-analyse en oncologie [Villejuif], Institut Gustave Roussy (IGR), Centre de recherche en épidémiologie et santé des populations (CESP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Département de radiothérapie [Gustave Roussy], Université Paris-Sud - Paris 11 (UP11), UT Southwestern University School of Medicine, EORTC Data Center, British Columbia Cancer Agency, University College London Hospitals (UCLH), Alliance Data and Statistical Center, Duke University [Durham], Osaka Prefectural Habikino Hospital, Hôpital St Antoine, Wake Forest University, Second Department of Medical Oncology, Metropolitan Hospital N. Faliro, The Netherlands Cancer Institute, Department of Radiation Oncology, University of Texas Southwestern Medical Center [Dallas], Cancer Research UK Edinburgh Centre [Edinburgh, UK], University of Edinburgh-MRC Institute of Genetics and Molecular Medicine [Edinburgh] (IGMM), University of Edinburgh-Medical Research Council-Medical Research Council, NCIC Clinical Trials Group [Kingston, Canada], Université Queen's [Canada], The meta-analysis was funded by the French National Cancer Institute (Programme Hospitalier de Recherche Clinique), the Ligue Nationale Contre le Cancer, and partly by Sanofi-Aventis (unrestricted grants). The investigators meeting was also funded by Gustave Roussy, Lilly and Astra-Zeneca (unrestricted grants). No grant number is applicable., RTT-SCLC Collaborative Group : De Ruysscher D, Le Pechoux C, Lueza B, Paris E, Pignon JP, Pijls-Johannesma M, Veillard AS, Arriagada R, Baas P, Blackstock W, Chevret S, Choy H, Crawford J, Dafni U, Dahlberg S, De Ruysscher D, Hackshaw A, Hasan B, Johnson DH, Le Pechoux C, Lebeau B, Lovato J, Lueza B, Murray N, O'Brien M, Paris E, Pignon JP, Pijls-Johannesma M, Price A, Spiro S, Seymour L, Shibata T, Skarlos D, Spiro S, Takada M, Veillard AS, Wang X., Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM), and Lueza, Béranger
- Subjects
Male ,medicine.medical_specialty ,medicine.medical_treatment ,Thoracic radiotherapy ,Reviews ,[SDV.CAN]Life Sciences [q-bio]/Cancer ,Disease-Free Survival ,03 medical and health sciences ,0302 clinical medicine ,[SDV.CAN] Life Sciences [q-bio]/Cancer ,Drug Therapy ,radiotherapy timing ,small-cell lung cancer ,medicine ,Humans ,030212 general & internal medicine ,Lung cancer ,Proportional Hazards Models ,Randomized Controlled Trials as Topic ,randomised clinical trials ,Chemotherapy ,business.industry ,Incidence (epidemiology) ,Standard treatment ,Hazard ratio ,Hematology ,medicine.disease ,individual participant data meta-analysis ,Combined Modality Therapy ,Small Cell Lung Carcinoma ,3. Good health ,Surgery ,Radiation therapy ,Oncology ,chemotherapy compliance ,030220 oncology & carcinogenesis ,Meta-analysis ,Female ,Cisplatin ,business ,thoracic radiotherapy - Abstract
International audience; BackgroundChemotherapy combined with radiotherapy is the standard treatment of “limited-stage” small-cell lung cancer. However, controversy persists over the optimal timing of thoracic radiotherapy and chemotherapy.Material and methodsWe performed a meta-analysis of individual patient data in randomised trials comparing earlier versus later radiotherapy, or shorter vs. longer radiotherapy duration, as defined in each trial. We combined the results from trials using the stratified log-rank test to calculate pooled hazard ratios (HRs). The primary outcome was overall survival.ResultsTwelve trials with 2,668 patients were eligible. Data from nine trials comprising 2,305 patients were available for analysis. The median follow-up was 10 years. When all trials were analysed together, “earlier or shorter” vs. “later or longer” thoracic radiotherapy did not affect overall survival. However, the HR for overall survival was significantly in favour of “earlier or shorter” radiotherapy among trials with a similar proportion of patients who were compliant with chemotherapy (defined as having received 100% or more of the planned chemotherapy cycles) in both arms (HR 0.79, 95% CI 0.69–0.91) and in favour of “later or longer” radiotherapy among trials with different chemotherapy compliance (HR 1.19, 1.05–1.34, interaction test p
- Published
- 2016