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Article: Chemotherapy as an adjunct to radiotherapy in locally advanced nasopharyngeal carcinoma.

TitleChemotherapy as an adjunct to radiotherapy in locally advanced nasopharyngeal carcinoma.
Authors
Issue Date2006
PublisherJohn Wiley & Sons Ltd. The Journal's web site is located at http://www.mrw.interscience.wiley.com/cochrane/cochrane_clsysrev_articles_fs.html
Citation
Cochrane Database Of Systematic Reviews (Online), 2006 n. 4, p. CD004329 How to Cite?
AbstractBACKGROUND: A previous meta-analysis investigated the role of chemotherapy in head and neck locally advanced carcinoma. This work had not been performed on nasopharyngeal carcinoma. OBJECTIVES: The aim of the project was to study the effect of adding chemotherapy to radiotherapy on overall survival (OS) and event-free survival (EFS) in patients with nasopharyngeal carcinoma. SEARCH STRATEGY: We searched MEDLINE (1966 to October 2003), EMBASE (1980 to October 2003) and the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library, Issue 3, 2003) and trial registers. Handsearches of meeting abstracts, references in review articles and of the Chinese medical literature were carried out. Experts and pharmaceutical companies were asked to identify trials. SELECTION CRITERIA: Randomised trials comparing chemotherapy plus radiotherapy to radiotherapy alone in locally advanced nasopharyngeal carcinoma were included. DATA COLLECTION AND ANALYSIS: The meta-analysis was based on updated individual patient data. The log rank test, stratified by trial, was used for comparisons and the hazard ratios (HR) of death and failure (loco-regional/distant failure or death) were calculated. MAIN RESULTS: Eight trials with 1753 patients were included. One trial with a 2 x 2 design was counted twice in the analysis. The analysis was performed including 11 comparisons based on 1975 patients. The median follow up was six years. The pooled hazard ratio of death was 0.82 (95% confidence interval (CI) 0.71 to 0.95; P = 0.006) corresponding to an absolute survival benefit of 6% at five years from chemotherapy (from 56% to 62%). The pooled hazard ratio of tumour failure or death was 0.76 (95% CI 0.67 to 0.86; P < 0.00001) corresponding to an absolute event-free survival benefit of 10% at five years from chemotherapy (from 42% to 52%). A significant interaction was observed between chemotherapy timings and overall survival (P = 0.005), explaining the heterogeneity observed in the treatment effect (P = 0.03) with the highest benefit from concomitant chemotherapy. AUTHORS' CONCLUSIONS: 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 radiotherapy.
Persistent Identifierhttp://hdl.handle.net/10722/150814
ISSN
2014 Impact Factor: 6.035
2015 SCImago Journal Rankings: 2.366
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorBaujat, Ben_HK
dc.contributor.authorAudry, Hen_HK
dc.contributor.authorBourhis, Jen_HK
dc.contributor.authorChan, ATen_HK
dc.contributor.authorOnat, Hen_HK
dc.contributor.authorChua, DTen_HK
dc.contributor.authorKwong, DLen_HK
dc.contributor.authorAlSarraf, Men_HK
dc.contributor.authorChi, KHen_HK
dc.contributor.authorHareyama, Men_HK
dc.contributor.authorLeung, SFen_HK
dc.contributor.authorThephamongkhol, Ken_HK
dc.contributor.authorPignon, JPen_HK
dc.date.accessioned2012-06-26T06:11:04Z-
dc.date.available2012-06-26T06:11:04Z-
dc.date.issued2006en_HK
dc.identifier.citationCochrane Database Of Systematic Reviews (Online), 2006 n. 4, p. CD004329en_HK
dc.identifier.issn1469-493Xen_HK
dc.identifier.urihttp://hdl.handle.net/10722/150814-
dc.description.abstractBACKGROUND: A previous meta-analysis investigated the role of chemotherapy in head and neck locally advanced carcinoma. This work had not been performed on nasopharyngeal carcinoma. OBJECTIVES: The aim of the project was to study the effect of adding chemotherapy to radiotherapy on overall survival (OS) and event-free survival (EFS) in patients with nasopharyngeal carcinoma. SEARCH STRATEGY: We searched MEDLINE (1966 to October 2003), EMBASE (1980 to October 2003) and the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library, Issue 3, 2003) and trial registers. Handsearches of meeting abstracts, references in review articles and of the Chinese medical literature were carried out. Experts and pharmaceutical companies were asked to identify trials. SELECTION CRITERIA: Randomised trials comparing chemotherapy plus radiotherapy to radiotherapy alone in locally advanced nasopharyngeal carcinoma were included. DATA COLLECTION AND ANALYSIS: The meta-analysis was based on updated individual patient data. The log rank test, stratified by trial, was used for comparisons and the hazard ratios (HR) of death and failure (loco-regional/distant failure or death) were calculated. MAIN RESULTS: Eight trials with 1753 patients were included. One trial with a 2 x 2 design was counted twice in the analysis. The analysis was performed including 11 comparisons based on 1975 patients. The median follow up was six years. The pooled hazard ratio of death was 0.82 (95% confidence interval (CI) 0.71 to 0.95; P = 0.006) corresponding to an absolute survival benefit of 6% at five years from chemotherapy (from 56% to 62%). The pooled hazard ratio of tumour failure or death was 0.76 (95% CI 0.67 to 0.86; P < 0.00001) corresponding to an absolute event-free survival benefit of 10% at five years from chemotherapy (from 42% to 52%). A significant interaction was observed between chemotherapy timings and overall survival (P = 0.005), explaining the heterogeneity observed in the treatment effect (P = 0.03) with the highest benefit from concomitant chemotherapy. AUTHORS' CONCLUSIONS: 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 radiotherapy.en_HK
dc.languageengen_US
dc.publisherJohn Wiley & Sons Ltd. The Journal's web site is located at http://www.mrw.interscience.wiley.com/cochrane/cochrane_clsysrev_articles_fs.htmlen_HK
dc.relation.ispartofCochrane database of systematic reviews (Online)en_HK
dc.subject.meshChemotherapy, Adjuvanten_US
dc.subject.meshDisease-Free Survivalen_US
dc.subject.meshHumansen_US
dc.subject.meshNasopharyngeal Neoplasms - Drug Therapy - Mortality - Radiotherapyen_US
dc.subject.meshRandomized Controlled Trials As Topicen_US
dc.titleChemotherapy as an adjunct to radiotherapy in locally advanced nasopharyngeal carcinoma.en_HK
dc.typeArticleen_HK
dc.identifier.emailChua, DT: dttchua@hkucc.hku.hken_HK
dc.identifier.emailKwong, DL: dlwkwong@hku.hken_HK
dc.identifier.authorityChua, DT=rp00415en_HK
dc.identifier.authorityKwong, DL=rp00414en_HK
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1016/j.chaos.2005.10.066-
dc.identifier.pmid17054200-
dc.identifier.scopuseid_2-s2.0-39049196239en_HK
dc.identifier.issue4en_HK
dc.identifier.spageCD004329en_HK
dc.identifier.epageCD004329en_HK
dc.identifier.isiWOS:000241386000031-
dc.publisher.placeUnited Kingdomen_HK
dc.identifier.scopusauthoridBaujat, B=6603156185en_HK
dc.identifier.scopusauthoridAudry, H=10142967300en_HK
dc.identifier.scopusauthoridBourhis, J=7101841706en_HK
dc.identifier.scopusauthoridChan, AT=13404833700en_HK
dc.identifier.scopusauthoridOnat, H=6701530171en_HK
dc.identifier.scopusauthoridChua, DT=7006773480en_HK
dc.identifier.scopusauthoridKwong, DL=15744231600en_HK
dc.identifier.scopusauthoridAlSarraf, M=7004775850en_HK
dc.identifier.scopusauthoridChi, KH=7102221567en_HK
dc.identifier.scopusauthoridHareyama, M=7004687889en_HK
dc.identifier.scopusauthoridLeung, SF=7202044876en_HK
dc.identifier.scopusauthoridThephamongkhol, K=6506860951en_HK
dc.identifier.scopusauthoridPignon, JP=7004568027en_HK

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