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

TitleChemotherapy in locally advanced nasopharyngeal carcinoma: An individual patient data meta-analysis of eight randomized trials and 1753 patients
Authors
KeywordsChemotherapy
Individual patient data
Meta-analysis
Nasopharyngeal carcinoma
Randomized trial
Issue Date2006
PublisherElsevier Inc. The Journal's web site is located at http://www.elsevier.com/locate/ijrobp
Citation
International Journal of Radiation Oncology - Biology - Physics, 2006, v. 64 n. 1, p. 47-56 How to Cite?
AbstractObjectives: 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 × 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. © 2006 Elsevier Inc.
Persistent Identifierhttp://hdl.handle.net/10722/71919
ISSN
2015 Impact Factor: 4.495
2015 SCImago Journal Rankings: 2.274
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorBaujat, Ben_HK
dc.contributor.authorAudry, Hen_HK
dc.contributor.authorBourhis, Jen_HK
dc.contributor.authorChan, ATCen_HK
dc.contributor.authorOnat, Hen_HK
dc.contributor.authorChua, DTTen_HK
dc.contributor.authorKwong, DLWen_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.accessioned2010-09-06T06:36:29Z-
dc.date.available2010-09-06T06:36:29Z-
dc.date.issued2006en_HK
dc.identifier.citationInternational Journal of Radiation Oncology - Biology - Physics, 2006, v. 64 n. 1, p. 47-56en_HK
dc.identifier.issn0360-3016en_HK
dc.identifier.urihttp://hdl.handle.net/10722/71919-
dc.description.abstractObjectives: 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 × 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. © 2006 Elsevier Inc.en_HK
dc.languageengen_HK
dc.publisherElsevier Inc. The Journal's web site is located at http://www.elsevier.com/locate/ijrobpen_HK
dc.relation.ispartofInternational Journal of Radiation Oncology - Biology - Physicsen_HK
dc.rightsInternational Journal of Radiation: Oncology - Biology - Physics. Copyright © Elsevier Inc.en_HK
dc.subjectChemotherapyen_HK
dc.subjectIndividual patient dataen_HK
dc.subjectMeta-analysisen_HK
dc.subjectNasopharyngeal carcinomaen_HK
dc.subjectRandomized trialen_HK
dc.subject.meshAntineoplastic Agents - therapeutic useen_HK
dc.subject.meshCombined Modality Therapyen_HK
dc.subject.meshConfidence Intervalsen_HK
dc.subject.meshHumansen_HK
dc.subject.meshLinear Modelsen_HK
dc.subject.meshNasopharyngeal Neoplasms - drug therapy - mortality - radiotherapyen_HK
dc.subject.meshRandomized Controlled Trials as Topicen_HK
dc.titleChemotherapy in locally advanced nasopharyngeal carcinoma: An individual patient data meta-analysis of eight randomized trials and 1753 patientsen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0360-3016&volume=64&issue=1&spage=47&epage=56&date=2006&atitle=Chemotherapy+in+locally+advanced+nasopharyngeal+carcinoma:+an+individual+patient+data+meta-analysis+of+eight+randomized+trials+and+1753+patients.en_HK
dc.identifier.emailChua, DTT: dttchua@hkucc.hku.hken_HK
dc.identifier.emailKwong, DLW: dlwkwong@hku.hken_HK
dc.identifier.authorityChua, DTT=rp00415en_HK
dc.identifier.authorityKwong, DLW=rp00414en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1016/j.ijrobp.2005.06.037en_HK
dc.identifier.pmid16377415-
dc.identifier.scopuseid_2-s2.0-29244448683en_HK
dc.identifier.hkuros124600en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-29244448683&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume64en_HK
dc.identifier.issue1en_HK
dc.identifier.spage47en_HK
dc.identifier.epage56en_HK
dc.identifier.isiWOS:000234442200008-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridBaujat, B=6603156185en_HK
dc.identifier.scopusauthoridAudry, H=10142967300en_HK
dc.identifier.scopusauthoridBourhis, J=7101841706en_HK
dc.identifier.scopusauthoridChan, ATC=13404833700en_HK
dc.identifier.scopusauthoridOnat, H=6701530171en_HK
dc.identifier.scopusauthoridChua, DTT=7006773480en_HK
dc.identifier.scopusauthoridKwong, DLW=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
dc.identifier.citeulike788412-

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