Dataset Information

Hyperfractionated or accelerated radiotherapy in lung cancer: an individual patient data meta-analysis.

ABSTRACT:

Purpose

In lung cancer, randomized trials assessing hyperfractionated or accelerated radiotherapy seem to yield conflicting results regarding the effects on overall (OS) or progression-free survival (PFS). The Meta-Analysis of Radiotherapy in Lung Cancer Collaborative Group decided to address the role of modified radiotherapy fractionation.

Material and methods

We performed an individual patient data meta-analysis in patients with nonmetastatic lung cancer, which included trials comparing modified radiotherapy with conventional radiotherapy.

Results

In non-small-cell lung cancer (NSCLC; 10 trials, 2,000 patients), modified fractionation improved OS as compared with conventional schedules (hazard ratio [HR] = 0.88, 95% CI, 0.80 to 0.97; P = .009), resulting in an absolute benefit of 2.5% (8.3% to 10.8%) at 5 years. No evidence of heterogeneity between trials was found. There was no evidence of a benefit on PFS (HR = 0.94; 95% CI, 0.86 to 1.03; P = .19). Modified radiotherapy reduced deaths resulting from lung cancer (HR = 0.89; 95% CI, 0.81 to 0.98; P = .02), and there was a nonsignificant reduction of non-lung cancer deaths (HR = 0.87; 95% CI, 0.66 to 1.15; P = .33). In small-cell lung cancer (SCLC; two trials, 685 patients), similar results were found: OS, HR = 0.87, 95% CI, 0.74 to 1.02, P = .08; PFS, HR = 0.88, 95% CI, 0.75 to 1.03, P = .11. In both NSCLC and SCLC, the use of modified radiotherapy increased the risk of acute esophageal toxicity (odds ratio [OR] = 2.44 in NSCLC and OR = 2.41 in SCLC; P < .001) but did not have an impact on the risk of other acute toxicities.

Conclusion

Patients with nonmetastatic NSCLC derived a significant OS benefit from accelerated or hyperfractionated radiotherapy; a similar but nonsignificant trend was observed for SCLC. As expected, there was increased acute esophageal toxicity.

SUBMITTER: Mauguen A

PROVIDER: S-EPMC4934452 | biostudies-literature | 2012 Aug

REPOSITORIES: biostudies-literature

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Publications

Hyperfractionated or accelerated radiotherapy in lung cancer: an individual patient data meta-analysis.

Mauguen Audrey A Le Péchoux Cécile C Saunders Michele I MI Schild Steven E SE Turrisi Andrew T AT Baumann Michael M Sause William T WT Ball David D Belani Chandra P CP Bonner James A JA Zajusz Aleksander A Dahlberg Suzanne E SE Nankivell Matthew M Mandrekar Sumithra J SJ Paulus Rebecca R Behrendt Katarzyna K Koch Rainer R Bishop James F JF Dische Stanley S Arriagada Rodrigo R De Ruysscher Dirk D Pignon Jean-Pierre JP

Journal of clinical oncology : official journal of the American Society of Clinical Oncology 20120702 22

<h4>Purpose</h4>In lung cancer, randomized trials assessing hyperfractionated or accelerated radiotherapy seem to yield conflicting results regarding the effects on overall (OS) or progression-free survival (PFS). The Meta-Analysis of Radiotherapy in Lung Cancer Collaborative Group decided to address the role of modified radiotherapy fractionation.<h4>Material and methods</h4>We performed an individual patient data meta-analysis in patients with nonmetastatic lung cancer, which included trials c ...[more]

PMID: 22753901

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Dataset Information

Hyperfractionated or accelerated radiotherapy in lung cancer: an individual patient data meta-analysis.

Purpose

Material and methods

Results

Conclusion

Publications

Hyperfractionated or accelerated radiotherapy in lung cancer: an individual patient data meta-analysis.

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