Season of radiotherapy and outcomes of head & neck cancer patients in the MACH-NC & MARCH meta-analyses.

Autor: Limkin E; Department of Radiation Oncology, Gustave Roussy Cancer Campus, Université Paris-Saclay, Gustave-Roussy, Villejuif, France., Blanchard P; Department of Radiation Oncology, Gustave Roussy Cancer Campus, Université Paris-Saclay, Gustave-Roussy, Villejuif, France; Oncostat U1018 INSERM, Labeled Ligue Contre le Cancer, Villejuif, France; Groupe d'Oncologie Radiothérapie Tête Et Cou, Tours, France. Electronic address: pierre.blanchard@gustaveroussy.fr., Lacas B; Oncostat U1018 INSERM, Labeled Ligue Contre le Cancer, Villejuif, France; Department of Biostatistics and Epidemiology, Gustave Roussy Cancer Campus, Université Paris-Saclay, Gustave-Roussy, Villejuif, France., Bourhis J; Groupe d'Oncologie Radiothérapie Tête Et Cou, Tours, France; CHUV, Lausanne, Switzerland., Parmar M; MRC Clinical Trials Unit at UCL, London, United Kingdom., Licitra L; Fondazione IRCCS Istituto Tumori Milan and University of Milan, Italy., Le QT; Stanford University School of Medicine, Stanford, CA, USA; NRG Oncology, Philadelphia, PA, USA., Yom SS; NRG Oncology, Philadelphia, PA, USA., Fortpied C; EORTC, Brussels, Belgium., Langendijk J; University Medical Center Groningen, Groningen, Netherlands., Vermorken JB; Antwerp University Hospital, Edegem, Belgium., Bernier J; Clinique de Genolier, Genolier, Switzerland., Overgaard J; Aarhus University Hospital, Aarhus, Denmark., Harris J; NRG Oncology, Philadelphia, PA, USA., Pignon JP; Oncostat U1018 INSERM, Labeled Ligue Contre le Cancer, Villejuif, France; Groupe d'Oncologie Radiothérapie Tête Et Cou, Tours, France; Department of Biostatistics and Epidemiology, Gustave Roussy Cancer Campus, Université Paris-Saclay, Gustave-Roussy, Villejuif, France., Auperin A; Oncostat U1018 INSERM, Labeled Ligue Contre le Cancer, Villejuif, France; Groupe d'Oncologie Radiothérapie Tête Et Cou, Tours, France; Department of Biostatistics and Epidemiology, Gustave Roussy Cancer Campus, Université Paris-Saclay, Gustave-Roussy, Villejuif, France.
Jazyk: angličtina
Zdroj: Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology [Radiother Oncol] 2024 Jan; Vol. 190, pp. 110011. Date of Electronic Publication: 2023 Nov 11.
DOI: 10.1016/j.radonc.2023.110011
Abstrakt: Background: A single institution retrospective study suggested that head and neck squamous cell cancer (HNSCC) patients receiving radiotherapy (RT) during "dark" season (fall/winter) may have better outcomes than those treated during "light" season (spring/summer), possibly secondary to seasonal variations in cell cycle progression. We investigated the impact of season of RT in two large, multi-institutional, prospective datasets of randomized trials.
Methods: Individual patient data from the MACH-NC and MARCH meta-analyses were analyzed. Dark season was defined as mid-radiotherapy date during fall or winter and light the reverse, using equinoxes to separate the two periods. Primary endpoint was progression-free survival (PFS) and secondary endpoint was locoregional failure (LRF). The effect of season was estimated with a Cox model stratified by trial and adjusted on sex, tumor site, stage, and treatment. Planned sensitivity analyses were performed on patients treated around solstices, who received "complete radiotherapy", patients treated with concomitant radio-chemotherapy and on trials performed in Northern countries.
Results: 11320 patients from 33 trials of MARCH and 6276 patients from 29 trials of MACH-NC were included. RT during dark season had no benefit on PFS in the MARCH (hazard ratio[HR]: 1.01 [95%CI 0.97;1.05],p=0.72) or MACH-NC dataset (HR:1.00 [95%CI 0.94;1.06],p=1.0. No difference in LRF was observed in the MARCH (HR:1.00 [95%CI 0.94;1.06,p=0.95) or MACH-NC dataset (HR:0.99 [95%CI 0.91; 1.07],p=0.77). Sensitivity analyses showed similar results.
Conclusion: Season of RT had no impact on PFS or LRF in two large databases of HNSCC.
Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2023. Published by Elsevier B.V.)
Databáze: MEDLINE
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