Chemotherapy and radiotherapy in locally advanced head and neck cancer: an individual patient data network meta-analysis

Autor: Brian O'Sullivan, Everett E. Vokes, J. Bernier, J. Vermorken, Jean-Jacques Mazeron, J.W. Lee, J. Simes, Carlo Fallai, P. Olmi, Cai Grau, K.H. Cho, B. Lacas, J.J. Cruz Hernandez, P. Graff-Cailleaud, Branislav Jeremic, J. Overgaard, Giuseppe Sanguineti, J.H. Hay, Voichita Bar-Ad, B. Gery, H. Quon, W. Dobrowsky, B. Maciejewski, M. Nankivell, Catherine Fortpied, Y. Belkacemi, Z. Szutkowski, V. Budach, David J. Adelstein, Maria Grazia Ghi, Allan Hackshaw, A. Trotti, Vincent Grégoire, Jens Overgaard, P. Blanchard, David I. Rosenthal, B. O'Sullivan, B.G. Haffty, Ju-Whei Lee, E. Moyal, M. Alfonsi, O. Choussy, S. Kumar, Barbara Burtness, M. Cheugoua-Zanetsie, C.M.P. Viegas, V. Tseroni, E. Lartigau, H. Bartelink, Björn Zackrisson, Jean-Pierre Pignon, S. Staar, J. Waldron, J.S. Wu, A. Lopes, M.G. Ghi, Sarbani Ghosh Laskar, Lisa Licitra, K.D Wernecke, C. Grau, Y.G. Tao, J. Agarwal, Yoann Pointreau, Maurice Cheugoua-Zanetsie, M. Lotayef, G. Calais, Claire Petit, J. Moon, J.A. Langendijk, C.A. Kristensen, W. Budach, Mahesh K.B. Parmar, Mahesh K. B. Parmar, Athanassios Argiris, Benjamin Lacas, C. Sire, S. Spencer, Beth M. Beadle, C. Petit, John Simes, Michael Poulsen, Arlene A. Forastiere, Q.T. Le, Adam S. Garden, L.P. Zhong, J.J. Mazeron, H. van Tinteren, Å. Bratland, Jean Pierre Pignon, Yi Li, Jeffrey S Tobias, S.H. Moon, P. Strojan, J. Bourhis, S. Temam, A. Bacigalupo, Pedro A. Torres-Saavedra, E.E. Vokes, C.M.L. Driessen, Stéphane Temam, M.M Dominello, E. Chamorey, J. Widder, Ricardo Hitt, C. van Herpen, Séverine Racadot, M. Julieron, H. Yamazaki, Rafał Suwiński, Z. Takácsi-Nagy, A. Hansen, K. Skladowski, D. Chaukar, P. Lee, S. Hayoz, F. Lewin, Marshall R. Posner, Atul Sharma, S. Mehta, M.G. Poulsen, S. Ghosh Laskar, R. Suwinski, B. Campbell, Wojciech Michalski, Jimmy J. Caudell, Jørgen Johansen, C. Simon, C. Fortpied, R. Orecchia, Volker Budach, George Shenouda, V. Torri, Shaleen Kumar, E Haddad, P. Rovea, P. Torres-Saavedra, Juan Jesús Cruz Hernández, Lai-Ping Zhong, Quynh-Thu Le, B. Zaktonik, J.W. Denham, A. Aupérin, B. Zackrisson, Gregory T. Wolf, J.C. Horiot, C. Stromberger, Jean Bourhis, S. Chabaud, Michel Lapeyre, Eric Lartigau, S.J. Wong, George Fountzilas, P. Nilsson, David M. Brizel, M.R. Posner, L. Tripcony, René-Jean Bensadoun, C. Jones, M.G. Ruo Redda, Pierre Blanchard, D. Thomson, A. Hackshaw, B. Jeremic, G. Sanguineti, Pirus Ghadjar, A. Auperin, P. Garaud
Přispěvatelé: Damage and Repair in Cancer Development and Cancer Treatment (DARE), Guided Treatment in Optimal Selected Cancer Patients (GUTS)
Rok vydání: 2021
Předmět:
Zdroj: Lancet Oncology, 22, 727-736
Petit, C, Lacas, B, Pignon, J-P, Le, Q T, Grégoire, V, Grau, C, Hackshaw, A, Zackrisson, B, Parmar, M K B, Lee, J-W, Ghi, M G, Sanguineti, G, Temam, S, Cheugoua-Zanetsie, M, O'Sullivan, B, Posner, M R, Vokes, E E, Cruz Hernandez, J J, Szutkowski, Z, Lartigau, E, Budach, V, Suwiński, R, Poulsen, M, Kumar, S, Ghosh Laskar, S, Mazeron, J-J, Jeremic, B, Simes, J, Zhong, L-P, Overgaard, J, Fortpied, C, Torres-Saavedra, P, Bourhis, J, Aupérin, A, Blanchard, P & MACH-NC and MARCH Collaborative Groups 2021, ' Chemotherapy and radiotherapy in locally advanced head and neck cancer : an individual patient data network meta-analysis ', The Lancet Oncology, vol. 22, no. 5, pp. 727-736 . https://doi.org/10.1016/S1470-2045(21)00076-0
The Lancet Oncology, 22(5), 727-736. ELSEVIER SCIENCE INC
Lancet Oncology, 22, 5, pp. 727-736
Petit, C, Lacas, B, Pignon, J P, Le, Q T, Grégoire, V, Grau, C, Hackshaw, A, Zackrisson, B, Parmar, M K B, Lee, J W, Ghi, M G, Sanguineti, G, Temam, S, Cheugoua-Zanetsie, M, O'Sullivan, B, Posner, M R, Vokes, E E, Cruz Hernandez, J J, Szutkowski, Z, Lartigau, E, Budach, V, Suwiński, R, Poulsen, M, Kumar, S, Ghosh Laskar, S, Mazeron, J J, Jeremic, B, Simes, J, Zhong, L P, Overgaard, J, Fortpied, C, Torres-Saavedra, P, Bourhis, J, Aupérin, A, Blanchard, P, MACH-NC and MARCH Collaborative Groups & Johansen, J 2021, ' Chemotherapy and radiotherapy in locally advanced head and neck cancer : an individual patient data network meta-analysis ', The Lancet Oncology, vol. 22, no. 5, pp. 727-736 . https://doi.org/10.1016/S1470-2045(21)00076-0
ISSN: 1470-2045
DOI: 10.1016/S1470-2045(21)00076-0
Popis: Contains fulltext : 235407.pdf (Publisher’s version ) (Closed access) BACKGROUND: Randomised, controlled trials and meta-analyses have shown the survival benefit of concomitant chemoradiotherapy or hyperfractionated radiotherapy in the treatment of locally advanced head and neck cancer. However, the relative efficacy of these treatments is unknown. We aimed to determine whether one treatment was superior to the other. METHODS: We did a frequentist network meta-analysis based on individual patient data of meta-analyses evaluating the role of chemotherapy (Meta-Analysis of Chemotherapy in Head and Neck Cancer [MACH-NC]) and of altered fractionation radiotherapy (Meta-Analysis of Radiotherapy in Carcinomas of Head and Neck [MARCH]). Randomised, controlled trials that enrolled patients with non-metastatic head and neck squamous cell cancer between Jan 1, 1980, and Dec 31, 2016, were included. We used a two-step random-effects approach, and the log-rank test, stratified by trial to compare treatments, with locoregional therapy as the reference. Overall survival was the primary endpoint. The global Cochran Q statistic was used to assess homogeneity and consistency and P score to rank treatments (higher scores indicate more effective therapies). FINDINGS: 115 randomised, controlled trials, which enrolled patients between Jan 1, 1980, and April 30, 2012, yielded 154 comparisons (28 978 patients with 19 253 deaths and 20 579 progression events). Treatments were grouped into 16 modalities, for which 35 types of direct comparisons were available. Median follow-up based on all trials was 6·6 years (IQR 5·0-9·4). Hyperfractionated radiotherapy with concomitant chemotherapy (HFCRT) was ranked as the best treatment for overall survival (P score 97%; hazard ratio 0·63 [95% CI 0·51-0·77] compared with locoregional therapy). The hazard ratio of HFCRT compared with locoregional therapy with concomitant chemoradiotherapy with platinum-based chemotherapy (CLRT(P)) was 0·82 (95% CI 0·66-1·01) for overall survival. The superiority of HFCRT was robust to sensitivity analyses. Three other modalities of treatment had a better P score, but not a significantly better HR, for overall survival than CLRT(P) (P score 78%): induction chemotherapy with taxane, cisplatin, and fluorouracil followed by locoregional therapy (IC(TaxPF)-LRT; 89%), accelerated radiotherapy with concomitant chemotherapy (82%), and IC(TaxPF) followed by CLRT (80%). INTERPRETATION: The results of this network meta-analysis suggest that further intensifying chemoradiotherapy, using HFCRT or IC(TaxPF)-CLRT, could improve outcomes over chemoradiotherapy for the treatment of locally advanced head and neck cancer. FUNDINGS: French Institut National du Cancer, French Ligue Nationale Contre le Cancer, and Fondation ARC.
Databáze: OpenAIRE
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