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Induction Chemotherapy plus Concurrent Chemoradiotherapy in Endemic Nasopharyngeal Carcinoma: Individual Patient Data Pooled Analysis of Four Randomized Trials.
Chen, Yu-Pei; Tang, Ling-Long; Yang, Qi; Poh, Sharon-Shuxian; Hui, Edwin P; Chan, Anthony T C; Ong, Whee-Sze; Tan, Terence; Wee, Joseph; Li, Wen-Fei; Chen, Lei; Ma, Brigette B Y; Tong, Macy; Tan, Sze-Huey; Cheah, Shie-Lee; Fong, Kam-Weng; Sommat, Kiattisa; Soong, Yoke Lim; Guo, Ying; Lin, Ai-Hua; Sun, Ying; Hong, Ming-Huang; Cao, Su-Mei; Chen, Ming-Yuan; Ma, Jun.
Afiliación
  • Chen YP; Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, P.R. China.
  • Tang LL; Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, P.R. China.
  • Yang Q; Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, P.R. China.
  • Poh SS; Division of Radiation Oncology, National Cancer Centre, Singapore.
  • Hui EP; Partner State Key Laboratory of Oncology in South China, Sir Y K Pao Centre for Cancer, Department of Clinical Oncology, Hong Kong Cancer Institute and Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong.
  • Chan ATC; Partner State Key Laboratory of Oncology in South China, Sir Y K Pao Centre for Cancer, Department of Clinical Oncology, Hong Kong Cancer Institute and Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong.
  • Ong WS; Division of Clinical Trials and Epidemiological Sciences, National Cancer Centre, Singapore.
  • Tan T; Division of Radiation Oncology, National Cancer Centre, Singapore.
  • Wee J; Division of Radiation Oncology, National Cancer Centre, Singapore.
  • Li WF; Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, P.R. China.
  • Chen L; Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, P.R. China.
  • Ma BBY; Partner State Key Laboratory of Oncology in South China, Sir Y K Pao Centre for Cancer, Department of Clinical Oncology, Hong Kong Cancer Institute and Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong.
  • Tong M; Partner State Key Laboratory of Oncology in South China, Sir Y K Pao Centre for Cancer, Department of Clinical Oncology, Hong Kong Cancer Institute and Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong.
  • Tan SH; Division of Clinical Trials and Epidemiological Sciences, National Cancer Centre, Singapore.
  • Cheah SL; Division of Radiation Oncology, National Cancer Centre, Singapore.
  • Fong KW; Division of Radiation Oncology, National Cancer Centre, Singapore.
  • Sommat K; Division of Radiation Oncology, National Cancer Centre, Singapore.
  • Soong YL; Division of Radiation Oncology, National Cancer Centre, Singapore.
  • Guo Y; Clinical Trials Centre, Sun Yat-sen University Cancer Centre, State Key Laboratory of Oncology in South China, Collaborative Innovation Centre of Cancer Medicine, Guangzhou, P.R. China.
  • Lin AH; Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, P.R. China.
  • Sun Y; Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, P.R. China.
  • Hong MH; Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, P.R. China.
  • Cao SM; Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, P.R. China. majun2@mail.sysu.edu.cn chenmy@sysucc.org.cn caosm@sysucc.org.cn.
  • Chen MY; Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, P.R. China. majun2@mail.sysu.edu.cn chenmy@sysucc.org.cn caosm@sysucc.org.cn.
  • Ma J; Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, P.R. China. majun2@mail.sysu.edu.cn chenmy@sysucc.org.cn caosm@sysucc.org.cn.
Clin Cancer Res ; 24(8): 1824-1833, 2018 04 15.
Article en En | MEDLINE | ID: mdl-29431618
Purpose: Because of the uneven geographic distribution and small number of randomized trials available, the value of additional induction chemotherapy (IC) to concurrent chemoradiotherapy (CCRT) in nasopharyngeal carcinoma (NPC) remains controversial. This study performed an individual patient data (IPD) pooled analysis to better assess the precise role of IC + CCRT in locoregionally advanced NPC.Experimental Design: Four randomized trials in endemic areas were identified, representing 1,193 patients; updated IPD were obtained. Progression-free survival (PFS) and overall survival (OS) were the primary and secondary endpoints, respectively.Results: Median follow-up was 5.0 years. The HR for PFS was 0.70 [95% confidence interval (CI), 0.56-0.86; P = 0.0009; 9.3% absolute benefit at 5 years] in favor of IC + CCRT versus CCRT alone. IC + CCRT also improved OS (HR = 0.75; 95% CI, 0.57-0.99; P = 0.04) and reduced distant failure (HR = 0.68; 95% CI, 0.51-0.90; P = 0.008). IC + CCRT had a tendency to improve locoregional control compared with CCRT alone (HR = 0.70; 95% CI, 0.48-1.01; P = 0.06). There was no heterogeneity between trials in any analysis. No interactions between patient characteristics and treatment effects on PFS or OS were found. After adding two supplementary trials to provide a more comprehensive overview, the conclusions remained valid and were strengthened. In a supplementary Bayesian network analysis, no statistically significant differences in survival between different IC regimens were detected.Conclusions: This IPD pooled analysis demonstrates the superiority of additional IC over CCRT alone in locoregionally advanced NPC, with the survival benefit mainly associated with improved distant control. Clin Cancer Res; 24(8); 1824-33. ©2018 AACR.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Protocolos de Quimioterapia Combinada Antineoplásica / Carcinoma Nasofaríngeo Tipo de estudio: Clinical_trials / Prognostic_studies / Systematic_reviews Límite: Female / Humans / Male Idioma: En Revista: Clin Cancer Res Asunto de la revista: NEOPLASIAS Año: 2018 Tipo del documento: Article Pais de publicación: Estados Unidos
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Protocolos de Quimioterapia Combinada Antineoplásica / Carcinoma Nasofaríngeo Tipo de estudio: Clinical_trials / Prognostic_studies / Systematic_reviews Límite: Female / Humans / Male Idioma: En Revista: Clin Cancer Res Asunto de la revista: NEOPLASIAS Año: 2018 Tipo del documento: Article Pais de publicación: Estados Unidos