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首页> 外文期刊>Radiotherapy and oncology: Journal of the European Society for Therapeutic Radiology and Oncology >Meta-analysis of chemotherapy in head and neck cancer (MACH-NC): an update on 93 randomised trials and 17,346 patients.
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Meta-analysis of chemotherapy in head and neck cancer (MACH-NC): an update on 93 randomised trials and 17,346 patients.

机译：头颈癌化疗的荟萃分析（MACH-NC）：93项随机试验和17,346例患者的最新动态。

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BACKGROUND: Our previous individual patient data (IPD) meta-analysis showed that chemotherapy improved survival in patients curatively treated for non-metastatic head and neck squamous cell carcinoma (HNSCC), with a higher benefit with concomitant chemotherapy. However the heterogeneity of the results limited the conclusions and prompted us to confirm the results on a more complete database by adding the randomised trials conducted between 1994 and 2000. METHODS: The updated IPD meta-analysis included trials comparing loco-regional treatment to loco-regional treatment+chemotherapy in HNSCC patients and conducted between 1965 and 2000. The log-rank-test, stratified by trial, was used to compare treatments. The hazard ratios of death were calculated. RESULTS: Twenty-four new trials, most of them of concomitant chemotherapy, were included with a total of 87 trials and 16,485 patients. The hazard ratio of death was 0.88 (p<0.0001) with an absolute benefit for chemotherapy of 4.5% at 5 years, and a significant interaction (p<0.0001) between chemotherapy timing (adjuvant, induction or concomitant) and treatment. Both direct (6 trials) and indirect comparisons showed a more pronounced benefit of the concomitant chemotherapy as compared to induction chemotherapy. For the 50 concomitant trials, the hazard ratio was 0.81 (p<0.0001) and the absolute benefit 6.5% at 5 years. There was a decreasing effect of chemotherapy with age (p=0.003, test for trend). CONCLUSION: The benefit of concomitant chemotherapy was confirmed and was greater than the benefit of induction chemotherapy.
机译：背景：我们以前的患者数据（IPD）荟萃分析显示，化疗改善了非转移性头颈部鳞状细胞癌（HNSCC）治愈性治疗的患者的生存率，伴随化疗的获益更高。但是，结果的异质性限制了结论，并促使我们通过添加1994年至2000年之间进行的随机试验，在更完整的数据库中确认结果。在1965年至2000年之间对HNSCC患者进行了区域治疗+化学治疗。按试验分层的对数秩检验用于比较治疗。计算了死亡的危险比。结果：共纳入24项新试验，其中大多数为伴随化疗，共有87项试验和16,485例患者入选。死亡的危险比为0.88（p <0.0001），在5年时化疗的绝对获益为4.5％，化疗时机（辅助，诱导或伴随）与治疗之间存在显着的相互作用（p <0.0001）。直接（6个试验）和间接比较均显示，与诱导化疗相比，伴随化疗的获益更大。在50项伴随试验中，5年的风险比为0.81（p <0.0001），绝对收益为6.5％。随着年龄的增长，化疗的效果逐渐降低（p = 0.003，趋势检验）。结论：伴随化疗的益处已得到证实，并大于诱导化疗的益处。

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