Mixed treatment comparison meta-analysis of altered fractionated radiotherapy and chemotherapy in head and neck cancer.
Détails
ID Serval
serval:BIB_DCC11F6E4F83
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Mixed treatment comparison meta-analysis of altered fractionated radiotherapy and chemotherapy in head and neck cancer.
Périodique
Journal of Clinical Epidemiology
Collaborateur⸱rice⸱s
MARCH Collaborative Groups
Contributeur⸱rice⸱s
MACH-NC
ISSN
1878-5921 (Electronic)
ISSN-L
0895-4356
Statut éditorial
Publié
Date de publication
2011
Volume
64
Numéro
9
Pages
985-992
Langue
anglais
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov'tPublication Status: ppublish
Résumé
OBJECTIVE: Different treatments have been investigated in head and neck cancers (HNCs) but not all of them have been appraised using pairwise comparison. This has resulted in failure to directly identify the best treatment with standard methods. Mixed treatment comparison (MTC) meta-analysis allows one to perform simultaneous inference regarding all treatments and select the best among them.
STUDY DESIGN AND SETTING: We applied MTC models to the Meta-Analyses of Chemotherapy and Radiotherapy in HNC, which pooled individual patient data concerning more than 24,000 patients involved in 102 trials. Fixed- and random-effects models, models with or without consistency factors, possibly adapted to multiarm trials are discussed.
RESULTS: Altered fractionated concomitant chemoradiotherapy (AF-CRT) leads to the highest probability of survival in nonmetastatic HNC. The probability that AF-CRT is the best treatment is 94% with random-effects models. There was no relevant inconsistency. When only the most recent trials were selected, AF-CRT and concomitant chemoradiotherapy (CRT) were the two best treatments. AF-CRT remains better than CRT but with a lower posterior probability.
CONCLUSION: MTC is a powerful method for investigating networks of randomized trials. Homogeneity, similarity of trial designs, populations, and the consistency of the network should be thoroughly checked.
STUDY DESIGN AND SETTING: We applied MTC models to the Meta-Analyses of Chemotherapy and Radiotherapy in HNC, which pooled individual patient data concerning more than 24,000 patients involved in 102 trials. Fixed- and random-effects models, models with or without consistency factors, possibly adapted to multiarm trials are discussed.
RESULTS: Altered fractionated concomitant chemoradiotherapy (AF-CRT) leads to the highest probability of survival in nonmetastatic HNC. The probability that AF-CRT is the best treatment is 94% with random-effects models. There was no relevant inconsistency. When only the most recent trials were selected, AF-CRT and concomitant chemoradiotherapy (CRT) were the two best treatments. AF-CRT remains better than CRT but with a lower posterior probability.
CONCLUSION: MTC is a powerful method for investigating networks of randomized trials. Homogeneity, similarity of trial designs, populations, and the consistency of the network should be thoroughly checked.
Mots-clé
Antineoplastic Combined Chemotherapy Protocols, Bayes Theorem, Carcinoma/drug therapy, Carcinoma/mortality, Carcinoma, Squamous Cell, Combined Modality Therapy, Dose Fractionation, Evidence-Based Medicine, Head and Neck Neoplasms/drug therapy, Head and Neck Neoplasms/mortality, Humans, Meta-Analysis as Topic, Models, Statistical, Neoplasms, Squamous Cell/drug therapy, Neoplasms, Squamous Cell/mortality, Outcome Assessment (Health Care)/statistics & numerical data, Platinum Compounds/administration & dosage, Probability, Randomized Controlled Trials as Topic, Survival Analysis
Pubmed
Web of science
Création de la notice
01/12/2014 17:05
Dernière modification de la notice
20/08/2019 16:01