Taxane-cisplatin-fluorouracil as induction chemotherapy in locally advanced head and neck cancers: an individual patient data meta-analysis of the meta-analysis of chemotherapy in head and neck cancer group.

Détails

ID Serval
serval:BIB_CFC3A3756309
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Taxane-cisplatin-fluorouracil as induction chemotherapy in locally advanced head and neck cancers: an individual patient data meta-analysis of the meta-analysis of chemotherapy in head and neck cancer group.
Périodique
Journal of Clinical Oncology
Auteur(s)
Blanchard P., Bourhis J., Lacas B., Posner M.R., Vermorken J.B., Hernandez J.J., Bourredjem A., Calais G., Paccagnella A., Hitt R., Pignon J.P., Meta-Analysis of Chemotherapy in Head
Collaborateur(s)
Neck Cancer Induction Project Collaborative Group
Contributeur(s)
Meta-Analysis of Chemotherapy in Head
ISSN
1527-7755 (Electronic)
ISSN-L
0732-183X
Statut éditorial
Publié
Date de publication
2013
Volume
31
Numéro
23
Pages
2854-2860
Langue
anglais
Notes
Publication types: Journal Article ; Meta-Analysis ; Research Support, Non-U.S. Gov'tPublication Status: ppublish
Résumé
PURPOSE Cisplatin plus fluorouracil (PF) induction chemotherapy has been compared with taxane (docetaxel or paclitaxel), cisplatin, and fluorouracil (Tax-PF) in randomized trials in locoregionally advanced head and neck cancers (LAHNCs). The aim of this meta-analysis was to study the efficacy and toxicity of Tax-PF and PF and identify differences in outcomes in subsets of patients. METHODS Five randomized trials representing 1,772 patients were identified. Updated individual patient data (IPD) were retrieved for all trials. The log-rank test, stratified by trial, was used for comparison. Interaction or trend tests were used to study the interaction between covariates and treatment. Results Median follow-up was 4.9 years. The hazard ratio (HR) of death was 0.79 (95% CI, 0.70 to 0.89; P < .001; absolute benefit at 5 years: 7.4%) in favor of Tax-PF. Heterogeneity was significant (P = .08, I(2) = 51%) and related to one trial. There was no more heterogeneity after exclusion of this trial (P = .99, I(2) = 0%), and HR of death was 0.72 (95% CI, 0.63 to 0.83) in favor of Tax-PF. There was no interaction between treatment effect and the following patient covariates: age, sex, performance status, tumor stage, or site. Tax-PF was associated with significant reductions of progression, locoregional failure, and distant failure compared with PF, with HRs of 0.78 (95% CI, 0.69 to 0.87; P < .001), 0.79 (95% CI, 0.66 to 0.94; P = .007), and 0.63 (95% CI, 0.45 to 0.89; P = .009) respectively. CONCLUSION This IPD meta-analysis shows the superiority of Tax-PF over PF as induction chemotherapy. Its precise role in the management of LAHNC remains to be determined.
Mots-clé
Antineoplastic Combined Chemotherapy Protocols/adverse effects, Antineoplastic Combined Chemotherapy Protocols/therapeutic use, Bridged Compounds/administration & dosage, Bridged Compounds/adverse effects, Cisplatin/administration & dosage, Cisplatin/adverse effects, Disease-Free Survival, Fluorouracil/administration & dosage, Fluorouracil/adverse effects, Head and Neck Neoplasms/drug therapy, Humans, Induction Chemotherapy/methods, Middle Aged, Randomized Controlled Trials as Topic, Taxoids/administration & dosage, Taxoids/adverse effects, Treatment Outcome
Pubmed
Web of science
Création de la notice
10/03/2014 15:17
Dernière modification de la notice
20/08/2019 16:50
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