View in EDS PDF Full Text

Hyperfractionated or accelerated radiotherapy in head and neck cancer: a meta-analysis.

Saved in:
Bibliographic Details
Title: Hyperfractionated or accelerated radiotherapy in head and neck cancer: a meta-analysis.
Authors: Bourhis J (AUTHOR), Overgaard J (AUTHOR), Audry H (AUTHOR), Ang KK (AUTHOR), Saunders M (AUTHOR), Bernier J (AUTHOR), Horiot J (AUTHOR), Le Maître A (AUTHOR), Pajak TF (AUTHOR), Poulsen MG (AUTHOR), O'Sullivan B (AUTHOR), Dobrowsky W (AUTHOR), Hliniak A (AUTHOR), Skladowski K (AUTHOR), Hay JH (AUTHOR), Pinto LHJ (AUTHOR), Fallai C (AUTHOR), Fu KK (AUTHOR), Sylvester R (AUTHOR), Pignon J (AUTHOR)
Source: Lancet. 9/2/2006, Vol. 368 Issue 9538, p843-854. 12p.
Abstract: Background: Several trials have studied the role of unconventional fractionated radiotherapy in head and neck squamous cell carcinoma, but the effect of such treatment on survival is not clear. The aim of this meta-analysis was to assess whether this type of radiotherapy could improve survival.Methods: Randomised trials comparing conventional radiotherapy with hyperfractionated or accelerated radiotherapy, or both, in patients with non-metastatic HNSCC were identified and updated individual patient data were obtained. Overall survival was the main endpoint. Trials were grouped in three pre-specified categories: hyperfractionated, accelerated, and accelerated with total dose reduction.Findings: 15 trials with 6515 patients were included. The median follow-up was 6 years. Tumours sites were mostly oropharynx and larynx; 5221 (74%) patients had stage III-IV disease (International Union Against Cancer, 1987). There was a significant survival benefit with altered fractionated radiotherapy, corresponding to an absolute benefit of 3.4% at 5 years (hazard ratio 0.92, 95% CI 0.86-0.97; p=0.003). The benefit was significantly higher with hyperfractionated radiotherapy (8% at 5 years) than with accelerated radiotherapy (2% with accelerated fractionation without total dose reduction and 1.7% with total dose reduction at 5 years, p=0.02). There was a benefit on locoregional control in favour of altered fractionation versus conventional radiotherapy (6.4% at 5 years; p<0.0001), which was particularly efficient in reducing local failure, whereas the benefit on nodal control was less pronounced. The benefit was significantly higher in the youngest patients (hazard ratio 0.78 [0.65-0.94] for under 50 year olds, 0.95 [0.83-1.09] for 51-60 year olds, 0.92 [0.81-1.06] for 61-70 year olds, and 1.08 [0.89-1.30] for over 70 year olds; test for trends p=0.007).Interpretation: Altered fractionated radiotherapy improves survival in patients with head and neck squamous cell carcinoma. Comparison of the different types of altered radiotherapy suggests that hyperfractionation has the greatest benefit. [ABSTRACT FROM AUTHOR]
Copyright of Lancet is the property of Lancet and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
FullText Links:
  – Type: pdflink
Text:
  Availability: 0
Header DbId: pbh
DbLabel: Psychology and Behavioral Sciences Collection
An: 106211522
AccessLevel: 6
PubType: Academic Journal
PubTypeId: academicJournal
PreciseRelevancyScore: 0
IllustrationInfo
Items – Name: Title
  Label: Title
  Group: Ti
  Data: Hyperfractionated or accelerated radiotherapy in head and neck cancer: a meta-analysis.
– Name: Author
  Label: Authors
  Group: Au
  Data: &lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Bourhis+J%22&quot;&gt;Bourhis J&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Overgaard+J%22&quot;&gt;Overgaard J&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Audry+H%22&quot;&gt;Audry H&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Ang+KK%22&quot;&gt;Ang KK&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Saunders+M%22&quot;&gt;Saunders M&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Bernier+J%22&quot;&gt;Bernier J&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Horiot+J%22&quot;&gt;Horiot J&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Le+Ma&#238;tre+A%22&quot;&gt;Le Ma&#238;tre A&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Pajak+TF%22&quot;&gt;Pajak TF&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Poulsen+MG%22&quot;&gt;Poulsen MG&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22O&#39;Sullivan+B%22&quot;&gt;O&#39;Sullivan B&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Dobrowsky+W%22&quot;&gt;Dobrowsky W&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Hliniak+A%22&quot;&gt;Hliniak A&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Skladowski+K%22&quot;&gt;Skladowski K&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Hay+JH%22&quot;&gt;Hay JH&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Pinto+LHJ%22&quot;&gt;Pinto LHJ&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Fallai+C%22&quot;&gt;Fallai C&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Fu+KK%22&quot;&gt;Fu KK&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Sylvester+R%22&quot;&gt;Sylvester R&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Pignon+J%22&quot;&gt;Pignon J&lt;/searchLink&gt; (AUTHOR)
– Name: TitleSource
  Label: Source
  Group: Src
  Data: &lt;searchLink fieldCode=&quot;JN&quot; term=&quot;%22Lancet%22&quot;&gt;Lancet&lt;/searchLink&gt;. 9/2/2006, Vol. 368 Issue 9538, p843-854. 12p.
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: &lt;bold&gt;Background: &lt;/bold&gt;Several trials have studied the role of unconventional fractionated radiotherapy in head and neck squamous cell carcinoma, but the effect of such treatment on survival is not clear. The aim of this meta-analysis was to assess whether this type of radiotherapy could improve survival.&lt;bold&gt;Methods: &lt;/bold&gt;Randomised trials comparing conventional radiotherapy with hyperfractionated or accelerated radiotherapy, or both, in patients with non-metastatic HNSCC were identified and updated individual patient data were obtained. Overall survival was the main endpoint. Trials were grouped in three pre-specified categories: hyperfractionated, accelerated, and accelerated with total dose reduction.&lt;bold&gt;Findings: &lt;/bold&gt;15 trials with 6515 patients were included. The median follow-up was 6 years. Tumours sites were mostly oropharynx and larynx; 5221 (74%) patients had stage III-IV disease (International Union Against Cancer, 1987). There was a significant survival benefit with altered fractionated radiotherapy, corresponding to an absolute benefit of 3.4% at 5 years (hazard ratio 0.92, 95% CI 0.86-0.97; p=0.003). The benefit was significantly higher with hyperfractionated radiotherapy (8% at 5 years) than with accelerated radiotherapy (2% with accelerated fractionation without total dose reduction and 1.7% with total dose reduction at 5 years, p=0.02). There was a benefit on locoregional control in favour of altered fractionation versus conventional radiotherapy (6.4% at 5 years; p&lt;0.0001), which was particularly efficient in reducing local failure, whereas the benefit on nodal control was less pronounced. The benefit was significantly higher in the youngest patients (hazard ratio 0.78 [0.65-0.94] for under 50 year olds, 0.95 [0.83-1.09] for 51-60 year olds, 0.92 [0.81-1.06] for 61-70 year olds, and 1.08 [0.89-1.30] for over 70 year olds; test for trends p=0.007).&lt;bold&gt;Interpretation: &lt;/bold&gt;Altered fractionated radiotherapy improves survival in patients with head and neck squamous cell carcinoma. Comparison of the different types of altered radiotherapy suggests that hyperfractionation has the greatest benefit. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
  Label:
  Group: Ab
  Data: &lt;i&gt;Copyright of Lancet is the property of Lancet and its content may not be copied or emailed to multiple sites without the copyright holder&#39;s express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.&lt;/i&gt; (Copyright applies to all Abstracts.)
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=pbh&AN=106211522
RecordInfo BibRecord:
  BibEntity:
    Identifiers:
      – Type: doi
        Value: 10.1016/s0140-6736(06)69121-6
    Languages:
      – Code: eng
        Text: English
    PhysicalDescription:
      Pagination:
        PageCount: 12
        StartPage: 843
    Titles:
      – TitleFull: Hyperfractionated or accelerated radiotherapy in head and neck cancer: a meta-analysis.
        Type: main
  BibRelationships:
    HasContributorRelationships:
      – PersonEntity:
          Name:
            NameFull: Bourhis J
      – PersonEntity:
          Name:
            NameFull: Overgaard J
      – PersonEntity:
          Name:
            NameFull: Audry H
      – PersonEntity:
          Name:
            NameFull: Ang KK
      – PersonEntity:
          Name:
            NameFull: Saunders M
      – PersonEntity:
          Name:
            NameFull: Bernier J
      – PersonEntity:
          Name:
            NameFull: Horiot J
      – PersonEntity:
          Name:
            NameFull: Le Maître A
      – PersonEntity:
          Name:
            NameFull: Pajak TF
      – PersonEntity:
          Name:
            NameFull: Poulsen MG
      – PersonEntity:
          Name:
            NameFull: O'Sullivan B
      – PersonEntity:
          Name:
            NameFull: Dobrowsky W
      – PersonEntity:
          Name:
            NameFull: Hliniak A
      – PersonEntity:
          Name:
            NameFull: Skladowski K
      – PersonEntity:
          Name:
            NameFull: Hay JH
      – PersonEntity:
          Name:
            NameFull: Pinto LHJ
      – PersonEntity:
          Name:
            NameFull: Fallai C
      – PersonEntity:
          Name:
            NameFull: Fu KK
      – PersonEntity:
          Name:
            NameFull: Sylvester R
      – PersonEntity:
          Name:
            NameFull: Pignon J
    IsPartOfRelationships:
      – BibEntity:
          Dates:
            – D: 02
              M: 09
              Text: 9/2/2006
              Type: published
              Y: 2006
          Identifiers:
            – Type: issn-print
              Value: 01406736
          Numbering:
            – Type: volume
              Value: 368
            – Type: issue
              Value: 9538
          Titles:
            – TitleFull: Lancet
              Type: main
ResultId 1