Concurrent chemoradiotherapy in non-small cell lung cancer.

摘要: Background This is an updated version of the original review published in Issue 4, 2004. The use concurrent chemotherapy and radiotherapy non-small cell lung cancer (NSCLC) might be seen as a way increasing effectiveness radical at same time reducing risks metastatic disease. Objectives To determine chemoradiotherapy compared to alone with regard overall survival, tumour control treatment-related morbidity. To versus sequential chemoradiotherapy. Search methods For this update we ran new search October 2009, using strategy adapted from design review. We searched: CENTRAL (accessed through Cochrane Library, 4), MEDLINE PubMed), EMBASE Ovid). Selection criteria Randomised trials patients stage I-III NSCLC undergoing randomised receive alone, or chemoradiotherapy. Data collection analysis Study selection, data extraction assessment risk bias was performed independently by two authors. Pooled hazard ratios relative were calculated according random-effects model. Main results Nineteen studies (2728 participants) included. Chemoradiotherapy significantly reduced death (HR 0.71, 95% CI 0.64 0.80; I2 0%; 1607 progression-free survival any site 0.69, 0.58 0.81; 45%; 1145 participants). Incidence acute oesophagitis, neutropenia anaemia increased chemoradiation. Six (1024 patients) chemoradiation A significant benefit treatment shown 0.74, 0.62 0.89; 702 This represented 10% absolute 2 years. More deaths (4% vs 2%) reported arm without statistical significance (RR 2.02, 0.90 4.52; 950 There severe oesophagitis 4.96, 95%CI 2.17 11.37; 66%; 947 participants). Authors' conclusions This 2004 incorporates additional more mature data. It demonstrates over chemoradiotherapy. Patient selection important consideration view added toxicity treatment. Uncertainty remains how far purely due radiosensitising effect whether similar benefits could achieved modern techniques dose intensive accelerated and/ hyperfractionated regimens.