Magnitude of benefit of adjuvant chemotherapy for non-small cell lung cancer: Meta-analysis of randomized clinical trials

摘要: Summary Several randomized trials investigating the benefit of adjuvant chemotherapy after surgery in non-small cell lung cancer (NSCLC) have provided conflicting results. With over 7000 patients included, we analyzed results 13 reports past 10 years which received either platinum-containing or not. The major endpoint was to assess magnitude terms absolute benefit. All phase III and meta-analyses published as peer-reviewed papers abstracts from 1994 2007 were eligible. A literature-based meta-analysis performed; event-based overall- disease-free survival (OS/DFS) Relative Risks (RRs) with 95% confidence intervals (CIs) derived. Magnitudes evaluated with: number treated for one patient Seven sub-populations examined. Combined effect estimation computed fixed- random-effect models; a heterogeneity test also applied. Twelve plus an individual (7334 patients) gathered; designed determine if cisplatin- carboplatin-based improves surgery. When data pooled plotted, significant differences favor seen OS all seven sub-population, relative 7–12% ranging 2.5% 4.1%. more trend found DFS. No observed outcomes sub-populations. remains essentially same regardless how are screened. While clearly this analysis, small large population, especially when considering needed benefit, raises important issues weighing risks benefits treatment patients.