cancer: a meta-analysis using individual patient data from randomised
Aim: To evaluate the effect of post-operative radiotherapy (PORT) on survival and recurrence in patients with completely resected non-small cell lung cancer.
Methods: Meta-analysis using updated data on individual patients from all available randomised trials. Data on 2128 patients from 9 randomised controlled trials were included (published and unpublished).
Findings: Overall, the results show a significant adverse effect of PORT on survival with a hazard ratio of 1.21 or 21% relative increase in the risk of death, equivalent to an absolute detriment of 7% at 2 years (95% confidence interval 3 to 11%) reducing overall survival from 55% to 48%. Exploratory subgroup analyses suggests that this detrimental effect was most pronounced for patients with stage I/II, N0-N1 disease, whereas for stage III, N2 patients there was no clear evidence of an adverse effect.
Interpretation: PORT is detrimental to patients
with early stage completely resected non-small cell lung cancer and should
not be used in the routine treatment of such patients. The role of PORT in
the treatment of N2 tumours is not clear and may warrant further research.
information may be obtained from:
MRC Cancer Trials Office
222 Euston Road
London NW1 2DA
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