Simultaneous Chemoradiotherapy Compared With Radiotherapy Alone After Induction Chemotherapy in Inoperable Stage IIIA or IIIB Non–Small-Cell Lung Cancer: Study CTRT99/97 by the Bronchial Carcinoma Therapy Group

Huber, Rudolf M.; Flentje, Michael; Schmidt, M; Pöllinger, Barbara; Gosse, H.; Willner, Jochen; Ulm, Kurt

doi:10.1200/jco.2005.05.4163

Cited by 117 publications

(67 citation statements)

References 19 publications

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“…Similar results were obtained for subgroup analysis of the five Phase-III trials. 15,19,20,21,37 Patterns of failure Pooling data of the initial relapse sites (Figure 2), difference between overall relapses (locoregional or distant) in both groups was statistically significant (OR ¼ 0.82; 95%CI: 0.69-0.97; p ¼ 0.02) in favor of concurrent group. Subset analyses revealed that isolated loco-regional relapses (primary tumor and/or regional nodes) were significantly lower frequent in the concurrent RT-CT than in the sequential arm (OR ¼ 0.68; 95%CI: 0.52-0.87; p ¼ 0.002), while the number of distant (e.g., brain, bone, or liver) relapses (OR ¼ 1.01; 95%CI: 0.79-1.30; p ¼ 0.927) and relapses at both sites (locoregional þ distant) (OR ¼ 0.74; 95%CI: 0.43-1.12; p ¼ 0.267) were similar in the two arms.…”

Section: Progression-free Survivalmentioning

confidence: 97%

“…[15][16][17][18][19][20][21][22][23]37,38 Main characteristics of the 11 trials are described in Table 1. Of the 11 trials, 6 were randomized phase III trials, 15,16,[19][20][21]37 and the remaining 5 were randomized phase II trials. As of August 2009, 10 trials have already been published as full length articles and one was presented at the 2003 Annual Meeting of the ASCO.…”

Section: Trial Flow and Characteristics Of The Eligible Trialsmentioning

confidence: 99%

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Chemo‐radiotherapy for advanced non‐small cell lung cancer: concurrent or sequential? It's no longer the question: a systematic review

Lee

Zhou

et al. 2010

Intl Journal of Cancer

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There has been conflicting evidence concerning the best sequence of radiotherapy (RT) and chemotherapy (CT) for advanced non-small-cell-lung-cancer (NSCLC). To investigate whether current clinical trials can clarify this schedule and offer further bases for clinical decision making, we performed a systematic review of 11 trials (2,043 patients; concurrent-1,019, sequential-1,024) that compared concurrent RT-CT with sequential arm in advanced NSCLC patients. Primary end point was overall survival (OS). Pooled median ratios (MRs) and progression-free-survival ratios (FRs) for median survival and progression-free survival (PFS) were calculated using the weighted sum of the log ratio of MR and FR of individual study. Pooled odds ratios (ORs) for the objective response rate, relapse control rate, and toxic events were calculated using the Mantel-Haenszel estimate. Results confirmed that concurrent RT-CT determined a statistically significant increase in median survival time (16.3 vs. 13.9 months; MR 5 1.17,95%CI:1.09-1.26), response rate (64.0% vs. 56.3%; OR 5 1.38,95%CI:1.10-1.72), and tumor-relapse control (OR 5 0.82,95%CI:0.69-0.97), though at the expense of increased hematological toxicity (neutropenia and thrombocytopenia) and non-hematological toxicity (nausea/vomiting, stomatitis, and esophagitis). Similar results were obtained from the sensitivity analysis of all Phase-III/trials designed to evaluate the primary end point of OS. Subgroup analysis revealed that concurrent strategy was mainly associated with improved loco-regional control (OR 5 0.68,95%CI:0.52-0.87). However, no difference in PFS is shown. While careful interpretation of our conclusions is required because of potential bias, the present study, to some extent, exhibits the superiority of the concurrent arm over the sequential in the treatment of advanced NSCLC. Further improvements will be obtained by optimizing the conditions for a concurrent regimen.Lung cancer, with its high incidence and grim prognosis, remains a major public health menace for both men and women worldwide. 1,2 Non-small-cell lung cancer (NSCLC) accounts for more than 80% of all lung tumors. 3,4 For early stage NSCLC, surgical resection continues to be the standard treatment with curative intent. 5 Unfortunately, approximately 70% of NSCLC patients are diagnosed in advanced stage of the disease (locoregionally advanced or distant metastatic disease). 3,6 Advanced NSCLC, characterized by large primary lesions and/or widespread involvement of the ipsilateral or contralateral mediastinum or supraclavicular regions, 7,8 poses a major therapeutic challenge not only due to poor response to treatment but also due to treatment related morbidities. 9 Although there is currently no official consensus on the definitive treatment of advanced NSCLC, it has been well documented that the addition of chemotherapy to radiotherapy improves survival. [10][11][12][13][14] Combined modality approaches have been studied intensively, including concurrent radio-chemotherapy (RT-CT) and sequential RT...

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Section: Progression-free Survivalmentioning

confidence: 97%

Section: Trial Flow and Characteristics Of The Eligible Trialsmentioning

confidence: 99%

Chemo‐radiotherapy for advanced non‐small cell lung cancer: concurrent or sequential? It's no longer the question: a systematic review

Lee

Zhou

et al. 2010

Intl Journal of Cancer

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show abstract

“…Five further trials were identified [13][14][15][16][17]; one of these was not considered in the meta-analysis because the sequential chemo-radiotherapy arm was stopped early after 19 patients and its results…”

Section: Meta-analysismentioning

confidence: 99%

“…The remaining 4 trials and the present study were divided in two sub-groups according to the timing of randomization: after induction in three trials [13][14][15] and before induction in two trials [16 and PITCAP trial].…”

Section: Meta-analysismentioning

confidence: 99%

“…Since we were aware of other few studies [13][14][15][16][17] with similar design and objective, we also performed a systematic review and a literature-based meta-analysis (TROCODILE meta-analysis, Taxane-based chemo-RadiOtherapy COmpared with raDIotherapy aLonE after induction chemotherapy in locally advanced Non-SmallCell Lung Cancer) including all randomized trials addressing the same scientific question. …”

Section: Introductionmentioning

confidence: 99%

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Randomized phase III PITCAP trial and meta-analysis of induction chemotherapy followed by thoracic irradiation with or without concurrent taxane-based chemotherapy in locally advanced NSCLC

et al. 2016

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Concurrent chemoradiotherapy in non-small cell lung cancer

O’Rourke

Figuls

Bernadó

et al. 2010

Cochrane Database of Systematic Reviews

278

208

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Simultaneous Chemoradiotherapy Compared With Radiotherapy Alone After Induction Chemotherapy in Inoperable Stage IIIA or IIIB Non–Small-Cell Lung Cancer: Study CTRT99/97 by the Bronchial Carcinoma Therapy Group

Abstract: Induction chemotherapy followed by chemoradiotherapy with weekly paclitaxel is feasible. Response, time to progression, and survival favor chemoradiotherapy compared with radiotherapy alone.

Cited by 117 publications

References 19 publications

Chemo‐radiotherapy for advanced non‐small cell lung cancer: concurrent or sequential? It's no longer the question: a systematic review

Chemo‐radiotherapy for advanced non‐small cell lung cancer: concurrent or sequential? It's no longer the question: a systematic review

Randomized phase III PITCAP trial and meta-analysis of induction chemotherapy followed by thoracic irradiation with or without concurrent taxane-based chemotherapy in locally advanced NSCLC

Concurrent chemoradiotherapy in non-small cell lung cancer

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