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Quimioterapia adyuvante para el cáncer de pulmón de células no pequeñas en estadio inicial resecado
Sarah Burdett, Jean Pierre Pignon, Jayne Tierney, Helene Tribodet, Lesley Stewart, Cecile Le Pechoux, Anne Aupérin, Thierry Le Chevalier, Richard J Stephens, Rodrigo Arriagada, Julian PT Higgins, David H Johnson, Jan Van Meerbeeck, Mahesh KB Parmar, Robert L Souhami, Bengt Bergman, Jean‐Yves Douillard, Ariane Dunant, Chiaki Endo, David Girling, Harubumi Kato, Steven M Keller, Hideki Kimura, Aija Knuuttila, Ken Kodama, Ritsuko Komaki, Mark G Kris, Thomas Lad, Tommaso Mineo, Steven Piantadosi, Rafael Rosell, Giorgio Scagliotti, Lesley K Seymour, Frances A Shepherd, Richard Sylvester, Hirohito Tada, Fumihiro Tanaka, Valter Torri, David Waller, Ying Liang, for the Non‐Small Cell Lung Cancer Collaborative Group | 2 marzo 2015

Topics

Temas

Dose‐intensity chemotherapy
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Figure 1

Dose‐intensity chemotherapy

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Methodological quality graph: review authors' judgements about each methodological quality item presented as percentages across all included studies.
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Figure 2

Methodological quality graph: review authors' judgements about each methodological quality item presented as percentages across all included studies.

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Methodological quality summary: review authors' judgements about each methodological quality item for each included study.
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Figure 3

Methodological quality summary: review authors' judgements about each methodological quality item for each included study.

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Forest plot of comparison: 1 Early versus late chest RT, outcome: 1.8 Local toxicity, all studies.
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Figure 4

Forest plot of comparison: 1 Early versus late chest RT, outcome: 1.8 Local toxicity, all studies.

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Forest plot of comparison: 1 Early versus late chest RT, outcome: 1.9 Local toxicity, excluding studies with non‐platinum CT.
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Figure 5

Forest plot of comparison: 1 Early versus late chest RT, outcome: 1.9 Local toxicity, excluding studies with non‐platinum CT.

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Forest plot of comparison: 1 Early versus late chest RT, outcome: 1.10 Local toxicity, only studies with overall treatment time of chest RT less than 30 days.
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Figure 6

Forest plot of comparison: 1 Early versus late chest RT, outcome: 1.10 Local toxicity, only studies with overall treatment time of chest RT less than 30 days.

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Forest plot of comparison: 1 Early versus late chest RT, outcome: 1.11 Haematological toxicity, all studies.
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Figure 7

Forest plot of comparison: 1 Early versus late chest RT, outcome: 1.11 Haematological toxicity, all studies.

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Forest plot of comparison: 1 Early versus late chest RT, outcome: 1.12 Haematological toxicity, excluding studies delivering radiation concurrently with doxorubicin.
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Figure 8

Forest plot of comparison: 1 Early versus late chest RT, outcome: 1.12 Haematological toxicity, excluding studies delivering radiation concurrently with doxorubicin.

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Forest plot of comparison: 1 Early versus late chest RT, outcome: 1.13 Haematological toxicity, only studies with overall treatment time of chest RT less than 30 days.
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Figure 9

Forest plot of comparison: 1 Early versus late chest RT, outcome: 1.13 Haematological toxicity, only studies with overall treatment time of chest RT less than 30 days.

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Distribution chemotherapy dose per study arm
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Figure 10

Distribution chemotherapy dose per study arm

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Comparison 1 Early versus late chest RT, Outcome 1 Overall survival.
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Analysis 1.1

Comparison 1 Early versus late chest RT, Outcome 1 Overall survival.

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Comparison 1 Early versus late chest RT, Outcome 2 Overall survival (only studies with OTT < 30 days).
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Analysis 1.2

Comparison 1 Early versus late chest RT, Outcome 2 Overall survival (only studies with OTT < 30 days).

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Comparison 1 Early versus late chest RT, Outcome 3 Local tumour control (5‐yrs).
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Analysis 1.3

Comparison 1 Early versus late chest RT, Outcome 3 Local tumour control (5‐yrs).

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Comparison 1 Early versus late chest RT, Outcome 4 Local toxicity, all studies.
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Analysis 1.4

Comparison 1 Early versus late chest RT, Outcome 4 Local toxicity, all studies.

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Comparison 1 Early versus late chest RT, Outcome 5 Local toxicity, excluding studies with non‐platinum CT.
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Analysis 1.5

Comparison 1 Early versus late chest RT, Outcome 5 Local toxicity, excluding studies with non‐platinum CT.

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Comparison 1 Early versus late chest RT, Outcome 6 Local toxicity, only studies with overall treatment time of chest RT less than 30 days.
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Analysis 1.6

Comparison 1 Early versus late chest RT, Outcome 6 Local toxicity, only studies with overall treatment time of chest RT less than 30 days.

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Comparison 1 Early versus late chest RT, Outcome 7 Haematological toxicity, all studies.
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Analysis 1.7

Comparison 1 Early versus late chest RT, Outcome 7 Haematological toxicity, all studies.

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Comparison 1 Early versus late chest RT, Outcome 8 Haematological toxicity, excluding studies with non‐platinum CT.
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Analysis 1.8

Comparison 1 Early versus late chest RT, Outcome 8 Haematological toxicity, excluding studies with non‐platinum CT.

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Comparison 1 Early versus late chest RT, Outcome 9 Haematological toxicity, only studies with overall treatment time of chest RT less than 30 days.
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Analysis 1.9

Comparison 1 Early versus late chest RT, Outcome 9 Haematological toxicity, only studies with overall treatment time of chest RT less than 30 days.

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Comparison 2 High (> 80%) versus low (< 80%) compliance chemotherapy, Outcome 1 High (> 80%) versus low (< 80%) compliance CT.
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Analysis 2.1

Comparison 2 High (> 80%) versus low (< 80%) compliance chemotherapy, Outcome 1 High (> 80%) versus low (< 80%) compliance CT.

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Comparison 1. Early versus late chest RT

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Overall survival Show forest plot

7

Hazard Ratio (Random, 95% CI)

0.91 [0.75, 1.10]

1.1 Platinum‐based CT

6

Hazard Ratio (Random, 95% CI)

0.86 [0.71, 1.04]

1.2 Non‐platinum based CT

1

Hazard Ratio (Random, 95% CI)

1.27 [0.97, 1.67]

2 Overall survival (only studies with OTT < 30 days) Show forest plot

5

Hazard Ratio (Random, 95% CI)

0.82 [0.64, 1.06]

3 Local tumour control (5‐yrs) Show forest plot

4

880

Risk Ratio (M‐H, Random, 95% CI)

0.86 [0.69, 1.07]

3.1 Platinum‐based CT

3

610

Risk Ratio (M‐H, Random, 95% CI)

0.93 [0.75, 1.15]

3.2 Non‐platinum based CT

1

270

Risk Ratio (M‐H, Random, 95% CI)

0.71 [0.57, 0.87]

4 Local toxicity, all studies Show forest plot

6

Risk Ratio (M‐H, Random, 95% CI)

Subtotals only

4.1 Pneumonitis

4

762

Risk Ratio (M‐H, Random, 95% CI)

1.83 [0.95, 3.50]

4.2 Oesophagitis

6

1289

Risk Ratio (M‐H, Random, 95% CI)

1.36 [0.99, 1.88]

5 Local toxicity, excluding studies with non‐platinum CT Show forest plot

5

Risk Ratio (M‐H, Random, 95% CI)

Subtotals only

5.1 Pneumonitis

3

492

Risk Ratio (M‐H, Random, 95% CI)

2.15 [0.82, 5.64]

5.2 Oesophagitis

5

1019

Risk Ratio (M‐H, Random, 95% CI)

1.39 [0.97, 1.98]

6 Local toxicity, only studies with overall treatment time of chest RT less than 30 days Show forest plot

5

Risk Ratio (M‐H, Random, 95% CI)

Subtotals only

6.1 Pneumonitis

3

492

Risk Ratio (M‐H, Random, 95% CI)

2.15 [0.82, 5.64]

6.2 Oesophagitis

5

1019

Risk Ratio (M‐H, Random, 95% CI)

1.39 [0.97, 1.98]

7 Haematological toxicity, all studies Show forest plot

7

Risk Ratio (M‐H, Random, 95% CI)

Subtotals only

7.1 Leucopenia

6

1200

Risk Ratio (M‐H, Random, 95% CI)

1.50 [1.26, 1.78]

7.2 Thrombocytopaenia

7

1508

Risk Ratio (M‐H, Random, 95% CI)

1.23 [0.96, 1.57]

8 Haematological toxicity, excluding studies with non‐platinum CT Show forest plot

6

Risk Ratio (M‐H, Random, 95% CI)

Subtotals only

8.1 Leucopenia

5

930

Risk Ratio (M‐H, Random, 95% CI)

1.45 [1.19, 1.77]

8.2 Thrombocytopaenia

6

1238

Risk Ratio (M‐H, Random, 95% CI)

1.28 [0.99, 1.65]

9 Haematological toxicity, only studies with overall treatment time of chest RT less than 30 days Show forest plot

6

Risk Ratio (M‐H, Random, 95% CI)

Subtotals only

9.1 Leucopenia

5

930

Risk Ratio (M‐H, Random, 95% CI)

1.45 [1.19, 1.77]

9.2 Thrombocytopaenia

6

1238

Risk Ratio (M‐H, Random, 95% CI)

1.28 [0.99, 1.65]
Figuras y tablas -
Comparison 1. Early versus late chest RT
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Comparison 2. High (> 80%) versus low (< 80%) compliance chemotherapy

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 High (> 80%) versus low (< 80%) compliance CT Show forest plot

2

Hazard Ratio (Random, 95% CI)

1.11 [0.89, 1.37]
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Comparison 2. High (> 80%) versus low (< 80%) compliance chemotherapy
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