Treatment-related death during concurrent chemoradiotherapy for locally advanced non-small cell lung cancer: A meta-analysis of randomized studies

Jing Zhao, Yingfeng Xia, Joseph Michael Kaminski, Zhonglin Hao, Frank Edmund Mott, Jeff Campbell, Ramses F Sadek, Feng Ming Kong

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Treatment related death (TRD) is the worst adverse event in chemotherapy and radiotherapy for patients with cancer, the reports for TRDs were sporadically. We aimed to study TRDs in non-small cell lung cancer (NSCLC) patients treated with concurrent chemoradiotherapy (CCRT), and determine whether high radiation dose and newer chemotherapy regimens were associated with the risk of TRD. Data from randomized clinical trials for locally advanced/unresectable NSCLC patients were analyzed. Eligible studies had to have at least one arm with CCRT. The primary endpoint was TRD. Pooled odds ratios (ORs) for TRDs were calculated. In this study, a total of fifty-three trials (8940 patients) were eligible. The pooled TRD rate (accounting for heterogeneity) was 1.44% for all patients. In 20 trials in which comparison of TRDs between CCRT and non-CCRT was possible, the OR (95% CI) of TRDs was 1.08 (0.70-1.66) (P = 0.71). Patients treated with third-generation chemotherapy and concurrent radiotherapy had an increase of TRDs compared to those with other regimens in CCRT (2.70% vs. 1.37%, OR = 1.50, 95% CI: 1.09-2.07, P = 0.008). No significant difference was found in TRDs between high (≥ 66 Gy) and low (< 66 Gy) radiation dose during CCRT (P = 0.605). Neither consolidation (P = 0.476) nor induction chemotherapy (P = 0.175) had significant effects with increased TRDs in this study. We concluded that CCRT is not significantly associated with the risk of TRD compared to non-CCRT. The third-generation chemotherapy regimens may be a risk factor with higher TRDs in CCRT, while high dose radiation is not significantly associated with more TRDs. This observation deserves further study.

Original languageEnglish (US)
Article numbere0157455
JournalPloS one
Volume11
Issue number6
DOIs
StatePublished - Jun 2016

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Chemoradiotherapy
lung neoplasms
meta-analysis
Non-Small Cell Lung Carcinoma
Meta-Analysis
drug therapy
Cells
death
Chemotherapy
odds ratio
radiotherapy
cells
Dosimetry
Drug Therapy
Therapeutics
dosage
Odds Ratio
Radiotherapy
randomized clinical trials
endpoints

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)
  • General

Cite this

Treatment-related death during concurrent chemoradiotherapy for locally advanced non-small cell lung cancer : A meta-analysis of randomized studies. / Zhao, Jing; Xia, Yingfeng; Kaminski, Joseph Michael; Hao, Zhonglin; Mott, Frank Edmund; Campbell, Jeff; Sadek, Ramses F; Kong, Feng Ming.

In: PloS one, Vol. 11, No. 6, e0157455, 06.2016.

Research output: Contribution to journalArticle

Zhao, Jing ; Xia, Yingfeng ; Kaminski, Joseph Michael ; Hao, Zhonglin ; Mott, Frank Edmund ; Campbell, Jeff ; Sadek, Ramses F ; Kong, Feng Ming. / Treatment-related death during concurrent chemoradiotherapy for locally advanced non-small cell lung cancer : A meta-analysis of randomized studies. In: PloS one. 2016 ; Vol. 11, No. 6.
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abstract = "Treatment related death (TRD) is the worst adverse event in chemotherapy and radiotherapy for patients with cancer, the reports for TRDs were sporadically. We aimed to study TRDs in non-small cell lung cancer (NSCLC) patients treated with concurrent chemoradiotherapy (CCRT), and determine whether high radiation dose and newer chemotherapy regimens were associated with the risk of TRD. Data from randomized clinical trials for locally advanced/unresectable NSCLC patients were analyzed. Eligible studies had to have at least one arm with CCRT. The primary endpoint was TRD. Pooled odds ratios (ORs) for TRDs were calculated. In this study, a total of fifty-three trials (8940 patients) were eligible. The pooled TRD rate (accounting for heterogeneity) was 1.44{\%} for all patients. In 20 trials in which comparison of TRDs between CCRT and non-CCRT was possible, the OR (95{\%} CI) of TRDs was 1.08 (0.70-1.66) (P = 0.71). Patients treated with third-generation chemotherapy and concurrent radiotherapy had an increase of TRDs compared to those with other regimens in CCRT (2.70{\%} vs. 1.37{\%}, OR = 1.50, 95{\%} CI: 1.09-2.07, P = 0.008). No significant difference was found in TRDs between high (≥ 66 Gy) and low (< 66 Gy) radiation dose during CCRT (P = 0.605). Neither consolidation (P = 0.476) nor induction chemotherapy (P = 0.175) had significant effects with increased TRDs in this study. We concluded that CCRT is not significantly associated with the risk of TRD compared to non-CCRT. The third-generation chemotherapy regimens may be a risk factor with higher TRDs in CCRT, while high dose radiation is not significantly associated with more TRDs. This observation deserves further study.",
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