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Treatment-Related Death during Concurrent Chemoradiotherapy for Locally Advanced Non-Small Cell Lung Cancer: A Meta-Analysis of Randomized Studies

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单位: [1]Georgia Regents Univ, Med Coll Georgia, GRU Canc Ctr, Dept Radiat Oncol, Augusta, GA USA [2]Huazhong Univ Sci & Technol, Tongji Hosp, Tongji Med Coll, Dept Oncol, Wuhan 430074, Peoples R China [3]Three Gorges Univ, Peoples Hosp, Hosp Yichang 1, Yichang, Peoples R China [4]Georgia Regents Univ, Med Coll Georgia, GRU Canc Ctr, Dept Internal Med, Augusta, GA USA [5]Georgia Regents Univ, Med Coll Georgia, GRU Canc Ctr, Dept Biostat & Epidemiol, Augusta, GA USA [6]Indiana Univ Sch Med, Dept Radiat Oncol, Simon Canc Ctr, Indianapolis, IN 46202 USA
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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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出版当年[2015]版:
大类 | 3 区 生物
小类 | 3 区 综合性期刊
最新[2025]版:
大类 | 3 区 综合性期刊
小类 | 3 区 综合性期刊
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出版当年[2014]版:
Q1 MULTIDISCIPLINARY SCIENCES
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Q1 MULTIDISCIPLINARY SCIENCES

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第一作者单位: [1]Georgia Regents Univ, Med Coll Georgia, GRU Canc Ctr, Dept Radiat Oncol, Augusta, GA USA [2]Huazhong Univ Sci & Technol, Tongji Hosp, Tongji Med Coll, Dept Oncol, Wuhan 430074, Peoples R China
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通讯机构: [1]Georgia Regents Univ, Med Coll Georgia, GRU Canc Ctr, Dept Radiat Oncol, Augusta, GA USA [6]Indiana Univ Sch Med, Dept Radiat Oncol, Simon Canc Ctr, Indianapolis, IN 46202 USA
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