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Concomitant Radio-Chemotherapy Based On Platin

introduction
Lung cancer remains a major cause of death worldwide with
over 1.1 million deaths per year [1]. Non-small cell lung
cancer (NSCLC) accounts for at least 80% of all lung tumours.
About 35% of these patients present with locally advanced
non-metastatic disease [2] for whom radical thoracic
radiotherapy is frequently part of treatment. The NSCLC
Collaborative Group meta-analysis [3] showed that sequential
cisplatin-based chemotherapy given in addition to radical
radiotherapy prolonged survival in patients with locally
advanced NSCLC. However, the prognosis for these patients
remained poor with a 3-year survival rate of approximately
14%. Cytotoxic agents used as radiosensitisers given at the
same time as radiotherapy have been evaluated against
radiotherapy alone in several randomised trials [4–14].
A primary aim of this combined approach was to improve
survival by increasing loco-regional control, while the
sequential use of chemotherapy has been directed at reducing
the rate of distant metastasis. However, the majority of the
trials performed have reported inconclusive results and it is
original
article
*Correspondence to: Dr A. Aupe´ rin, Unit of Biostatistics and Epidemiology,
Institut Gustave-Roussy, 94805 Villejuif Cedex, France. E-mail: auperin@igr.fr
ª 2006 European Society for Medical Oncology
still controversial whether concomitant radio-chemotherapy
does in fact improve survival of patients with locally advanced
NSCLC. The size of most of these trials has not been large
enough to detect a 5 to 10% increase in survival and there
were also some heterogeneities in the trial designs.
The Meta-Analysis of Cisplatin/carboplatin based
Concomitant Chemotherapy in non-small cell Lung Cancer
(MAC3-LC) Group was therefore created to undertake
a meta-analysis based on all available individual patient data
from randomised trials. Combining the data of these trials
could provide increased statistical power, time to event...