Meta analysisMeta-analysis of chemotherapy in head and neck cancer (MACH-NC): An update on 93 randomised trials and 17,346 patients
Section snippets
Materials and methods
The methods were pre-specified in a protocol (copy available on request).
Results
The meta-analysis included 87 randomised trials (16,485 patients) comparing loco-regional treatment versus the same loco-regional treatment + chemotherapy. The trials included in the previous MACH-NC meta-analysis have been described previously [2]. Twenty-four new trials (5744 patients) evaluated chemotherapy concomitant with radiotherapy. One trial [5 of the Web-appendix] evaluated both adjuvant and concomitant chemotherapy. Data from one trial [11] that included 86 patients were lost, and two
Discussion
This updated individual patient data meta-analysis provides a reliable evaluation of the effect of chemotherapy in locally advanced head and neck cancer. Compared to the previous study, a large number of patients and randomised trials have been added and the follow-up has been markedly increased, including for the older trials. Consequently, the statistical power has been increased and we were able to undertake more complete analyses with new endpoints (effect of different types of
Role of the funding source
The sponsors of this study had no role in the study design, data collection, data analysis, data interpretation, or the writing of the report.
Investigator contribution (see list of investigator at the end of the paper)
Secretariat: J.P.P., J.B., B.L., J.L.L., J.P.A. conceived, designed and supervised the study;
J.P.P., J.B. obtained funding;
C.A., N.S., A.L.M., E.M., J.P.P. participated in data collection and checking;
C.A., A.L.M., E.M., J.P.P. did statistical analyses;
J.P.P., J.B., A.L.M., E.M. wrote the draft, with revision from the other investigator.
The authors had full access to all the data and analyses and, after consultation with the collaborators, had final responsibility for the decision to submit for
Secretariat
Caroline Amand, Jean Pierre Armand, Jean Bourhis, Aurélie Le Maître, Bernard Luboinski, Emilie Maillard, Jean-Pierre Pignon, Jean-Louis Lefebvre, Nathalie Syz
Steering Committee
Jacques Bernier, Volker Budach, Arlene A. Forastiere, Lesley A. Stewart, Everett E. Vokes.
Investigators
D.J. Adelstein (Cleveland Clinic Foundation), J.P. Armand (Institut Claudius Regaud), C. Amand (Intitut Gustave-Roussy [IGR]), H. Audry (IGR), J.M. Bachaud (Institut Claudius Regaud), H.G. Bartelink (Netherlands Cancer Institute, Amsterdam), J.
Acknowledgements
The chief acknowledgement is to the trialists who agreed to share their data.
We also thank the following institutions for funding the investigators meeting or the meta-analysis project: Association pour la Recherche sur le Cancer (ARC No. 2015), Institut Gustave-Roussy, Ligue Nationale Contre le Cancer, Programme Hospitalier de Recherche Clinique (No. IDF 95009), Sanofi-Aventis.
We thank Denise Avenell, for secretarial assistance, Francine Courtial for electronic literature search, Charlotte
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Collaborators listed at the end of the paper.