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Adjuvant chemotherapy improves survival with operable lung cancer: meta-analyses

Reuters Health • The Doctor's Channel Daily Newscast

NEW YORK (Reuters Health) – Adjuvant chemotherapy, with or without postoperative radiotherapy, improves survival in patients with operable non-small-cell lung cancer, according to a March 24th online report in The Lancet.

“Meta-analyses showing significant survival benefits with adjuvant chemotherapy have included many trials and patients,” said Dr. Sarah Burdett, from MRC Clinical Trials Unit, London, and her coauthors. “We aimed to assess the effects of adjuvant chemotherapy, with or without postoperative radiotherapy, in two new comprehensive meta-analyses of individual patient data.”

The first meta-analysis, which compared surgery plus chemotherapy versus surgery alone, featured 34 trial comparisons with 8447 patients (3323 deaths). Surgery plus chemotherapy increased 5-year survival from 60% to 64%.

The second meta-analysis was similar to the first except that patients in both treatment arms also received radiotherapy. In this analysis, based on 13 trial comparisons and 2660 patients (1909 deaths), adding chemotherapy to treatment improved 5-year survival from 29% to 33%.

The type of chemotherapy, patient subgroup, and other trial characteristics had minimal impact on the results in both analyses, the report indicates.

“Today’s meta-analysis adds further support to the use of adjuvant chemotherapy in patients with resected non-small-cell-lung cancer,” said Dr. Gregory P. Kalemkerian from the University of Michigan, Ann Arbor in a related editorial.

He added, “Although the survival benefit seems small, worldwide adoption of adjuvant chemotherapy could save up to 10,000 lives every year.”

Reference:

Lancet 2010.