Abstract | BACKGROUND: METHODS: RESULTS: The relative risk of death in the treatment group as compared with the control group was 0.84 (95 percent confidence interval, 0.73 to 0.97; P= 0.01), which corresponds to a 5.4 percent increase in the rate of survival at three years (15.3 percent in the control group vs. 20.7 percent in the treatment group). Prophylactic cranial irradiation also increased the rate of disease-free survival (relative risk of recurrence or death, 0.75; 95 percent confidence interval, 0.65 to 0.86; P<0.001) and decreased the cumulative incidence of brain metastasis (relative risk, 0.46; 95 percent confidence interval, 0.38 to 0.57; P<0.001). Larger doses of radiation led to greater decreases in the risk of brain metastasis, according to an analysis of four total doses (8 Gy, 24 to 25 Gy, 30 Gy, and 36 to 40 Gy) (P for trend=0.02), but the effect on survival did not differ significantly according to the dose. We also identified a trend (P=0.01) toward a decrease in the risk of brain metastasis with earlier administration of cranial irradiation after the initiation of induction chemotherapy. CONCLUSIONS:
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Authors | A Aupérin, R Arriagada, J P Pignon, C Le Péchoux, A Gregor, R J Stephens, P E Kristjansen, B E Johnson, H Ueoka, H Wagner, J Aisner |
Journal | The New England journal of medicine
(N Engl J Med)
Vol. 341
Issue 7
Pg. 476-84
(Aug 12 1999)
ISSN: 0028-4793 [Print] United States |
PMID | 10441603
(Publication Type: Comparative Study, Journal Article, Meta-Analysis, Research Support, Non-U.S. Gov't)
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Topics |
- Adult
- Aged
- Aged, 80 and over
- Brain Neoplasms
(prevention & control, secondary)
- Carcinoma, Small Cell
(mortality, radiotherapy)
- Cranial Irradiation
- Disease-Free Survival
- Female
- Humans
- Lung Neoplasms
(mortality, radiotherapy)
- Male
- Middle Aged
- Randomized Controlled Trials as Topic
- Remission Induction
- Risk
- Survival Analysis
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