Abstract | BACKGROUND: OBJECTIVES: SEARCH STRATEGY: Published and unpublished trials were eligible. Electronic databases, reference lists of trial publications, review articles and relevant books were used to identify potentially eligible trials. The search was also guided by discussions with investigators and experts, and the examination of meeting proceedings and of the Physician Data Query clinical trial registry. SELECTION CRITERIA: DATA COLLECTION AND ANALYSIS: Meta-analysis based on updated individual data. The main endpoint was survival. MAIN RESULTS: The relative risk of death in the treatment group compared to the control group was 0.84 (95% confidence interval=0.73 to 0.97, P=0.01), corresponding to a 5.4 percent increase in the 3-year survival rate (from 15.3 percent in the control group to 20.7 percent in the treatment group). Prophylactic cranial irradiation also increased disease-free survival (relative risk=0.75, 95% confidence interval=0.65 to 0.86, P<0.001) and decreased the risk of brain metastases (relative risk=0.46, 95% confidence interval=0.38 to 0.57, P<0.001). Increasing doses of irradiation decreased the risk of brain metastases when four groups (8 Gy, 24-25 Gy, 30 Gy, 36-40 Gy) were analyzed [trend test, P=0.02], but the effect on survival did not differ significantly according to the dose. We found a trend (P=0.01) for a decrease in the brain metastasis risk in favour of earlier administration of cranial irradiation after the initiation of induction treatment. REVIEWER'S CONCLUSIONS:
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Authors | Prophylactic Cranial Irradiation Overview Collaborative Group |
Journal | The Cochrane database of systematic reviews
(Cochrane Database Syst Rev)
Issue 4
Pg. CD002805
( 2000)
ISSN: 1469-493X [Electronic] England |
PMID | 11034766
(Publication Type: Journal Article, Review, Systematic Review)
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Topics |
- Brain Neoplasms
(prevention & control, secondary)
- Carcinoma, Small Cell
(secondary)
- Cranial Irradiation
- Humans
- Lung Neoplasms
(pathology)
- Meta-Analysis as Topic
- Proportional Hazards Models
- Randomized Controlled Trials as Topic
- Remission Induction
- Survival Analysis
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