Meta-analyses of clinical trials in patients with non-small cell lung cancer. Minireview.
Currently lung cancer is the most common worldwide cause of major cancer incidence and mortality. The treatment outcome is poor and there are still many questions which remain unanswered such as the interest of the best treatment schedule. To approach the answer what is the best treatment for patients with non-small cell lung cancer (NSCLC) we made a review of the published meta-analyses. Meta-analysis is a systematic approach to identification and abstraction of critical information from different randomized, controlled trials. The review of meta-analyses of clinical trials we had made showed that --in radically operated patients the postoperative radiotherapy should be detrimental if standard fields are used; postoperative chemotherapy with regimens based on cisplatin has an absolute benefit of 5% at 5 years survival; we can improve the survival of patients with locally advanced NSCLC using chemoradiation comparing to radiotherapy alone; chemotherapy with cisplatin can prolong the survival and improve the quality of life in patients with advanced NSCLC; platinum-based doublets remain the standard regimen in patients with advanced NSCLC; there is a slight but significant improvement in efficacy of gemcitabine plus platinum agent when compared with other platinum based comparators in regard to the survival and time to disease progression. In our dealing with NSCLC patients there are still many controversial opinions, and the meta-analyses are seldom the only way to find more effective treatment regimen, while the improvement in lung cancer treatment is a story of small steps.
Kovac
V
V
Institute of Oncology, SI-1000 Ljubljana, Slovenia. vkovac@onko-i.si
Smrdel
U
U
D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D002986:Clinical Trials as Topic; D003131:Combined Modality Therapy; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*