title: Chemotherapy alone versus chemotherapy followed by consolidative radiotherapy for limited-stage aggressive non-Hodgkin's lymphoma: a meta-analysis of randomized controlled trials.
abstract: OBJECTIVE
  To systematically investigate chemotherapy versus chemotherapy followed by involved field radiotherapy for limited-stage aggressive non-Hodgkin's lymphoma.
  
  
  METHODS
  A systematic literature search of Pubmed, EMBASE, and the Cochrane central register of controlled trials was performed. Data from all randomized controlled trials comparing chemotherapy alone with chemotherapy followed by involved field radiotherapy in patients with limited-stage aggressive non-Hodgkin's lymphoma was collaborate. The primary outcome was overall survival; secondary outcomes were event-free survival and cumulative incidences of toxicity.
  
  
  RESULTS
  Three randomized controlled trials, with 1263 participants in total, were analyzed. Median follow-up was 11 years. Patients receiving chemotherapy followed by involved field radiotherapy had a significant benefit on event-free survival (hazards ratio [HR]=1.47, 95% confidence interval [CI]: 1.14 to 1.90; P=0.003), but not improved overall survival (HR=1.00, 95% CI: 0.80 to 1.25; P=0.978) at 8 years, in relation to those in the chemotherapy alone arm. There were great differences in the reporting of cumulative incidences of toxicity.
  
  
  CONCLUSIONS
  Chemotherapy followed by involved field radiotherapy, as compared with chemotherapy alone, is associated with better event-free survival, but no survival benefit is observed for patients for limited-stage aggressive non-Hodgkin's lymphoma. These results needed to be confirmed by high quality trials and further studies in the East.
authors.affiliation: Radiation, No. 303 hospital of PLA, No. 52 Zhiwu Road, Nanning, China.
authors.forename: Z
authors.initials: Z
authors.lastname: Huang
authors.forename: Z
authors.initials: Z
authors.lastname: Xu
authors.forename: Y
authors.initials: Y
authors.lastname: Zhou
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use*; D059248:Chemoradiotherapy; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000401:mortality / Q000473:pathology / Q000628:therapy*
chemical_list: D000970:Antineoplastic Agents
keywords: Chemotherapy; Chimiothérapie; Lymphomes non hodgkinien; Meta-analysis; Méta-analyse; Non-Hodgkin's lymphoma; Radiotherapy; Radiothérapie