Critical appraisal:De Ruysscher D, Pijls-Johannesma M, Bentzen SM, Minken A, Wanders R, Lutgens L, et al 2006
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Critical Appraisal
Article being appraised
De Ruysscher D, Pijls-Johannesma M, Bentzen SM, Minken A, Wanders R, Lutgens L, et al. Time between the first day of chemotherapy and the last day of chest radiation is the most important predictor of survival in limited-disease small-cell lung cancer. J Clin Oncol 2006 Mar 1;24(7):1057-63 Available from: http://www.ncbi.nlm.nih.gov/pubmed/16505424.
Applicable clinical question
Key Facts
Study Design
systematic review — Randomised phase III
Number of Patients:
1056
Evidence ratings
Level of evidence
I
Risk of bias
| Low risk of bias | Comments: Appropriate analysis |
Size of effect
| 1 | Reason for decision: There was a significantly higher 5-year survival rate in the shorter SER arms (relative risk [RR] = 0.62; 95% CI, 0.49 to 0.80; P = .0003), which was more than 20% when the SER was less than 30 days (upper bound of 95% CI, 90 days). |
Relevance of evidence
| 1 | Additional comments: There was a significantly higher 5-year survival rate in the shorter SER arms (relative risk [RR] = 0.62; 95% CI, 0.49 to 0.80; P = .0003), which was more than 20% when the SER was less than 30 days (upper bound of 95% CI, 90 days). A low SER was associated with a higher incidence of severe esophagitis (RR = 0.55; 95% CI, 0.42 to 073; P < .0001). Each week of extension of the SER beyond that of the study arm with the shortest SER resulted in an overall absolute decrease in the 5-year survival rate of 1.83% +/- 0.18% (95% CI).A low time between the first day of chemotherapy and the last day of chest radiotherapy is associated with improved survival in LD-SCLC patients |
Result of appraisal
Included
Completed by
Associate Professor Michael Michael MBBS(Hons), BSc(Hons), MD, FRACP
This appraisal has been completed.
- Article
- De Ruysscher D, Pijls-Johannesma M, Bentzen SM, Minken A, Wanders R, Lutgens L, et al. Time between the first day of chemotherapy and the last day of chest radiation is the most important predictor of survival in limited-disease small-cell lung cancer. J Clin Oncol 2006 Mar 1;24(7):1057-63 Available from: http://www.ncbi.nlm.nih.gov/pubmed/16505424.
- Assigned to
- User:Michael.michael
- Topic area
- Guidelines:Lung cancer/Treatment/Small cell limited stage
- Clinical question
Section below only relevant for Cancer Council Project Officer