Meta-Analysis

. 2021 Mar:156:281-293.

doi: 10.1016/j.radonc.2021.01.013. Epub 2021 Jan 27.

Meta-analysis of chemotherapy in head and neck cancer (MACH-NC): An update on 107 randomized trials and 19,805 patients, on behalf of MACH-NC Group

Benjamin Lacas¹, Alexandra Carmel², Cécile Landais², Stuart J Wong³, Lisa Licitra⁴, Jeffrey S Tobias⁵, Barbara Burtness⁶, Maria Grazia Ghi⁷, Ezra E W Cohen⁸, Cai Grau⁹, Gregory Wolf¹⁰, Ricardo Hitt¹¹, Renzo Corvò¹², Volker Budach¹³, Shaleen Kumar¹⁴, Sarbani Ghosh Laskar¹⁵, Jean-Jacques Mazeron¹⁶, Lai-Ping Zhong¹⁷, Werner Dobrowsky¹⁸, Pirus Ghadjar¹⁹, Carlo Fallai⁷, Branko Zakotnik¹⁰, Atul Sharma²⁰, René-Jean Bensadoun²¹, Maria Grazia Ruo Redda²², Séverine Racadot²³, George Fountzilas²⁴, David Brizel²⁵, Paolo Rovea²⁶, Athanassios Argiris²⁷, Zoltán Takácsi Nagy²⁸, Ju-Whei Lee²⁹, Catherine Fortpied³⁰, Jonathan Harris³¹, Jean Bourhis³², Anne Aupérin¹, Pierre Blanchard³³, Jean-Pierre Pignon¹; MACH-NC Collaborative Group

Collaborators, Affiliations

Collaborators

MACH-NC Collaborative Group:
D J Adelstein³⁴, M Alfonsi³⁵, Y Belkacemi³⁶, V Bar-Ad³⁷, J Bernier³⁸, Å Bratland³⁹, G Calais⁴⁰, B Campbell⁴¹, J Caudell⁴², S Chabaud⁴³, E Chamorey⁴⁴, D Chaukar⁴⁵, K N Choi⁴⁶, O Choussy⁴⁷, L Collette⁴⁸, J J Cruz⁴⁹, C Dani⁵⁰, E Dauzier⁵¹, A A Forastiere⁵², P Garaud⁵³, V Gregoire⁵⁴, A Hackshaw⁵⁵, E Haddad⁵⁶, B G Haffty⁵⁷, A Hansen⁵⁸, S Hayoz⁵⁹, J C Horiot⁶⁰, B Jeremic⁶¹, T G Karrison⁶², J A Langendijk⁶³, M Lapeyre⁶⁴, E Lartigau⁶⁵, T Leong⁶⁶, Q T Le⁶⁷, P P Y Lee⁶⁸, F Lewin⁶⁹, A Lin⁷⁰, A Lopes²⁰, S Mehta⁷¹, J Moon⁷², E Moyal⁷³, B V Occéan¹⁸, P Olmi⁷⁴, R Orecchia⁷⁵, B O'Sullivan²³, J Overgaard⁷⁶, C Petit¹⁸, H Quon¹⁹, G Sanguineti⁷⁷, T Satar¹⁸, J Simes⁷⁸, C Simon⁷⁹, C Sire⁸⁰, S Staar⁸¹, C Stromberger⁸², P Strojan⁸³, S Temam¹⁸, D Thomson⁸⁴, A Timochenko⁸⁵, V Torri⁸⁶, V Tseroni⁸⁷, J Vermorken⁸⁸, E E Vokes⁸⁹, J Waldron²³, K D Wernecke⁸², J Widder⁹⁰, B Zackrisson⁹¹

Affiliations

¹ Cleveland Clinic Foundation, OH, USA; Institut Saint Catherine, France.
² Cleveland Clinic Foundation, OH, USA.
³ CHU Henri Mondor, France.
⁴ Thomas Jefferson University Hospital, USA.
⁵ Genolier Swiss Oncology Network, Switzerland.
⁶ Oslo University Hospital, Norway.
⁷ Centre Hospitalier Universitaire de Tours, France.
⁸ Medical College of Wisconsin, USA.
⁹ H. Lee Moffitt Cancer Center & Research Institute, USA.
¹⁰ Centre Léon Bérard, France.
¹¹ Centre Antoine Lacassagne, France.
¹² Tata Memorial Centre Advanced Centre for Treatment, Research and Education in Cancer, India.
¹³ State University of New York Downstate Medical Center, USA.
¹⁴ Institut Curie, France.
¹⁵ EORTC Headquarters, Belgium.
¹⁶ Spanish Head and Neck Cancer Cooperative Group, Spain.
¹⁷ Ospedale Policlinico San Martino, Genoa, Italy.
¹⁸ Gustave Roussy, France.
¹⁹ Johns Hopkins Univ/Sidney Kimmel Cancer Center, MD, USA.
²⁰ Cancer Research UK & UCL Cancer Trials Centre, UK.
²¹ Hôpital Henri Mondor, Créteil, France.
²² Rutgers Robert Wood Johnson and NJ Medical School, NJ, USA.
²³ Princess Margaret Cancer Centre/University of Toronto, Ontario, Canada.
²⁴ SAKK Coordinating Center, Switzerland.
²⁵ Centre Georges François Leclerc, France.
²⁶ Kragulevac University Hospital, Yugoslavia, Serbia.
²⁷ University of Chicago, IL, USA.
²⁸ University Medical Center Groningen, Netherlands.
²⁹ Centre Jean Perrin, France.
³⁰ Centre Oscar Lambret, France.
³¹ Rollins School of Public Health, Emory University, GA, USA.
³² Institut Saint Catherine, France; Stanford University School of Medicine, CA, USA.
³³ Cleveland Clinic Foundation, OH, USA; Institut Saint Catherine, France; University of Texas-MD Anderson Cancer Center, USA. Electronic address: pierre.blanchard@gustavetoussy.fr.
³⁴ Service de Biostatistique et d'Epidémiologie, Gustave Roussy, Oncostat U1018 INSERM, labeled Ligue Contre le Cancer, Université Paris-Saclay, Villejuif, France.
³⁵ Groupe d'Oncologie Radiothérapie Tête Et Cou, Tours, France.
³⁶ Department of Medicine, Medical College of Wisconsin, Milwaukee, USA.
³⁷ Department of Medical Oncology 3, Fondazione IRCCS-Istituto Nazionale dei Tumori, Milano and University of Milan, Italy.
³⁸ Department of Radiotherapy, University College London Hospital, UK.
³⁹ Department of Internal Medicine and Yale Cancer Center, Yale University, New Haven, USA.
⁴⁰ Oncology Unit 2, Veneto Oncology Institute-IRCCS, Padua, Italy.
⁴¹ UC San Diego, Moores Cancer Center, California, USA.
⁴² Department of Experimental Clinical Oncology, Aarhus, Denmark.
⁴³ Department of Otolaryngology, University of Michigan, Ann Arbor, USA.
⁴⁴ Servicio Oncologia Medica, Hospital Universitario Severo Ochoa, Madrid, Spain.
⁴⁵ Department of Radiation Oncology, Ospedale Policlinico San Martino and University of Genoa, Genoa, Italy.
⁴⁶ Department of Radiation Oncology, Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.
⁴⁷ Department of Radiotherapy, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India.
⁴⁸ Department of Radiation Oncology, Tata Memorial Hospital, Homi Bhabha National Institute Mumbai, India.
⁴⁹ Département de radiothérapie, hôpital Pitié-Salpêtrière, Paris, France.
⁵⁰ Department of Oral and Maxillofacial-Head and Neck Oncology, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
⁵¹ Dept. Clinical Oncology, Northern Centre for Cancer Care, Freeman Hospital, Newcastle upon Tyne, United Kingdom.
⁵² Department of Radiation Oncology, Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany and SAKK Coordinating Center, Bern, Switzerland.
⁵³ Department of Radiotherapy, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy.
⁵⁴ Department of Medical Oncology, Institute of Oncology, Ljubljana, Slovenia.
⁵⁵ Departments of Medical Oncology, Dr BR Ambedkar Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India.
⁵⁶ Departments of Radiation Oncology, Centre Antoine Lacassagne, Nice, France.
⁵⁷ Department of Radiation Oncology, Mauriziano Umberto I Hospital, University of Turin School of Medicine, Turin, Italy.
⁵⁸ Department of Radiation Oncology, Centre Léon Bérard, Lyon, France.
⁵⁹ Aristotle University of Thessaloniki School of Medicine, Thessaloniki, Greece.
⁶⁰ Departments of Radiation Oncology, Duke University Medical Center, Durham, USA.
⁶¹ Radiation Oncology Unit, San Giovanni Antica Sede Hospital, Turin, Italy.
⁶² Division of Hematology-Oncology, Department of Medicine, University of Pittsburgh, USA.
⁶³ Center of Radiotherapy, National Institute of Oncology, Department of Oncology, Semmelweis University, Budapest, Hungary.
⁶⁴ Dana Farber Cancer Institute - ECOG-ACRIN Biostatistics Center, Boston, USA.
⁶⁵ EORTC Headquarters, Brussels, Belgium.
⁶⁶ NRG Oncology Statistics and Data Management Center, American College of Radiology, Philadelphia, USA.
⁶⁷ Department of Radiotherapy, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
⁶⁸ Department of Radiation Therapy, Gustave Roussy Cancer Campus, Université Paris-Sud, Université Paris-Saclay, Villejuif, France.
⁶⁹ Huddinge University Hospital, Sweden.
⁷⁰ University of Pennsylvania Medical Center, USA.
⁷¹ Department of Surgery, Sarla Hospital, India.
⁷² SWOG Statistical Center, WA, USA.
⁷³ IUCT Oncopole - CLCC Institut Claudius Regaud, France.
⁷⁴ Università di Firenze, Italy.
⁷⁵ IRCCS Istituto Europeo di Oncologia, Italy.
⁷⁶ Aarhus University Hospital, Denmark.
⁷⁷ IRCCS Regina Elena National Cancer Institute, Rome, Italy.
⁷⁸ NHMRC Clinical Trials Center, Australia.
⁷⁹ Centre Hospitalier Universitaire Vaudois, Switzerland.
⁸⁰ Hôpital Bretagne Sud, France.
⁸¹ University of Cologne, Germany.
⁸² Charité Universitätsmedizin, Germany.
⁸³ Institute of Oncology, Slovenia.
⁸⁴ The Christie NHS FT, UK.
⁸⁵ CHU de St-Etienne, France.
⁸⁶ Mario Negri, Italy.
⁸⁷ San Giovanni Antica Sede Hospital, Italy.
⁸⁸ Antwerp University Hospital, Belgium.
⁸⁹ University of Chicago Medical Center, IL, USA.
⁹⁰ Medical University of Vienna, Austria.
⁹¹ Umeå University, Sweden.

PMID: 33515668
PMCID: PMC8386522
DOI: 10.1016/j.radonc.2021.01.013

Meta-Analysis

Meta-analysis of chemotherapy in head and neck cancer (MACH-NC): An update on 107 randomized trials and 19,805 patients, on behalf of MACH-NC Group

Benjamin Lacas et al. Radiother Oncol. 2021 Mar.

. 2021 Mar:156:281-293.

doi: 10.1016/j.radonc.2021.01.013. Epub 2021 Jan 27.

Authors

Collaborators

MACH-NC Collaborative Group:
D J Adelstein³⁴, M Alfonsi³⁵, Y Belkacemi³⁶, V Bar-Ad³⁷, J Bernier³⁸, Å Bratland³⁹, G Calais⁴⁰, B Campbell⁴¹, J Caudell⁴², S Chabaud⁴³, E Chamorey⁴⁴, D Chaukar⁴⁵, K N Choi⁴⁶, O Choussy⁴⁷, L Collette⁴⁸, J J Cruz⁴⁹, C Dani⁵⁰, E Dauzier⁵¹, A A Forastiere⁵², P Garaud⁵³, V Gregoire⁵⁴, A Hackshaw⁵⁵, E Haddad⁵⁶, B G Haffty⁵⁷, A Hansen⁵⁸, S Hayoz⁵⁹, J C Horiot⁶⁰, B Jeremic⁶¹, T G Karrison⁶², J A Langendijk⁶³, M Lapeyre⁶⁴, E Lartigau⁶⁵, T Leong⁶⁶, Q T Le⁶⁷, P P Y Lee⁶⁸, F Lewin⁶⁹, A Lin⁷⁰, A Lopes²⁰, S Mehta⁷¹, J Moon⁷², E Moyal⁷³, B V Occéan¹⁸, P Olmi⁷⁴, R Orecchia⁷⁵, B O'Sullivan²³, J Overgaard⁷⁶, C Petit¹⁸, H Quon¹⁹, G Sanguineti⁷⁷, T Satar¹⁸, J Simes⁷⁸, C Simon⁷⁹, C Sire⁸⁰, S Staar⁸¹, C Stromberger⁸², P Strojan⁸³, S Temam¹⁸, D Thomson⁸⁴, A Timochenko⁸⁵, V Torri⁸⁶, V Tseroni⁸⁷, J Vermorken⁸⁸, E E Vokes⁸⁹, J Waldron²³, K D Wernecke⁸², J Widder⁹⁰, B Zackrisson⁹¹

Affiliations

¹ Cleveland Clinic Foundation, OH, USA; Institut Saint Catherine, France.
² Cleveland Clinic Foundation, OH, USA.
³ CHU Henri Mondor, France.
⁴ Thomas Jefferson University Hospital, USA.
⁵ Genolier Swiss Oncology Network, Switzerland.
⁶ Oslo University Hospital, Norway.
⁷ Centre Hospitalier Universitaire de Tours, France.
⁸ Medical College of Wisconsin, USA.
⁹ H. Lee Moffitt Cancer Center & Research Institute, USA.
¹⁰ Centre Léon Bérard, France.
¹¹ Centre Antoine Lacassagne, France.
¹² Tata Memorial Centre Advanced Centre for Treatment, Research and Education in Cancer, India.
¹³ State University of New York Downstate Medical Center, USA.
¹⁴ Institut Curie, France.
¹⁵ EORTC Headquarters, Belgium.
¹⁶ Spanish Head and Neck Cancer Cooperative Group, Spain.
¹⁷ Ospedale Policlinico San Martino, Genoa, Italy.
¹⁸ Gustave Roussy, France.
¹⁹ Johns Hopkins Univ/Sidney Kimmel Cancer Center, MD, USA.
²⁰ Cancer Research UK & UCL Cancer Trials Centre, UK.
²¹ Hôpital Henri Mondor, Créteil, France.
²² Rutgers Robert Wood Johnson and NJ Medical School, NJ, USA.
²³ Princess Margaret Cancer Centre/University of Toronto, Ontario, Canada.
²⁴ SAKK Coordinating Center, Switzerland.
²⁵ Centre Georges François Leclerc, France.
²⁶ Kragulevac University Hospital, Yugoslavia, Serbia.
²⁷ University of Chicago, IL, USA.
²⁸ University Medical Center Groningen, Netherlands.
²⁹ Centre Jean Perrin, France.
³⁰ Centre Oscar Lambret, France.
³¹ Rollins School of Public Health, Emory University, GA, USA.
³² Institut Saint Catherine, France; Stanford University School of Medicine, CA, USA.
³³ Cleveland Clinic Foundation, OH, USA; Institut Saint Catherine, France; University of Texas-MD Anderson Cancer Center, USA. Electronic address: pierre.blanchard@gustavetoussy.fr.
³⁴ Service de Biostatistique et d'Epidémiologie, Gustave Roussy, Oncostat U1018 INSERM, labeled Ligue Contre le Cancer, Université Paris-Saclay, Villejuif, France.
³⁵ Groupe d'Oncologie Radiothérapie Tête Et Cou, Tours, France.
³⁶ Department of Medicine, Medical College of Wisconsin, Milwaukee, USA.
³⁷ Department of Medical Oncology 3, Fondazione IRCCS-Istituto Nazionale dei Tumori, Milano and University of Milan, Italy.
³⁸ Department of Radiotherapy, University College London Hospital, UK.
³⁹ Department of Internal Medicine and Yale Cancer Center, Yale University, New Haven, USA.
⁴⁰ Oncology Unit 2, Veneto Oncology Institute-IRCCS, Padua, Italy.
⁴¹ UC San Diego, Moores Cancer Center, California, USA.
⁴² Department of Experimental Clinical Oncology, Aarhus, Denmark.
⁴³ Department of Otolaryngology, University of Michigan, Ann Arbor, USA.
⁴⁴ Servicio Oncologia Medica, Hospital Universitario Severo Ochoa, Madrid, Spain.
⁴⁵ Department of Radiation Oncology, Ospedale Policlinico San Martino and University of Genoa, Genoa, Italy.
⁴⁶ Department of Radiation Oncology, Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.
⁴⁷ Department of Radiotherapy, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India.
⁴⁸ Department of Radiation Oncology, Tata Memorial Hospital, Homi Bhabha National Institute Mumbai, India.
⁴⁹ Département de radiothérapie, hôpital Pitié-Salpêtrière, Paris, France.
⁵⁰ Department of Oral and Maxillofacial-Head and Neck Oncology, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
⁵¹ Dept. Clinical Oncology, Northern Centre for Cancer Care, Freeman Hospital, Newcastle upon Tyne, United Kingdom.
⁵² Department of Radiation Oncology, Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany and SAKK Coordinating Center, Bern, Switzerland.
⁵³ Department of Radiotherapy, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy.
⁵⁴ Department of Medical Oncology, Institute of Oncology, Ljubljana, Slovenia.
⁵⁵ Departments of Medical Oncology, Dr BR Ambedkar Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India.
⁵⁶ Departments of Radiation Oncology, Centre Antoine Lacassagne, Nice, France.
⁵⁷ Department of Radiation Oncology, Mauriziano Umberto I Hospital, University of Turin School of Medicine, Turin, Italy.
⁵⁸ Department of Radiation Oncology, Centre Léon Bérard, Lyon, France.
⁵⁹ Aristotle University of Thessaloniki School of Medicine, Thessaloniki, Greece.
⁶⁰ Departments of Radiation Oncology, Duke University Medical Center, Durham, USA.
⁶¹ Radiation Oncology Unit, San Giovanni Antica Sede Hospital, Turin, Italy.
⁶² Division of Hematology-Oncology, Department of Medicine, University of Pittsburgh, USA.
⁶³ Center of Radiotherapy, National Institute of Oncology, Department of Oncology, Semmelweis University, Budapest, Hungary.
⁶⁴ Dana Farber Cancer Institute - ECOG-ACRIN Biostatistics Center, Boston, USA.
⁶⁵ EORTC Headquarters, Brussels, Belgium.
⁶⁶ NRG Oncology Statistics and Data Management Center, American College of Radiology, Philadelphia, USA.
⁶⁷ Department of Radiotherapy, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
⁶⁸ Department of Radiation Therapy, Gustave Roussy Cancer Campus, Université Paris-Sud, Université Paris-Saclay, Villejuif, France.
⁶⁹ Huddinge University Hospital, Sweden.
⁷⁰ University of Pennsylvania Medical Center, USA.
⁷¹ Department of Surgery, Sarla Hospital, India.
⁷² SWOG Statistical Center, WA, USA.
⁷³ IUCT Oncopole - CLCC Institut Claudius Regaud, France.
⁷⁴ Università di Firenze, Italy.
⁷⁵ IRCCS Istituto Europeo di Oncologia, Italy.
⁷⁶ Aarhus University Hospital, Denmark.
⁷⁷ IRCCS Regina Elena National Cancer Institute, Rome, Italy.
⁷⁸ NHMRC Clinical Trials Center, Australia.
⁷⁹ Centre Hospitalier Universitaire Vaudois, Switzerland.
⁸⁰ Hôpital Bretagne Sud, France.
⁸¹ University of Cologne, Germany.
⁸² Charité Universitätsmedizin, Germany.
⁸³ Institute of Oncology, Slovenia.
⁸⁴ The Christie NHS FT, UK.
⁸⁵ CHU de St-Etienne, France.
⁸⁶ Mario Negri, Italy.
⁸⁷ San Giovanni Antica Sede Hospital, Italy.
⁸⁸ Antwerp University Hospital, Belgium.
⁸⁹ University of Chicago Medical Center, IL, USA.
⁹⁰ Medical University of Vienna, Austria.
⁹¹ Umeå University, Sweden.

PMID: 33515668
PMCID: PMC8386522
DOI: 10.1016/j.radonc.2021.01.013

Abstract

Background and purpose: The Meta-Analysis of Chemotherapy in squamous cell Head and Neck Cancer (MACH-NC) demonstrated that concomitant chemotherapy (CT) improved overall survival (OS) in patients without distant metastasis. We report the updated results.

Materials and methods: Published or unpublished randomized trials including patients with non-metastatic carcinoma randomized between 1965 and 2016 and comparing curative loco-regional treatment (LRT) to LRT + CT or adding another timing of CT to LRT + CT (main question), or comparing induction CT + radiotherapy to radiotherapy + concomitant (or alternating) CT (secondary question) were eligible. Individual patient data were collected and combined using a fixed-effect model. OS was the main endpoint.

Results: For the main question, 101 trials (18951 patients, median follow-up of 6.5 years) were analyzed. For both questions, there were 16 new (2767 patients) and 11 updated trials. Around 90% of the patients had stage III or IV disease. Interaction between treatment effect on OS and the timing of CT was significant (p < 0.0001), the benefit being limited to concomitant CT (HR: 0.83, 95%CI [0.79; 0.86]; 5(10)-year absolute benefit of 6.5% (3.6%)). Efficacy decreased as patients age increased (p_trend = 0.03). OS was not increased by the addition of induction (HR = 0.96 [0.90; 1.01]) or adjuvant CT (1.02 [0.92; 1.13]). Efficacy of induction CT decreased with poorer performance status (p_trend = 0.03). For the secondary question, eight trials (1214 patients) confirmed the superiority of concomitant CT on OS (HR = 0.84 [0.74; 0.95], p = 0.005).

Conclusion: The update of MACH-NC confirms the benefit and superiority of the addition of concomitant CT for non-metastatic head and neck cancer.

Keywords: Chemotherapy; Head and Neck Cancer; Individual Patient Data; Meta-analysis; Radiotherapy; Randomised Clinical Trials.

PubMed Disclaimer

Conflict of interest statement

Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

**Fig. 1.**
Efficacy of loco-regional treatment plus chemotherapy versus loco-regional treatment alone by timing of chemotherapy. (A) Overall survival (see web-Figure 2, 10 and 11 for detailed HR plot), (B) Event-free survival. Dotted line and centre of the black diamond are the overall pooled hazard ratio. Horizontal tip of the diamond is the 95% confidence interval. Centre of the squares correspond are the HR of each chemotherapy timing. Area of the square is proportional to the number of deaths in each group of trials. CI: Confidence Interval, CT: Chemotherapy, HR: Hazard Ratio, LRT: Loco-Regional Treatment, O-E: Observed minus Expected.

**Fig. 2.**
Overall survival – Survival curves of loco-regional treatment plus chemotherapy and loco-regional treatment alone by timing. (A) Induction chemotherapy, (B) Concomitant chemotherapy, (C) Adjuvant chemotherapy. CI: confidence interval, CT: Chemotherapy, LRT: Loco-Regional Treatment.

**Fig. 3.**
Subgroup analyses for loco-regional treatment plus chemotherapy versus loco-regional treatment alone. (A) By performance status for induction chemotherapy, (B) By age for concomitant chemotherapy. CI: Confidence Interval, CT: Chemotherapy, LRT: Loco-Regional Treatment, PS: Performance Status.

See this image and copyright information in PMC

References

1. Pignon J-P, Bourhis J, Domenge C, Designé L. Chemotherapy added to locoregional treatment for head and neck squamous-cell carcinoma: three meta-analyses of updated individual data. MACH-NC Collaborative Group. Meta-Analysis of Chemotherapy on Head and Neck Cancer. Lancet 2000;355:949–55. - PubMed
1. Pignon J-P, le Maître A, Maillard E, Bourhis J. MACH-NC Collaborative Group. Meta-analysis of chemotherapy in head and neck cancer (MACH-NC): an update on 93 randomised trials and 17,346 patients. Radiother Oncol 2009;92:4–14. 10.1016/j.radonc.2009.04.014. - DOI - PubMed
1. Blanchard P, Bourhis J, Lacas B, Posner MR, Vermorken JB, Hernandez JJC, et al.Taxane-cisplatin-fluorouracil as induction chemotherapy in locally advanced head and neck cancers: an individual patient data meta-analysis of the Meta-Analysis of Chemotherapy in Head and Neck Cancer Group. J Clin Oncol 2013;31:2854–60. 10.1200/JCO.2012.47.7802. - DOI - PubMed
1. Dauzier E, Lacas B, Blanchard P, Le Q-T, Simon C, Wolf G, et al.Role of chemotherapy in 5000 patients with head and neck cancer treated by curative surgery: A subgroup analysis of the meta-analysis of chemotherapy in head and neck cancer. Oral Oncol 2019;95:106–14. - PMC - PubMed
1. Mehanna H, Robinson M, Hartley A, Kong A, Foran B, Fulton-Lieuw T, et al.Radiotherapy plus cisplatin or cetuximab in low-risk human papillomavirus-positive oropharyngeal cancer (De-ESCALaTE HPV): an open-label randomised controlled phase 3 trial. Lancet 2019;393:51–60. 10.1016/S0140-6736(18)32752-1. - DOI - PMC - PubMed

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Meta-analysis of chemotherapy in head and neck cancer (MACH-NC): An update on 107 randomized trials and 19,805 patients, on behalf of MACH-NC Group

Collaborators

Affiliations

Meta-analysis of chemotherapy in head and neck cancer (MACH-NC): An update on 107 randomized trials and 19,805 patients, on behalf of MACH-NC Group

Authors

Collaborators

Affiliations

Abstract

Conflict of interest statement

Figures

References

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MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources

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Medical