Chemotherapy and supportive care versus supportive care alone for advanced non-small cell lung cancer.


BACKGROUND:Since our individual patient data (IPD) meta-analysis of supportive care and chemotherapy for non-small cell lung cancer (NSCLC), published in 1995, many trials have been completed. We have carried out an updated IPD meta-analysis to assess newer regimens and determine conclusively the effect of chemotherapy. OBJECTIVES:To assess the effect on survival of supportive care and chemotherapy versus supportive care alone in advanced NSCLC. SEARCH STRATEGY:All randomised controlled trials (RCTs), published or unpublished. We searched bibliographic databases, trials registers, conference proceedings and reference lists of relevant trials. Searches were completed to November 2009. SELECTION CRITERIA:Trials had to have commenced accrual on or after 1 January 1965 and should have included patients with NSCLC who had received either chemotherapy and supportive care or supportive care alone. Patients should have not received any previous chemotherapy or had any prior malignancy. DATA COLLECTION AND ANALYSIS:For trials included in 1995 we sought updated follow up. For new trials we sought survival and baseline characteristics for all patients. We combined results from RCTs to calculate individual and pooled hazard ratios (HRs). MAIN RESULTS:We obtained data on 2714 patients from 16 RCTs. There were 1293 deaths among 1399 patients assigned supportive care and chemotherapy and 1240 among 1315 assigned supportive care alone. Results showed a significant benefit of chemotherapy (HR = 0.77; 95% CI 0.71 to 0.83, P < 0.0001), equivalent to a relative increase in survival of 23%, an absolute improvement in survival of 9% at 12 months, increasing survival from 20% to 29% or an absolute increase in median survival of 1.5 months (from 4.5 months to six months). There was no clear evidence that this effect was influenced by the drugs used (P = 0.63) or whether they were used as single agents or in combination (P = 0.40). Despite changes in patient demographics, the effect of chemotherapy in recent trials did not differ from those included previously (P = 0.77). There was no clear evidence of a difference in the relative effect of chemotherapy across patient subgroups. Quality of life could not be formally assessed. AUTHORS' CONCLUSIONS:All trials were of good methodological quality with no risk of bias. This meta-analysis of chemotherapy in the supportive care setting demonstrates that chemotherapy improves overall survival in all patients with advanced NSCLC. Patients who are fit enough and wish to receive it should be offered chemotherapy.


Non-Small Cell Lung Cancer Collaborative Group.




Has Abstract


2010-05-12 00:00:00








  • Electromechanical-assisted training for walking after stroke.

    abstract:BACKGROUND:Electromechanical- and robot-assisted gait-training devices are used in rehabilitation and might help to improve walking after stroke. This is an update of a Cochrane Review first published in 2007 and previously updated in 2017. OBJECTIVES:Primary • To determine whether electromechanical- and robot-assiste...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析


    authors: Mehrholz J,Thomas S,Kugler J,Pohl M,Elsner B

    更新日期:2020-10-22 00:00:00

  • Cervical assessment by ultrasound for preventing preterm delivery.

    abstract:BACKGROUND:Measurement of cervical length by ultrasound is predictive of preterm birth (PTB). There are three methods of ultrasound cervical assessment: transvaginal (TVU), transabdominal (TAU), and transperineal (TPU, also called translabial). Cervical length measured by TVU is a relatively new screening test, and has...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章


    authors: Berghella V,Saccone G

    更新日期:2019-09-25 00:00:00

  • Antibiotic prophylaxis for prevention of postoperative wound infection in adults undergoing open elective inguinal or femoral hernia repair.

    abstract:BACKGROUND:Inguinal or femoral hernia is a tissue protrusion in the groin region and has a cumulative incidence of 27% in adult men and of 3% in adult women. As most hernias become symptomatic over time, groin hernia repair is one of the most frequently performed surgical procedures worldwide. This type of surgery is c...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析


    authors: Orelio CC,van Hessen C,Sanchez-Manuel FJ,Aufenacker TJ,Scholten RJ

    更新日期:2020-04-21 00:00:00

  • Interventions for chronic abacterial prostatitis.

    abstract:BACKGROUND:Chronic abacterial prostatitis is a common disabling but enigmatic condition with a symptom complex of pelvic area pain and lower urinary tract symptoms. The scope of treatments recommended for chronic abacterial prostatitis is a testament to how little is known about what causes the condition and how to tre...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审


    authors: McNaughton C,Mac Donald R,Wilt T

    更新日期:2001-01-01 00:00:00

  • Lobeline for smoking cessation.

    abstract:BACKGROUND:Lobeline is a partial nicotine agonist, which has been used in a variety of commercially available preparations to help stop smoking. OBJECTIVES:The objective of this review was to assess the effects of lobeline on long term smoking cessation. SEARCH METHODS:We searched the Cochrane Tobacco Addiction Group...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审


    authors: Stead LF,Hughes JR

    更新日期:2012-02-15 00:00:00

  • Medically assisted nutrition for palliative care in adult patients.

    abstract:BACKGROUND:Many palliative care patients have a reduced oral intake during their illness. The management of this can include the provision of medically assisted nutrition with the aim of prolonging the length of life of a patient, improving their quality of life, or both. OBJECTIVES:To determine the effect of medicall...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审


    authors: Good P,Cavenagh J,Mather M,Ravenscroft P

    更新日期:2008-10-08 00:00:00

  • Plasma exchange for Guillain-Barré syndrome.

    abstract:BACKGROUND:Guillain-Barré syndrome (GBS) is an acute paralysing disease caused by peripheral nerve inflammation. This is an update of a review first published in 2001 and last updated in 2012. OBJECTIVES:To assess the effects of plasma exchange for treating GBS. SEARCH METHODS:On 18 January 2016 we searched the Cochr...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审


    authors: Chevret S,Hughes RA,Annane D

    更新日期:2017-02-27 00:00:00

  • Speech and language therapy versus placebo or no intervention for speech problems in Parkinson's disease.

    abstract:BACKGROUND:Parkinson's disease patients commonly suffer from speech and vocal problems including dysarthric speech, reduced loudness and loss of articulation. These symptoms increase in frequency and intensity with progression of the disease). Speech and language therapy (SLT) aims to improve the intelligibility of spe...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审


    authors: Herd CP,Tomlinson CL,Deane KH,Brady MC,Smith CH,Sackley CM,Clarke CE

    更新日期:2012-08-15 00:00:00

  • Posture and fluids for preventing post-dural puncture headache.

    abstract:BACKGROUND:Post-dural puncture headache (PDPH) is a common complication of lumbar punctures. Several theories have identified the leakage of cerebrospinal fluid (CSF) through the hole in the dura as a cause of this side effect. Therefore, it is necessary to take preventive measures to avoid this complication. Prolonged...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审


    authors: Arevalo-Rodriguez I,Ciapponi A,Munoz L,Roqué i Figuls M,Bonfill Cosp X

    更新日期:2013-07-12 00:00:00

  • Cognitive behaviour therapy for schizophrenia.

    abstract:BACKGROUND:Although medication is the mainstay of treatment for schizophrenia, always, some sort of informal or formal talking therapy is indicated. In cognitive behavioural therapy (CBT) links are made between the person's feelings and patterns of thinking which underpin their distress. OBJECTIVES:To review the effec...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审


    authors: Jones C,Cormac I,Mota J,Campbell C

    更新日期:2000-01-01 00:00:00

  • Long-term effects of weight-reducing drugs in people with hypertension.

    abstract:BACKGROUND:All major guidelines on antihypertensive therapy recommend weight loss; anti-obesity drugs may be able to help in this respect. OBJECTIVES: PRIMARY OBJECTIVES:To assess the long-term effects of pharmacologically induced reduction in body weight in adults with essential hypertension on all-cause mortality, ...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审


    authors: Siebenhofer A,Jeitler K,Horvath K,Berghold A,Posch N,Meschik J,Semlitsch T

    更新日期:2016-03-02 00:00:00

  • Mucolytic agents for chronic bronchitis or chronic obstructive pulmonary disease.

    abstract:BACKGROUND:Individuals with chronic bronchitis or chronic obstructive pulmonary disease (COPD) may suffer recurrent exacerbations with an increase in volume and/or purulence of sputum. Because of the personal and healthcare costs associated with exacerbations, any therapy that reduces the number of exacerbations is use...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审


    authors: Poole P,Black PN

    更新日期:2010-02-17 00:00:00

  • Endoscopic pneumatic dilation versus botulinum toxin injection in the management of primary achalasia.

    abstract:BACKGROUND:Achalasia is an oesophageal motility disorder, of unknown cause, which results in increased lower oesophageal sphincter (LOS) tone and symptoms of difficulty swallowing. Treatments are aimed at reducing the LOS tone. Current endoscopic therapeutic options include pneumatic dilation (PD) or botulinum toxin (B...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审


    authors: Leyden JE,Moss AC,MacMathuna P

    更新日期:2014-01-01 00:00:00

  • Recombinant human erythropoietin for chronic renal failure anaemia in pre-dialysis patients.

    abstract:BACKGROUND:Treatment with recombinant human erythropoietin (rHu EPO) in dialysis patients has been shown to be highly effective in terms of correcting anaemia and improving quality of life. There is debate concerning the benefits of rHu EPO use in pre-dialysis patients. There is a concern that rHu EPO may accelerate th...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审


    authors: Cody J,Daly C,Campbell M,Donaldson C,Grant A,Khan I,Pennington S,Vale L,Wallace S,MacLeod A

    更新日期:2001-01-01 00:00:00

  • Vasectomy occlusion techniques for male sterilization.

    abstract:BACKGROUND:Vasectomy is an increasingly popular and effective family planning method. A variety of vasectomy techniques are used worldwide, including vas occlusion techniques (excision and ligation, thermal or electrocautery, and mechanical and chemical occlusion methods), as well as vasectomy with vas irrigation or wi...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审


    authors: Cook LA,Van Vliet HA,Lopez LM,Pun A,Gallo MF

    更新日期:2014-03-30 00:00:00

  • Rituximab as maintenance therapy for patients with follicular lymphoma.

    abstract:BACKGROUND:Rituximab, a monoclonal anti-CD20 antibody, in combination with chemotherapy improves overall survival compared to chemotherapy alone when used for induction therapy for patients with newly diagnosed or relapsed indolent lymphoma. Randomised controlled trials have demonstrated that maintenance treatment with...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审


    authors: Vidal L,Gafter-Gvili A,Leibovici L,Shpilberg O

    更新日期:2009-04-15 00:00:00

  • Angiogenesis-inhibitors for metastatic thyroid cancer.

    abstract:BACKGROUND:Systemic cytostatic therapies for advanced, metastatic thyroid carcinomas have been poorly effective. Tumor growth and metastasis depend on blood supply and blood vessel formation (angiogenesis). Therefore, inhibition of angiogenesis may represent a promising target for cancer therapy. OBJECTIVES:To evaluat...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审


    authors: Tan A,Xia N,Gao F,Mo Z,Cao Y

    更新日期:2010-03-17 00:00:00

  • Phenytoin versus valproate monotherapy for partial onset seizures and generalised onset tonic-clonic seizures: an individual participant data review.

    abstract:BACKGROUND:Worldwide, phenytoin and valproate are commonly used antiepileptic drugs. It is generally believed that phenytoin is more effective for partial onset seizures, and that valproate is more effective for generalised onset tonic-clonic seizures (with or without other generalised seizure types). This review is on...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审


    authors: Nolan SJ,Marson AG,Weston J,Tudur Smith C

    更新日期:2016-04-28 00:00:00

  • WITHDRAWN: Iodine supplementation for preventing iodine deficiency disorders in children.

    abstract:BACKGROUND:Iodine deficiency is the main cause of potentially preventable mental retardation in childhood, as well as causing goitre and hypothyroidism in people of all ages. It is still prevalent in large parts of the world. OBJECTIVES:To assess the effects of iodine supplementation overall, and of different forms an...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章


    authors: Angermayr L,Clar C

    更新日期:2018-11-29 00:00:00

  • Supplemental oxygen for the treatment of prethreshold retinopathy of prematurity.

    abstract:BACKGROUND:Oxygen has long been implicated in the pathogenesis of retinopathy of prematurity (ROP) and is rigorously monitored in today's neonatal intensive care units. Recent research using a feline model has shown an improvement in ROP outcome of kittens treated with supplemental oxygen. Current treatment for ROP by ...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审


    authors: Lloyd J,Askie L,Smith J,Tarnow-Mordi W

    更新日期:2003-01-01 00:00:00

  • Short-acting insulin analogues versus regular human insulin for adult, non-pregnant persons with type 2 diabetes mellitus.

    abstract:BACKGROUND:The use of short-acting insulin analogues (insulin lispro, insulin aspart, insulin glulisine) for adult, non-pregnant people with type 2 diabetes is still controversial, as reflected in many scientific debates. OBJECTIVES:To assess the effects of short-acting insulin analogues compared to regular human insu...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析


    authors: Fullerton B,Siebenhofer A,Jeitler K,Horvath K,Semlitsch T,Berghold A,Gerlach FM

    更新日期:2018-12-17 00:00:00

  • Oral vitamin B12 versus intramuscular vitamin B12 for vitamin B12 deficiency.

    abstract:BACKGROUND:Vitamin B12 deficiency is common and rises with age. Most people with vitamin B12 deficiency are treated in primary care with intramuscular vitamin B12 which is a considerable source of work for health care professionals. Several case control and case series studies have reported equal efficacy of oral admin...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审


    authors: Vidal-Alaball J,Butler CC,Cannings-John R,Goringe A,Hood K,McCaddon A,McDowell I,Papaioannou A

    更新日期:2005-07-20 00:00:00

  • Ergonomic interventions for preventing work-related musculoskeletal disorders of the upper limb and neck among office workers.

    abstract:BACKGROUND:Work-related upper limb and neck musculoskeletal disorders (MSDs) are one of the most common occupational disorders worldwide. Studies have shown that the percentage of office workers that suffer from MSDs ranges from 20 to 60 per cent. The direct and indirect costs of work-related upper limb MSDs have been ...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析


    authors: Hoe VC,Urquhart DM,Kelsall HL,Zamri EN,Sim MR

    更新日期:2018-10-23 00:00:00

  • Antiarrhythmics for maintaining sinus rhythm after cardioversion of atrial fibrillation.

    abstract:BACKGROUND:Atrial fibrillation is the most frequent sustained arrhythmia. Atrial fibrillation often recurs after restoration of normal sinus rhythm. Antiarrhythmic drugs have been widely used to prevent recurrence. This is an update of a review previously published in 2006, 2012 and 2015. OBJECTIVES:To determine the e...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章


    authors: Valembois L,Audureau E,Takeda A,Jarzebowski W,Belmin J,Lafuente-Lafuente C

    更新日期:2019-09-04 00:00:00

  • Surgery versus thrombolysis for initial management of acute limb ischaemia.

    abstract:BACKGROUND:Both peripheral arterial thrombolysis and surgery can be used in the management of peripheral arterial ischaemia. Much is known about the indications, risks, and benefits of thrombolysis. However, whether thrombolysis works better than surgery for initial management of acute limb ischaemia remains unknown. T...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析


    authors: Darwood R,Berridge DC,Kessel DO,Robertson I,Forster R

    更新日期:2018-08-10 00:00:00

  • Care delivery and self-management strategies for children with epilepsy.

    abstract:BACKGROUND:In response to criticism that epilepsy care for children has little impact, healthcare professionals and administrators have developed various service models and strategies to address perceived inadequacies. OBJECTIVES:To assess the effects of any specialised or dedicated intervention for epilepsy versus us...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审


    authors: Fleeman N,Bradley PM

    更新日期:2018-03-01 00:00:00

  • Ocriplasmin for symptomatic vitreomacular adhesion.

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    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审


    authors: Neffendorf JE,Kirthi V,Pringle E,Jackson TL

    更新日期:2017-10-17 00:00:00

  • Medical interventions for primary open angle glaucoma and ocular hypertension.

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    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审


    authors: Vass C,Hirn C,Sycha T,Findl O,Bauer P,Schmetterer L

    更新日期:2007-10-17 00:00:00

  • Immobilisation and functional treatment for acute lateral ankle ligament injuries in adults.

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    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审


    authors: Kerkhoffs GM,Rowe BH,Assendelft WJ,Kelly K,Struijs PA,van Dijk CN

    更新日期:2002-01-01 00:00:00

  • Splenectomy versus conservative management for acute sequestration crises in people with sickle cell disease.

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    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审


    authors: Owusu-Ofori S,Remmington T

    更新日期:2017-11-07 00:00:00