Planned preoperative radiation therapy in muscle invasive bladder cancer; Results of a meta-analysis

Michael Huncharek, Joshua Muscat, J. F. Geschwind

Research output: Contribution to journalArticle

44 Citations (Scopus)

Abstract

Background. The role of pre-operative radiation therapy in the treatment of muscle invasive bladder cancer is unclear. The objective of this report is to present a meta-analysis of the published clinical trial data on this topic to determine whether pre-operative radiation improves survival in patients with this disease. Methods. Data from 5 randomized trials were pooled using the meta-analytic techniques previously described by Peto et al. Three and five year survival were compared between patients receiving pre-operative radiation therapy followed by cystectomy versus patients treated with cystectomy alone. Results. A summary odds ratio was calculated following a statistical analysis showing a lack of heterogeneity among the included studies in terms of their estimate of effect. The calculated Peto odds ratio was 0.71 favoring the use of pre-operative radiation (95% CI 0.48-1.06). Due to possible biases in this original analysis due to study design deficiencies, a sensitivity analysis showed a 'corrected' odds ratio of 0.94 with a 95% confidence interval of 0.57-1.55, a non-statistically significant result. Conclusion. The available clinical trial data do not support a role for routine use of pre-operative radiation therapy in the treatment of muscle invasive bladder cancer. Additional well designed trials are needed to address this issue.

Original languageEnglish (US)
Pages (from-to)1931-1934
Number of pages4
JournalAnticancer Research
Volume18
Issue number3 B
StatePublished - Jan 1 1998

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Urinary Bladder Neoplasms
Meta-Analysis
Radiotherapy
Cystectomy
Odds Ratio
Muscles
Clinical Trials
Radiation
Survival
Confidence Intervals
Therapeutics

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

Cite this

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title = "Planned preoperative radiation therapy in muscle invasive bladder cancer; Results of a meta-analysis",
abstract = "Background. The role of pre-operative radiation therapy in the treatment of muscle invasive bladder cancer is unclear. The objective of this report is to present a meta-analysis of the published clinical trial data on this topic to determine whether pre-operative radiation improves survival in patients with this disease. Methods. Data from 5 randomized trials were pooled using the meta-analytic techniques previously described by Peto et al. Three and five year survival were compared between patients receiving pre-operative radiation therapy followed by cystectomy versus patients treated with cystectomy alone. Results. A summary odds ratio was calculated following a statistical analysis showing a lack of heterogeneity among the included studies in terms of their estimate of effect. The calculated Peto odds ratio was 0.71 favoring the use of pre-operative radiation (95{\%} CI 0.48-1.06). Due to possible biases in this original analysis due to study design deficiencies, a sensitivity analysis showed a 'corrected' odds ratio of 0.94 with a 95{\%} confidence interval of 0.57-1.55, a non-statistically significant result. Conclusion. The available clinical trial data do not support a role for routine use of pre-operative radiation therapy in the treatment of muscle invasive bladder cancer. Additional well designed trials are needed to address this issue.",
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Planned preoperative radiation therapy in muscle invasive bladder cancer; Results of a meta-analysis. / Huncharek, Michael; Muscat, Joshua; Geschwind, J. F.

In: Anticancer Research, Vol. 18, No. 3 B, 01.01.1998, p. 1931-1934.

Research output: Contribution to journalArticle

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AU - Geschwind, J. F.

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AB - Background. The role of pre-operative radiation therapy in the treatment of muscle invasive bladder cancer is unclear. The objective of this report is to present a meta-analysis of the published clinical trial data on this topic to determine whether pre-operative radiation improves survival in patients with this disease. Methods. Data from 5 randomized trials were pooled using the meta-analytic techniques previously described by Peto et al. Three and five year survival were compared between patients receiving pre-operative radiation therapy followed by cystectomy versus patients treated with cystectomy alone. Results. A summary odds ratio was calculated following a statistical analysis showing a lack of heterogeneity among the included studies in terms of their estimate of effect. The calculated Peto odds ratio was 0.71 favoring the use of pre-operative radiation (95% CI 0.48-1.06). Due to possible biases in this original analysis due to study design deficiencies, a sensitivity analysis showed a 'corrected' odds ratio of 0.94 with a 95% confidence interval of 0.57-1.55, a non-statistically significant result. Conclusion. The available clinical trial data do not support a role for routine use of pre-operative radiation therapy in the treatment of muscle invasive bladder cancer. Additional well designed trials are needed to address this issue.

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