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Chemotherapy for non-small cell lung cancer

BMJ 1995; 311 doi: (Published 07 October 1995) Cite this as: BMJ 1995;311:889
  1. David P Carbone, Associate professor,
  2. John D Minna, Professor
  1. Simmons Cancer Center, University of Texas Southwestern Medical Center, Dallas, Texas, USA

    A meta-analysis suggests that the benefits are small

    For some cancers, treatments are so effective that the question of whether to treat does not arise. For many others, however, while gratifying responses sometimes occur, there are also substantial toxicities related to treatment, and benefits of any kind may be small. The toxicities, inconvenience, and expense of chemotherapy are endured by both patients whose tumours do and do not respond. When faced with such imperfect treatments, clinical trialists must determine, within the limitations of biological variability, whether these treatments result in statistically significant benefits and at what cost. Doctors thenhave to decide whether these benefits are clinically important and whether they outweigh potential risks for a particular patient.

    With the relatively small absolute survival benefits observed for chemotherapy of non-small cell lung cancer, large numbers of patients are required to draw conclusions with confidence. In this issue of the Journal Albertini et al report the results of a meta-analysis of updated data from 9387 patients participating in 52 randomised clinical trials comparing chemotherapy with no chemotherapy …

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