Description
A Cochrane meta-analysis has been carried out using data from 19 trials (17 published 2 unpublished). This review strongly suggested that chemo-radiation improves overall survival (HR = 0.71 p>0.00001) whether platinum was used (HR = 0.070 p>0.00001) or not (HR 0.81 p=0.20). As well reducing local recurrence (OR = 0.61 p=< 0.00001) chemo-radiation lead to highly significant reduction in distant metastases (OR = 0.57 p < 0.0001). Combination treatment increased acute toxicity particularly leucopenia and gastrointestinal side-effects. However, to-date there is no evidence to show an increase in late effects compared to control radiation schedules.
