MACH-NC is a meta-analysis that evaluated the results of 115 randomized controlled trials. Its main objective was to identify the relative gains between different therapies to combat locally advanced head and neck cancer, comparing conventional fractionated radiotherapy to hyperfractionated radiotherapy and concomitant chemotherapy. In all, data from 28,978 patients were collected.
“The grandiosity of the study, with the analysis of data from an expressive number of patients, is a complicating factor or one of its limitations, because over the 36 years there has been a lot of evolution in oncological treatments and also a change in the epidemiological profile of head and neck cancer patients,” explains Diego Chaves Rezende Morais, a radio-oncologist at Oncoclínicas Recife.
For the clinical oncologist Gustavo C. Baumgratz Lopes, who works at Grupo Oncoclínicas BH, the great statistical challenge is to validate the homogeneity between the studies being compared. “The MACH-NC study used a methodology called frequentist meta-analysis, which is based on the evaluation of individual patient data (28,978), with the advantage of showing consistent aggregate results of overall survival, as well as enabling trend comparison of which groups of treatment types did better,” he says, adding that “the results can only be used as a trend and must be confirmed in randomized studies to modify clinical practice.”
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