Blanchard P, Bourhis J, Lacas B, Le Teuff G, Michiels S, Pignon J-P
Service de biostatistique et d'épidémiologie, Gustave-Roussy, 114, rue Édouard-Vaillant, 94800 Villejuif, France; Département de radiothérapie, Gustave-Roussy, 114, rue Édouard-Vaillant, 94800 Villejuif, France; Inserm U1018, CESP, Université Paris-Sud, Villejuif, France.
CHU de Vaudois, rue du Bugnon 21, 1011 Lausanne, Suisse.
Cancer Radiother. 2015 May;19(3):198-204; quiz 228-9, 233. doi: 10.1016/j.canrad.2014.12.009. Epub 2015 Apr 6.
Meta-analyses are considered as an important pillar of evidence-based medicine. The aim of this review is to describe the main principles of a meta-analysis and to use examples of head and neck oncology to demonstrate their clinical impact and methodological interest. The major role of individual patient data is outlined, as well as the superiority of individual patient data over meta-analyses based on published summary data. The major clinical breakthrough of head and neck meta-analyses are summarized, regarding concomitant chemotherapy, altered fractionated chemotherapy, new regimens of induction chemotherapy or the use of radioprotectants. Recent methodological developments are described, including network meta-analyses, the validation of surrogate markers. Lastly, the future of meta-analyses is discussed in the context of personalized medicine.