Table I. Association of treatment characteristics with EFS.
Treatment characteristic | Subgroup | N studies | 5-yr EFS of reference group (95% CI) and absolute rate differences of comparison subgroups (95% CI) | Omnibus p-value | Adjusteda 5-yr EFS of reference group (95% CI) and absolute rate differences of comparison subgroups (95% CI) | Omnibus p-value |
---|---|---|---|---|---|---|
CRT | CRT for all (reference) | 43 | 63 (59, 68) | 0.08 | 65 (61,69) | 0.02 |
Risk-directed CRT | 21 | -3 (-11, 5) | -9 (-15, -2) | |||
CNS + only | 7 | -6 (-18, 7) | -3 (-14, 7) | |||
No CRT | 7 | 12 (1, 24) | 5 (-4, 15) | |||
IT chemotherapy | MTX (reference) | 39 | 63 (58, 68) | 0.89 | 65 (61, 69) | 0.11 |
TIT | 38 | 0 (-1, 1) | -5(-11, 1) | |||
Total doses of IT | 0-9 (reference) | 18 | 52 (45, 59) | <0.001 | 56 (49, 64) | 0.16 |
10-19 | 34 | 14 (6, 22) | 8 (-1, 17) | |||
>=20 | 16 | 18 (8, 27) | 10 (-1, 21) | |||
HD Methotrexate | No HD MTX (reference) | 24 | 58 (52,64) | 0.045 | 61 (55, 66) | 0.40 |
HD MTX | 45 | 8 (0, 15) | 3 (-4, 10) | |||
Asparaginase | <400,000 IU (reference) | 52 | 60 (56, 65) | 0.006 | 60 (57, 64) | 0.007 |
>=400,000 IU or PEG | 15 | 12 (4, 20) | 10 (3, 17) | |||
Anthracycline | <300 mg/m2(reference) | 46 | 64 (59, 68) | 0.97 | 62 (58, 65) | 0.14 |
>=300 mg/m2 | 20 | 0 (-8, 8) | 5 (-2, 12) | |||
Induction steroid | prednisone (reference) | 70 | 63 (59, 66) | 0.54 | 63 (60, 66) | 0.49 |
dexamethasone | 4 | 2 (-14, 19) | -9 (-24, 6) | |||
randomized | 3 | 9 (-7, 25) | -2 (-16, 12) | |||
EFS definition | includes induction failures (reference) | 57 | 61 (57, 65) | 0.06 | 61 (58, 65) | 0.07 |
excludes induction failures | 7 | 14 (1, 26) | 12 (2,23) | |||
definition not reported | 14 | 5 (-3, 14) | 1 (-6, 9) | |||
Enrollment year | per 5 years | 6 (4, 9) | <0.001 | N/A | N/A | |
Asparaginase | per 100,000 IU/m2 | 3 (1, 5) | <0.001 | 2 (1, 4) | 0.004 | |
HD Methotrexate | per 5 grams/m2 | 1 (-1, 3) | 0.20 | 1 (-1, 2) | 0.33 | |
Anthracycline | per 100 mg/m2 | 0 (-4, 3) | 0.77 | 2 (-1, 4) | 0.27 |
Adjusted for enrollment start year.
EFS= event-free survival;CRT=cranial irradiation therapy; IT = intrathecal; HD = high dose; PEG = polyethylene glycosylated asparaginase.