EUROSCAN

P.I.

1988

RANDOMIZZATO

MULTICENTRICO

2892 Pz

EUROSCAN

Sottotitolo
Studio cooperativo E.O.R.T.C. per lo screening e la chemioprevenzione dei secondi tumori in pazienti trattati curativamente per tumori della testa e collo, o del polmone.

Disegno Studio
Prospettico randomizzato di fase III

Centro
Multicentrico

Anno di inizio
1988

Ruolo di Ugo Pastorino
Principal Investigator

Numero di pazienti
2892

Stato
Concluso

Anno di conclusione
2000


Sinossi

Preclinical evidence suggests that retinoids and antioxidants may prevent or delay the occurrence of cancer in the upper or lower airways, but such effects have not been reliably established in clinical studies. To assess the chemopreventive effects of vitamin A (retinyl palmitate) and N-acetylcysteine, we conducted a large randomized intervention study in patients with head and neck cancer or with lung cancer, most of whom had a history of smoking.

From June 1988 through July 1994, a total of 2592 patients (60% with head and neck cancer and 40% with lung cancer) were randomly assigned to receive 1) retinyl palmitate (300000 IU daily for 1 year followed by 150000 IU for a 2nd year), 2) N-acetylcysteine (600 mg daily for 2 years), 3) both compounds, or 4) no intervention. All statistical tests were two-sided.

Of the patients, 93.5% had smoked tobacco at sometime in their lives (and 25% continued to smoke after cancer diagnosis). After a median follow-up of 49 months, 916 patients were reported with an event (recurrence, second primary tumor, or death). No statistically significant difference was observed in overall survival or event-free survival between patients who received retinyl palmitate and patients who did not. Similarly, no difference was seen in overall survival or event-free survival between patients who received N-acetylcysteine and patients who did not. There was a lower incidence of second primary tumors in the no intervention arm, but the difference was not statistically significant.

A 2-year supplementation of retinyl palmitate and/or N-acetylcysteine resulted in no benefit in terms of survival, event-free survival, or second primary tumors for patients with head and neck cancer or with lung cancer, most of whom were previous or current smokers.



Pubblicazioni

BJC

1991

 

IF 3.036

OO

1992

 

IF 1.265

LC

1993

 

IF 1.902

AJO

1993

 

IF .437

EJCOO

1994

 

IF 1.2

JNCI

2000

 

IF 10.73