Study designs of evaluations included in the review
Randomised controlled trials (RCTs) without a planned break of more than 14 days in the treatment arm, with overall treatment times in both arms not differing by more than 2 weeks, and with total radiation doses in the hyperfractionated arm equal to or greater than those in the conventionally-fractionated arm. Radiotherapy had to be the major treatment modality.
Specific interventions included in the review
Hyperfractionated and conventional radiotherapy for the treatment of localised tumour with curative intent for head and neck cancer, bladder cancer, non-small cell lung cancer or malignant gliomas.
For head and neck cancer: conventional radiotherapy total doses ranged from 60 to 70 Gy delivered at 2 Gy per fraction daily over a period of 6 to 7 weeks; hyperfractionated radiotherapy total doses ranged from 70.4 to 80.5 Gy delivered at 1.1 to 1.2 Gy per fraction twice daily over a period of 6 to 7 weeks.
For bladder cancer: conventional radiotherapy total doses ranged from 60 to 64 Gy delivered at 2 Gy per fraction over a period of 8 weeks; hyperfractionated radiotherapy total doses ranged from 60 to 84 Gy delivered at 1.0 to 1.2 Gy per fraction twice daily over a period of 7.5 to 9 weeks.
For non-small cell lung cancer: conventional radiotherapy total doses ranged from 60 to 65 Gy delivered at 1.8 to 2.5 Gy per fraction daily over a period of 6 to 7 weeks; hyperfractionated radiotherapy total doses ranged from 69.6 to 71.5 Gy delivered at 1.15 to 1.375 Gy per fraction twice daily over a period of 5.5 to 6.5 weeks.
For malignant gliomas: conventional radiotherapy total doses ranged from 50 to 60 Gy delivered at 1.93 to 2 Gy per fraction daily over a period of 5 to 6 weeks along with chemotherapy (misonidazole, lomustine, carmustine); hyperfractionated radiotherapy total doses ranged from 50 to 66 Gy delivered at 0.89 to 1.1 Gy per fraction twice or thrice daily over a period of 4 to 6 weeks.
Participants included in the review
No patient inclusion criteria are given. The stage of cancer in patients varied by trial.
Outcomes assessed in the review
The outcomes were survival, incomplete tumour response and local recurrence.
How were decisions on the relevance of primary studies made?
The authors do not state how the papers were selected for the review, or how many of the authors performed the selection.