Systematic review, including meta-analyses, on the management of locally advanced pancreatic cancer using radiation/combined modality therapy.
Systematic review, including meta-analyses, on the management of locally advanced pancreatic cancer using radiation/combined modality therapy.
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系统的综述，包括荟萃分析，使用辐射/组合式疗法对局部晚期胰腺癌进行管理。
DOI：
10.1038/sj.bjc.6603719
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发表时间：
2007-04-23
影响因子：
8.8
通讯作者：
Ghaneh, P.
中科院分区：
文献类型：
--
作者：
Sultana, A.;Smith, C. Tudur;Cunningham, D.;Starling, N.;Tait, D.;Neoptolemos, J. P.;Ghaneh, P.
对于采用化疗还是联合治疗方法治疗局部晚期胰腺癌尚未达成共识（Maheshwari 和 Moser，2005）。尚未发表的荟萃分析（Fung 等，2003；Banu 等，2005；Liang，2005；Bria 等，2006；Milella 等，2006）包括采用放射治疗的随机对照试验。本系统评价的目的是比较以下内容：(i) 放化疗后化疗（联合治疗）与最佳支持治疗 (ii) 放疗与放化疗 (iii) 放疗与联合治疗 (iv) 化疗与联合治疗 (v) 基于 5FU 的联合治疗与基于另一种药物的联合治疗。通过搜索数据库、试验登记册和会议记录来确定相关随机对照试验。主要终点是总生存期，次要终点是无进展生存期/进展时间、缓解率和不良事件。使用风险比（HR）和具有相对风险的反应率/不良事件数据总结生存数据。涉及 794 名患者的 11 项试验符合纳入标准。与单独放疗相比，放化疗的生存期延长（两项试验，168 名患者，HR 0.69；95% 置信区间 (CI) 0.51–0.94），但放化疗后化疗并没有比单独化疗带来生存优势（两项试验，134 名患者，HR 0.79；CI 0.32–1.95）。无法对其他比较进行荟萃分析。事实证明，放化疗比单纯放疗具有生存获益。放化疗后化疗与单独化疗相比并未显示出任何生存优势，但由于置信区间较宽，不能排除重要的临床差异。
There is no consensus on the management of locally advanced pancreatic cancer, with either chemotherapy or combined modality approaches being employed (Maheshwari and Moser, 2005). No published meta-analysis (Fung et al, 2003; Banu et al, 2005; Liang, 2005; Bria et al, 2006; Milella et al, 2006) has included randomised controlled trials employing radiation therapy. The aim of this systematic review was to compare the following: (i) chemoradiation followed by chemotherapy (combined modality therapy) vs best supportive care (ii) radiotherapy vs chemoradiation (iii) radiotherapy vs combined modality therapy (iv) chemotherapy vs combined modality therapy (v) 5FU-based combined modality treatment vs another-agent-based combined modality therapy. Relevant randomised controlled trials were identified by searching databases, trial registers and conference proceedings. The primary end point was overall survival and secondary end points were progression-free survival/time-to-progression, response rate and adverse events. Survival data were summarised using hazard ratio (HR) and response-rate/adverse-event data with relative risk. Eleven trials involving 794 patients met the inclusion criteria. Length of survival with chemoradiation was increased compared with radiotherapy alone (two trials, 168 patients, HR 0.69; 95% confidence interval (CI) 0.51–0.94), but chemoradiation followed by chemotherapy did not lead to a survival advantage over chemotherapy alone (two trials, 134 patients, HR 0.79; CI 0.32–1.95). Meta-analyses could not be performed for the other comparisons. A survival benefit was demonstrated for chemoradiation over radiotherapy alone. Chemoradiation followed by chemotherapy did not demonstrate any survival advantage over chemotherapy alone, but important clinical differences cannot be ruled out due to the wide CI.
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影响因子：
19.7
作者：
CHILDS, DS;MOERTEL, CG;COLBY, MY
通讯作者：
COLBY, MY
DOI：
10.1016/j.ijrobp.2004.12.074
发表时间：
2005-08-01
影响因子：
7
作者：
Cohen, SJ;Dobelbower, R;Haller, DG
通讯作者：
Haller, DG
DOI：
10.1016/j.bpg.2005.11.001
发表时间：
2006-04-01
影响因子：
3.2
作者：
Garofalo, M;Flannery, T;Regine, W
通讯作者：
Regine, W
在癌症期刊上发表的生存分析的综述。
影响因子：
8.8
作者：
Altman, D G;De Stavola, B L;Love, S B;Stepniewska, K A
通讯作者：
Stepniewska, K A
影响因子：
45.3
作者：
KLAASSEN, DJ;MACINTYRE, JM;MOERTEL, CG
通讯作者：
MOERTEL, CG