The effectiveness and safety of proton beam radiation therapy in children with malignant central nervous system (CNS) tumours: protocol for a systematic review.
The effectiveness and safety of proton beam radiation therapy in children with malignant central nervous system (CNS) tumours: protocol for a systematic review.
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DOI：
10.1186/s13643-016-0285-6
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发表时间：
2016-07-27
影响因子：
3.7
通讯作者：
Wilson JS
中科院分区：
文献类型：
--
作者：
Main C;Dandapani M;Pritchard M;Dodds R;Stevens SP;Thorp N;Taylor RE;Wheatley K;Pizer B;Morrall M;Phillips R;English M;Kearns PR;Wilne S;Wilson JS
本研究的目的是使用系统评价框架来识别和综合使用质子束治疗（PBT）治疗儿童CNS肿瘤的证据，并在可能的情况下将其与光子放疗（RT）进行比较。将采用旨在最小化偏倚的标准系统综述方法进行研究识别、选择和数据提取。已检索了12个电子数据库，并将采用进一步的引文、手工检索和参考文献检查。将纳入评估PBT单独使用或作为多模式治疗方案的一部分在CNS肿瘤儿童中的作用的研究。还将确定相关的经济评价。结局为生存期（总体、无进展、无事件、无疾病）、局部和区域控制率、短期和长期不良事件、功能状态指标和生存质量。两名评审员将独立筛选和选择纳入评审的研究。所有干预性研究设计均符合纳入审查的条件。然而，初步范围检索表明，证据基础可能仅限于病例系列研究，没有发现更高质量的研究。将使用预先规定的标准进行质量评估，并根据研究设计进行定制（如适用）。将使用叙述性综合对研究进行合并，突出显示研究之间的结果差异，并讨论与患者人群、干预措施和研究质量相关的差异。在适当的情况下，如果未识别出比较设计的研究，则将结局与文献中相似人群和治疗方案的一系列估计值进行比较，这些估计值来自包括使用先进传统光子治疗的研究的最佳可用证据。在CNS肿瘤儿童中使用PBT的证据基础可能相对稀疏，高度异质性，并且可能在样本量较小的情况下质量较低。此外，选择和出版偏见可能会限制研究的内部和外部有效性。然而，任何来自潜在治疗效果审查的初步结果都可以用于计划更高质量的研究，这些研究的设计适合与传统治疗进行结局比较。PROSPERO CRD 42015029583本文的在线版本（doi：10.1186/s13643-016-0285-6）包含补充材料，可供授权用户使用。
The aim of this study is to use a systematic review framework to identify and synthesise the evidence on the use of proton beam therapy (PBT) for the treatment of children with CNS tumours and where possible compare this to the use of photon radiotherapy (RT). Standard systematic review methods aimed at minimising bias will be employed for study identification, selection and data extraction. Twelve electronic databases have been searched, and further citation, hand searching and reference checking will be employed. Studies assessing the effects of PBT used either alone or as part of a multimodality treatment regimen in children with CNS tumours will be included. Relevant economic evaluations will also be identified. The outcomes are survival (overall, progression-free, event-free, disease-free), local and regional control rates, short- and long-term adverse events, functional status measures and quality of survival. Two reviewers will independently screen and select studies for inclusion in the review. All interventional study designs will be eligible for inclusion in the review. However, initial scoping searches indicate the evidence base is likely to be limited to case series studies, with no studies of a higher quality being identified. Quality assessment will be undertaken using pre-specified criteria and tailored to study design if applicable. Studies will be combined using a narrative synthesis, with differences in results between studies highlighted and discussed in relation to the patient population, intervention and study quality. Where appropriate, if no studies of a comparative design are identified, outcomes will be compared against a range of estimates from the literature for similar populations and treatment regimens from the best available evidence from studies that include the use of advanced conventional photon therapy. The evidence base for the use of PBT in children with CNS tumours is likely to be relatively sparse, highly heterogeneous and potentially of a low quality with small sample sizes. Furthermore, selection and publication biases may limit the internal and external validity of studies. However, any tentative results from the review on potential treatment effects can be used to plan better quality research studies that are of a design appropriate for outcome comparison with conventional therapy. PROSPERO CRD42015029583 The online version of this article (doi:10.1186/s13643-016-0285-6) contains supplementary material, which is available to authorized users.