晚期食管癌的系统肿瘤治疗和最佳支持治疗的比较分析:一项全面的范围审查和证据图

IF 3.6 2区 医学 Q1 MEDICINE, GENERAL & INTERNAL Journal of Evidence‐Based Medicine Pub Date : 2023-06-12 DOI:10.1111/jebm.12539
Santero Marilina, Meade Adriana, Selva Anna, Acosta-Dighero Roberto, Meza Nicolás, Quintana Maria Jesús, Bracchiglione Javier, Requeijo Carolina, Salazar Josefina, Rodríguez Grijalva Gerardo, Solà Ivan, Urrútia Gerard, Bonfill Cosp Xavier, Appropriateness of Systemic Oncological Treatments for Advanced Cancer (ASTAC) Research Group
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引用次数: 1

摘要

目的鉴别、描述和整理晚期食管癌的系统性肿瘤治疗与最佳支持治疗(BSC)比较的现有证据。方法我们在MEDLINE (PubMed)、EMbase (Ovid)、Cochrane图书馆、Epistemonikos、PROSPERO和Clinicaltrials.gov上进行了彻底的检索。我们的纳入标准包括系统评价、随机对照试验、准实验和观察性研究,涉及晚期食管癌或胃癌患者接受化疗、免疫治疗或生物/靶向治疗,与BSC相比。结果包括生存、生活质量、功能状态、毒性和临终关怀质量。结果:我们纳入并绘制了72项研究,包括SRs、实验和观察设计,其中12项研究涉及食管癌,51项涉及胃癌,10项涉及两个部位。大多数比较方案包括化疗(47项研究),但没有报道治疗线。此外,平衡记分卡作为对照组的定义不明确,包括整体支持和安慰剂。数据支持在生存结果方面使用全身肿瘤治疗,在毒性方面使用BSC。包括生活质量、功能状态和临终关怀质量在内的结果数据有限。我们发现了各种各样的证据差距,特别是在评估新疗法(如免疫疗法)和重要结果(如功能状态、症状控制、住院率和所有治疗的临终关怀质量)方面。结论关于晚期食管癌患者的新发病情况以及系统性肿瘤治疗对生存期以外以患者为中心的重要预后的影响存在重要的证据缺口。未来的研究应清楚地描述纳入的人群,说明既往治疗并考虑治疗性,并考虑所有以患者为中心的结果。否则,将研究成果应用于实践将是复杂的。
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Comparative analysis of systemic oncological treatments and best supportive care for advanced gastresophageal cancer: A comprehensive scoping review and evidence map

Objective

To identify, describe, and organize the available evidence regarding systemic oncological treatments compared to best supportive care (BSC) for advanced gastresophageal cancer.

Methods

We conducted a thorough search across MEDLINE (PubMed), EMbase (Ovid), The Cochrane Library, Epistemonikos, PROSPERO, and Clinicaltrials.gov. Our inclusion criteria encompassed systematic reviews, randomized controlled trials, quasi-experimental and observational studies involving patients with advanced esophageal or gastric cancer receiving chemotherapy, immunotherapy or biological/targeted therapy compared to BSC. The outcomes included survival, quality of life, functional status, toxicity, and quality of end-of-life care.

Results

We included and mapped 72 studies, comprising SRs, experimental and observational designs, 12 on esophageal cancer, 51 on gastric cancer, and 10 both locations. Most compared schemes including chemotherapy (47 studies), but did not report therapeutic lines. Moreover, BSC as a control arm was poorly defined, including integral support and placebo. Data favor the use of systemic oncological treatments in survival outcomes and BSC in toxicity. Data for outcomes including quality of life, functional status, and quality of end-of-life care were limited. We found sundry evidence gaps specifically in assessing new treatments such as immunotherapy and important outcomes such as functional status, symptoms control, hospital admissions, and the quality of end-life care for all the treatments.

Conclusions

There are important evidence gaps regarding new for patients with advanced gastresophageal cancer and the effect of systemic oncological treatments on important patient-centered outcomes beyond survival. Future research should clearly describe the population included, specifying previous treatments and considering therapeutic, and consider all patient-centered outcomes. Otherwise, it will be complex to apply research results into practice.

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来源期刊
Journal of Evidence‐Based Medicine
Journal of Evidence‐Based Medicine MEDICINE, GENERAL & INTERNAL-
CiteScore
11.20
自引率
1.40%
发文量
42
期刊介绍: The Journal of Evidence-Based Medicine (EMB) is an esteemed international healthcare and medical decision-making journal, dedicated to publishing groundbreaking research outcomes in evidence-based decision-making, research, practice, and education. Serving as the official English-language journal of the Cochrane China Centre and West China Hospital of Sichuan University, we eagerly welcome editorials, commentaries, and systematic reviews encompassing various topics such as clinical trials, policy, drug and patient safety, education, and knowledge translation.
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