Scolaris Content Display Scolaris Content Display

Contenido relacionado

Ir a:

Revisiones y protocolos relacionados

Topics

Temas

Flow diagram of selection of studies
Figuras y tablas -
Figure 1

Flow diagram of selection of studies

Ir a la figura de la revisiónAbrir en una pestaña nueva

'Risk of bias' graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
Figuras y tablas -
Figure 2

'Risk of bias' graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Forest plot of comparison: 1 Continuous platinum infusion versus bolus platinum infusion, outcome: 1.1 Hearing loss (asymptomatic and symptomatic disease).
Figuras y tablas -
Figure 3

Forest plot of comparison: 1 Continuous platinum infusion versus bolus platinum infusion, outcome: 1.1 Hearing loss (asymptomatic and symptomatic disease).

Ir a la figura de la revisiónAbrir en una pestaña nueva

Forest plot of comparison: 1 Continuous platinum infusion versus bolus platinum infusion, outcome: 1.2 Adverse effects: toxic death.
Figuras y tablas -
Figure 4

Forest plot of comparison: 1 Continuous platinum infusion versus bolus platinum infusion, outcome: 1.2 Adverse effects: toxic death.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 1 Continuous platinum infusion versus bolus platinum infusion, Outcome 1 Hearing loss (asymptomatic and symptomatic disease).
Figuras y tablas -
Analysis 1.1

Comparison 1 Continuous platinum infusion versus bolus platinum infusion, Outcome 1 Hearing loss (asymptomatic and symptomatic disease).

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 1 Continuous platinum infusion versus bolus platinum infusion, Outcome 2 Adverse effects: toxic death.
Figuras y tablas -
Analysis 1.2

Comparison 1 Continuous platinum infusion versus bolus platinum infusion, Outcome 2 Adverse effects: toxic death.

Ir a la figura de la revisiónAbrir en una pestaña nueva
Summary of findings for the main comparison. Continuous platinum infusion compared to bolus platinum infusion for children with cancer treated with platinum‐based therapy

Continuous platinum infusion compared to bolus platinum infusion for children with cancer treated with platinum‐based therapy

Patient or population: children with cancer treated with platinum‐based therapy
Settings: paediatric oncology departments
Intervention: continuous platinum infusion
Comparison: bolus platinum infusion (one hour)

Outcomes

Illustrative comparative risks* (95% CI)

Relative effect
(95% CI)

No of Participants
(studies)

Quality of the evidence
(GRADE)

Comments

Assumed risk

Corresponding risk

Bolus platinum infusion

Continuous platinum infusion

Hearing loss (asymptomatic and symptomatic disease according to Brock criteria)
exact instrument used to test hearing loss was not reported

139 per 10001

193 per 1000
(65 to 574)

RR 1.39
(0.47 to 4.13)

67
(1 study)

⊕⊕⊝⊝
low2,3

Length of follow‐up was not mentioned, but the median duration of induction was 102 days in the continuous infusion arm and 107 days in the bolus infusion arm (no significant difference) and only results from shortly after induction therapy were provided.

For 24 of the 91 children included in the study no data on hearing loss were available (12 in each treatment group). The RR presented here results from the 'available data' analysis. Intention‐to‐treat analyses (i.e. worst‐ and best‐case scenarios) also showed no significant difference between the treatment groups. The GRADE assessment for the worst‐ and best‐case scenarios was identical to that of the 'available data' analysis.

Tinnitus ‐ not reported

See comment

See comment

Not estimable

‐

See comment

No information on tinnitus was provided.

Overall survival ‐ not reported

See comment

See comment

Not estimable

‐

See comment

No information on overall survival was provided.

Event‐free survival ‐ not reported

See comment

See comment

Not estimable

‐

See comment

No information on event‐free survival was provided.

Tumour response (complete or partial remission according to INRC)

See comment

See comment

Not estimable (see comments)

Unclear
(1 study)

⊕⊕⊝⊝
low3,4

The number of children with a complete or partial remission was not provided, but it was stated that tumour response was equivalent in both treatment arms.

Length of follow‐up was not mentioned, but the median duration of induction was 102 days in the continuous infusion arm and 107 days in the bolus infusion arm (no significant difference) and only results from shortly after induction therapy were provided.

Adverse effects: toxic death (no definition provided)

21 per 10001

23 per 1000
(1 to 361)

RR 1.12
(0.07 to 17.31)

91
(1 study)

⊕⊕⊝⊝
low3,5

Length of follow‐up was not mentioned, but the median duration of induction was 102 days in the continuous infusion arm and 107 days in the bolus infusion arm (no significant difference) and only results from shortly after induction therapy were provided.

Quality of life ‐ not reported

See comment

See comment

Not estimable

‐

See comment

No information on quality of life was provided.

*The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% CI) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).
CI: Confidence interval; RR: Risk ratio; INRC: International Neuroblastoma Response Criteria

GRADE Working Group grades of evidence
High quality: further research is very unlikely to change our confidence in the estimate of effect.
Moderate quality: further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.
Low quality: further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.
Very low quality: we are very uncertain about the estimate.

1 The assumed risk is based on the prevalence in the control group of the included study.
2 We downgraded 1 level based on the fact that the presence of selection bias, performance bias, detection bias and other bias is unclear; high risk of attrition bias.
3 As this is a small study with a total number of events less than 300 (the threshold rule‐of‐thumb value stated in the GRADEpro software (GRADEpro GDT)) we downgraded 1 level.

4 We downgraded 1 level based on the fact that the presence of selection bias, performance bias, detection bias, attrition bias and other bias is unclear.

5 We downgraded 1 level based on the fact that the presence of selection bias, performance bias, detection bias and other bias is unclear.

Figuras y tablas -
Summary of findings for the main comparison. Continuous platinum infusion compared to bolus platinum infusion for children with cancer treated with platinum‐based therapy
Ir a la tabla de la revisión
Table 1. Brock criteria for the classification of hearing loss*

Grade

Description

A

None: bilateral hearing loss, less than 40 dB in all frequencies

B

Mild: bilateral hearing loss, greater than 40 dB at 8000 Hz

C

Moderate: bilateral hearing loss, greater than 40 dB at 6000 Hz

D

Marked: bilateral hearing loss, greater than 40 dB at 4000 Hz

E

Severe: bilateral hearing loss, greater than 40 dB at 2000 Hz

* As reported in the methods section of the included study (Coze 1997). Coze and colleagues refer to Brock 1987 for these criteria. However, Brock and colleagues define grade E as "Severe, bilateral hearing loss greater than 40 dB at 8000 Hz" (so identical to grade B).

dB: decibel; Hz: Hertz
Figuras y tablas -
Table 1. Brock criteria for the classification of hearing loss*
Ir a la tabla de la revisión
Comparison 1. Continuous platinum infusion versus bolus platinum infusion

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Hearing loss (asymptomatic and symptomatic disease) Show forest plot

1

67

Risk Ratio (M‐H, Fixed, 95% CI)

1.39 [0.47, 4.13]

2 Adverse effects: toxic death Show forest plot

1

91

Risk Ratio (M‐H, Fixed, 95% CI)

1.12 [0.07, 17.31]
Figuras y tablas -
Comparison 1. Continuous platinum infusion versus bolus platinum infusion
Ir a la tabla de la revisión