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Información

DOI:
https://doi.org/10.1002/14651858.CD010963.pub2Copiar DOI
Base de datos:
  1. Cochrane Database of Systematic Reviews
Versión publicada:
  1. 11 diciembre 2016see what's new
Tipo:
  1. Intervention
Etapa:
  1. Review
Grupo Editorial Cochrane:
  1. Grupo Cochrane de Enfermedades de oído, nariz y garganta

Copyright:
  1. Copyright © 2016 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.

Cifras del artículo

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Contraer

Autores

  • James Howard

    Correspondencia a: ENT Department, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK

    [email protected]

  • Liam Masterson

    ENT Department, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK

  • Raghav C Dwivedi

    ENT Department, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK

  • Faruque Riffat

    Westmead Hospital, University of Sydney, Sydney, Australia

  • Richard Benson

    Oncology Centre, Addenbrooke's Hospital, Cambridge, UK

  • Sarah Jefferies

    Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK

  • Piyush Jani

    ENT Department, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK

  • James R Tysome

    Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK

  • Chris Nutting

    Head and Neck Unit, Royal Marsden Hospital, London, UK

Contributions of authors

James Howard (JH): protocol draft, search strategy development, acquiring trial copies, trial selection, data extraction, data analysis, data interpretation, review draft and future review update.

Liam Masterson (LM): protocol draft, search strategy development, trial selection, data interpretation and review draft.

Raghav C Dwivedi (RCD): protocol draft, search strategy development, trial selection, data interpretation and review draft.

Faruque Riffat (FR): protocol draft, data interpretation and review draft.

James Tysome (JT): protocol draft, data interpretation and review draft.

Richard Benson (RB): protocol draft, data interpretation and review draft.

Sarah Jefferies (SJ): protocol draft, data interpretation and review draft.

Piyush Jani (PJ): protocol draft, data interpretation and review draft.

Christopher Nutting (CN): protocol draft, data interpretation and review draft.

Sources of support

Internal sources

  • NIHR Cambridge Biomedical Research Centre, UK.

External sources

  • National Institute for Health Research, UK.

    Infrastructure funding for Cochrane ENT

Declarations of interest

James EF Howard: none known.

Liam Masterson: none known.

Raghav C Dwivedi: none known.

Faruque Riffat: none known.

Richard Benson: none known.

Sarah Jefferies: none known.

Piyush Jani: none known.

James R Tysome: none known.

Chris Nutting: none known.

Acknowledgements

We acknowledge the very helpful contributions made by the editorial team of Cochrane ENT and in particular the guidance and input of Ms Jenny Bellorini.

This project was supported by the National Institute for Health Research, via Cochrane Infrastructure, Cochrane Programme Grant or Cochrane Incentive funding to Cochrane ENT. The views and opinions expressed therein are those of the authors and do not necessarily reflect those of the Systematic Reviews Programme, NIHR, NHS or the Department of Health.

Version history

Published

Title

Stage

Authors

Version

2016 Dec 11

Minimally invasive surgery versus radiotherapy/chemoradiotherapy for small‐volume primary oropharyngeal carcinoma

Review

James Howard, Liam Masterson, Raghav C Dwivedi, Faruque Riffat, Richard Benson, Sarah Jefferies, Piyush Jani, James R Tysome, Chris Nutting

https://doi.org/10.1002/14651858.CD010963.pub2

2014 Feb 20

Minimally invasive surgery versus radiotherapy/chemoradiotherapy for early‐stage oropharyngeal carcinoma

Protocol

James Howard, Liam Masterson, Raghav C Dwivedi, Faruque Riffat, Richard Benson, Sarah Jefferies, Piyush Jani, James R Tysome, Chris Nutting

https://doi.org/10.1002/14651858.CD010963

Differences between protocol and review

Title:

  • 'Early‐stage' changed to 'small‐volume, primary'. The same clarification was carried through the entire review.

Background:

  • Addition of work by Schache 2016 and new HPV demographic data.

Methods section:

  • Types of studies clarified to exclude quasi‐ and cluster‐randomised trials.

  • Types of interventions: clarification of planned comparisons.

  • Types of outcome measures: addition of statement to meet MECIR standards whereby studies are not included or excluded based on outcome measures; addition of further details of anticipated/allowable measurement instruments.

Keywords

MeSH

PICO

Population
Intervention
Comparison
Outcome

El uso y la enseñanza del modelo PICO están muy extendidos en el ámbito de la atención sanitaria basada en la evidencia para formular preguntas y estrategias de búsqueda y para caracterizar estudios o metanálisis clínicos. PICO son las siglas en inglés de cuatro posibles componentes de una pregunta de investigación: paciente, población o problema; intervención; comparación; desenlace (outcome).

Para saber más sobre el uso del modelo PICO, puede consultar el Manual Cochrane.

Process for sifting search results and selecting studies for inclusion.
Figuras y tablas -
Figure 1

Process for sifting search results and selecting studies for inclusion.

Summary of findings for the main comparison. Minimally invasive surgery versus radiotherapy/chemoradiotherapy for small‐volume primary oropharyngeal carcinoma

Minimally invasive surgery versus radiotherapy/chemoradiotherapy for small‐volume primary oropharyngeal carcinoma

Patient or population: patients with small‐volume primary oropharyngeal carcinoma

Settings: inpatient

Intervention: transoral, minimally invasive surgery (transoral robotic surgery/transoral laser microsurgery) with or without adjuvant radiotherapy or adjuvant chemoradiotherapy

Comparison: primary radiotherapy with or without induction or concurrent chemotherapy

Outcomes

Illustrative comparative risks* (95% CI)

Relative effect
(95% CI)

No of participants
(studies)

Quality of the evidence
(GRADE)

Comments

Assumed risk

Corresponding risk

Primary radiotherapy ± induction or concurrent chemotherapy

Transoral, minimally invasive surgery ± adjuvant radiotherapy or adjuvant chemoradiotherapy

Overall survival

No data

No data

No data

No data

Locoregional control

No data

No data

No data

No data

Progression‐free survival

No data

No data

No data

No data

Gastrostomy rate (at 1 year)

No data

No data

No data

No data

Tracheostomy rate

No data

No data

No data

No data

Swallowing function (MDADI)

No data

No data

No data

No data

Quality of life (EORTC QLQ‐C30 and H&N35)

No data

No data

No data

No data

*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% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).
CI: confidence interval; EORTC: European Organisation for Research and Treatment of Cancer; MDADI: MD Anderson Dysphagia Inventory

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.

Figuras y tablas -
Summary of findings for the main comparison. Minimally invasive surgery versus radiotherapy/chemoradiotherapy for small‐volume primary oropharyngeal carcinoma