Quimioterapia y radioterapia para el cáncer de páncreas avanzado
Información
- DOI:
- https://doi.org/10.1002/14651858.CD011044.pub2Copiar DOI
- Base de datos:
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- Cochrane Database of Systematic Reviews
- Versión publicada:
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- 20 marzo 2018see what's new
- Tipo:
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- Intervention
- Etapa:
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- Review
- Grupo Editorial Cochrane:
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Grupo Cochrane de Salud digestiva
- Copyright:
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- Copyright © 2018 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.
Cifras del artículo
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Autores
Contributions of authors
VC: protocol design, sourcing articles, reviewer one, data entry, analysis, results, discussion and conclusion, preparation of manuscript.
AN: protocol design, reviewer two, analysis, statistics support, reviewing of manuscript.
KS: protocol design, statistics support, reviewing of manuscript.
CO: protocol design, radiotherapy trials/methodology support, reviewing of manuscript.
LC: protocol design, reviewing of manuscript.
AB: protocol design, reviewing of manuscript.
RS: data analysis and statistical support, reviewing of the manuscript.
DY: author of previous version of this review, protocol design, methodological support, reviewer three, reviewing of manuscript.
Sources of support
Internal sources
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The Garvan Institute of Medical Research, Australia.
PhD stipend top up for Venessa Chin
External sources
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The Royal Australasian College of Physicians, Australia.
PhD stipend for Venessa Chin
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National Health and Medical Research Council, Australia.
PhD stipend for Venessa Chin
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Pancare Australia, Australia.
PhD stipend for Venessa Chin
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Sydney Catalyst, Australia.
PhD stipend for Venessa Chin
Declarations of interest
VC: Venessa Chin received scholarship funding from the Research and Education Foundation of the Royal Australasian College of Physicians, Pancare Australia, Sydney Catalyst, National Health and Medical Research Council, and the Garvan Institute of Medical Research for work related to this review.
AN: none known.
KS: Katrin Sjoquist received programme grant funding from the National Health and Medical Research Council for work related to this review. She has received consultancy fees, fees for expert testimony and travel support for work unrelated to this review.
CO: none known.
LC: Lorraine Chantrill is employed (part‐time) by NSW Health as a staff specialist in medical oncology and enrolled full‐time in PhD studies supported by the Australian Federal Government. She has been paid as an advisory board member in relation to chemotherapy for pancreas cancer and has been paid for formulating educational materials and presentations. She has received grants for the practice of clinical trials in pancreas and other cancers.
AB: Andew Biankin received grant funding from the Cancer Institute NSW for work related to this review. He also received consultancy fees from Celegene and Clovis Oncology for work unrelated to this review. His institution received consultancy fees from Roche for work unrelated to this review.
RS: Rob Scholten's institution has received grant funding from the Belgian Health Care Knowledge Centre for work related to this review. His institution has also received funding from the WHO and World Federation of Haemophilia for travel and consultancy unrelated to this review.
DY: Advisory Board Member, Specialised Therapeutics.
Acknowledgements
The authors would like to thank the Cochrane Upper Gastrointestinal and Pancreatic Diseases Editorial Team, in particular Karin Dearness, Sarah Rhodes and Racquel Simpson.
We would also like to acknowledge the two librarians who provided assistance in sourcing many of the papers in this analysis: Ms Cheng Sui (Garvan Institute of Medical Research and the University of NSW) and Mr Glenn Forbes (University of NSW).
We would like to thank Prof Val Gebski from the Clinical Trials Centre, Sydney, for his assistance with statistics.
The following investigators kindly responded to requests for further information on their studies: N Maisey, A Jacobs, , U Pelzer, S Ohkawa.
Special thanks to Dr Kazu Kikuchi, Dr Niantao Deng and Dr David Herrmann for assistance with translating articles into English.
Version history
| Published | Title | Stage | Authors | Version |
| 2018 Mar 20 | Chemotherapy and radiotherapy for advanced pancreatic cancer | Review | Venessa Chin, Adnan Nagrial, Katrin Sjoquist, Chelsie A O'Connor, Lorraine Chantrill, Andrew V Biankin, Rob JPM Scholten, Desmond Yip | |
| 2014 Aug 05 | Chemotherapy, radiotherapy, chemoradiotherapy and combination therapy in localised and locally advanced pancreatic cancer | Protocol | Asma Sultana, Richard J Jackson, Trevor Cox, Daniel Palmer, John Neoptolemos, Paula Ghaneh | |
Differences between protocol and review
Biological agents, second line therapies, locally advanced PC
The original protocol included studies addressing biological therapies, studies addressing second‐line treatment and people with locally advanced disease. We felt that due to the large number of comparisons, the review became unmanageable. We therefore decided to split the review and concentrate on chemotherapy and radiotherapy in the advanced setting. Separate reviews will report on biological and immunological agents, second‐line therapies and studies dealing exclusively with people with non‐metastatic, locally advanced disease.
Outcomes
The original protocol did not include adverse events, response rates and quality of life as secondary outcomes. Prior to data extraction, the review authors added those as secondary outcomes. We deleted disease‐specific survival as a secondary outcome.
Measures of treatment effect
The original protocol stated that fixed‐effect model meta‐analyses would be used to pool results for survival at 6 months and 12 months. It was never our intention to use 6‐ and 12‐month survival as endpoints in this review. We instead used HRs for overall and progression‐free survival. We employed random‐effect models for most analyses given the experimental arms were often very different within each comparison.
Dealing with multi‐armed studies
In such cases where studies reported the event rates for all arms, we divided the control arm accordingly and entered all arms of the studies into the analysis as appropriate. Where the event rates were not available, if the study had two arms that fell into a subgroup analysis, then we analysed only these two arms. We described any study that we could not analyse in the above two scenarios in table form only.
Number needed to treat (NNT) as a secondary endpoint
We replaced this outcome with GRADE 'Summary of findings' tables.
