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首页> 外文期刊>Acta oncologica. >Patient-reported outcomes evaluating palliative radiotherapy and chemotherapy in patients with oesophageal cancer: A systematic review
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Patient-reported outcomes evaluating palliative radiotherapy and chemotherapy in patients with oesophageal cancer: A systematic review

机译：患者报告的结果评估食管癌患者的姑息放疗和化疗：系统评价

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Background. Patient-reported outcomes (PROs) and assessments of treatment-related toxicity provide important information on the effect of palliative chemotherapy and/or radiotherapy. The aim of this study was to review the effect of palliative radiotherapy and/or chemotherapy on symptoms and quality of life assessed by PROs and measurement of toxicity for patients with oesophageal cancer. Methods. The Central, Medline and Embase databases (1990 to November 2011) were systematically searched for prospective studies of palliative chemotherapy and/or radiotherapy in patients with advanced oesophageal cancer with PRO- and/or toxicity outcomes. The risks of bias were assessed. Results. Of 2677 records identified, only 32 included PROs, of which eight were randomised controlled trials. In studies with sufficient standard of PRO (n = 18), either Health Related Quality of Life (HRQL) (n = 14) or patient-reported dysphagia (n = 4), were assessed. Docetaxel added to cisplatin + fluorouracil (CF) improved HRQL compared to CF only, even though toxicity increased. Epirubicin added to CF resulted in longer preserved HRQL than its comparator in two trials, and non-inferiority in one. All phase II chemotherapy studies reported maintained HRQL or improved dysphagia combined with low level of toxicity. Brachytherapy resulted in better HRQL compared to stent placement in two trials, and external radiotherapy relieved dysphagia. The quality of the HRQL methodology and the interpretation and presentation of the PRO results varied, and clinical significance was seldom discussed. Conclusion. PRO endpoints are seldom used and further studies of homogenous patient groups with valid measures and methodology of PROs should be encouraged in the evaluation of palliative treatment. Brachytherapy, external radiotherapy and combination chemotherapy improved HRQL and dysphagia in the few identified studies with sufficient PRO methodology.
机译：背景。患者报告的结局（PRO）和与治疗有关的毒性评估为姑息化疗和/或放疗的效果提供了重要信息。这项研究的目的是审查姑息放疗和/或化学疗法对通过PROs评估的症状和生活质量的影响以及食道癌患者的毒性测量。方法。系统地检索了Central，Medline和Embase数据库（1990年至2011年11月），以对具有PRO-和/或毒性结果的晚期食道癌患者进行姑息性化学疗法和/或放疗的前瞻性研究。评估偏见的风险。结果。在2677个记录中，只有32个包含PRO，其中8个是随机对照试验。在具有足够标准的PRO（n = 18）的研究中，评估了健康相关生活质量（HRQL）（n = 14）或患者报告的吞咽困难（n = 4）。与顺铂+氟尿嘧啶（CF）添加的多西他赛相比仅CF改善了HRQL，即使毒性增加了。在两项试验中，添加至CF的表柔比星导致HRQL的保存时间长于其对照，而在一项试验中不逊色。所有II期化疗研究均报告维持HRQL或吞咽困难改善并伴有低毒性。在两项试验中，与支架置入相比，近距离放射治疗产生了更好的HRQL，并且外部放射治疗缓解了吞咽困难。 HRQL方法学的质量以及PRO结果的解释和呈现各不相同，并且很少讨论临床意义。结论。很少使用PRO终点，在姑息治疗评估中应鼓励对具有PRO的有效措施和方法的同质患者群体进行进一步研究。近距离放射疗法，外部放射疗法和联合化学疗法在少数使用足够的PRO方法进行的已鉴定研究中改善了HRQL和吞咽困难。

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