Objective: Irinotecan in combination with cisplatin for extensive-stage disease small-cell lung cancer (ED-SCLC) patients has gained wide interest. Varying results for this treatment underpin the need for a synthesis ...Objective: Irinotecan in combination with cisplatin for extensive-stage disease small-cell lung cancer (ED-SCLC) patients has gained wide interest. Varying results for this treatment underpin the need for a synthesis of evidence. Methods: We conducted a literature-based meta-analysis to quantify the magnitude of the benefit comparing irinotecan in combination with cisplatin (IP) with etoposide in combination with cisplatin (EP) in ED-SCLC patients. The primary outcome was overall survival (OS) and progression-free survival (PFS); secondary outcomes included overall response rate, 1- and 2-year survival rates, disease control rate and toxicity. Results: Four trials including 1,541 patients were identified in the analysis. No positive results (P<0.05) were seen: OS (HR=0.85, CI95%=0.71-1.01; P=0.08) with high heterogeneity (Chi 2 =7.76, df=3 P=0.05]; I 2 =61%), PFS (HR=0.91, CI95%=0.74-1.28; P=0.36) with high heterogeneity (Chi 2 =11.96, df=3 P=0.008]; I 2 =75%), overall response rate(OR=1.16; CI95%=0.79-1.70; P=0.45), disease control rate (OR=1.01; CI95%=0.74-1.38; P=0.95), 1-year survival rate (OR = 1.30; CI95%=0.98-1.72; P=0.07) and 2-year survival rate (OR=1.97; CI95%=0.95-4.09; P=0.07). Fewer patients who received IP suffered severe hematologic toxicities (grade≥3), such as neutropenia, thrombocytopenia and leucopenia. However, severe non-hematologic toxicities (grade≥3), such as diarrhea, nausea, vomiting, fatigue, anorexia, and dehydration, were more common among patients who received IP. Conclusion: IP does not lengthen the overall survival or progression-free survival compared with EP in patients with ED-SCLC. Fewer patients receiving IP had grade ≥ 3 hematological toxicities of neutropenia, leucopenia and thrombocytopenia, but more had grade≥3 diarrhea, nausea, vomiting, fatigue, anorexia and dehydration.展开更多
[背景]目前关于甲状腺癌患者的膳食质量研究较少,膳食质量与甲状腺癌的关联尚不明确。[目的]应用中国健康膳食指数(CHDI)评估膳食质量,分析其与乳头状甲状腺癌(PTC)之间的关系。[方法]选取上海市肿瘤医院和仁济医院(东院)确诊的PTC新发...[背景]目前关于甲状腺癌患者的膳食质量研究较少,膳食质量与甲状腺癌的关联尚不明确。[目的]应用中国健康膳食指数(CHDI)评估膳食质量,分析其与乳头状甲状腺癌(PTC)之间的关系。[方法]选取上海市肿瘤医院和仁济医院(东院)确诊的PTC新发病例为病例组,按性别、年龄1∶1匹配无甲状腺癌的健康人为对照组。采用统一设计的调查表收集研究对象的人口学信息、疾病史、膳食行为和生活方式等资料;采用经验证的食物频率法,调查研究对象过去一年的膳食情况。根据中国居民膳食指南选择CHDI构成指标,参照中国人群各类食物和营养素的推荐摄入量标准,确定每个构成指标的取值方法,运用CHDI评价两组人群的膳食质量,并利用多因素条件logistic回归模型分析膳食质量与PTC的关系。[结果] 350对PTC病例对照纳入研究,病例组CHDI得分中位数低于对照组(67.8 vs. 73.4,P <0.001)。在CHDI的各评分项中,病例组水果类、奶类、大豆类得分中位数低于对照组(分别为6.8 vs. 9.5、3.6 vs. 5.6、4.6 vs. 5.5,P <0.05);病例组精制谷物得分中位数高于对照组(5.0 vs. 4.9),且得分达满分(即推荐摄入量)的比例高于对照组(65.4%vs. 48.6%,P <0.05);病例组全谷物和杂豆薯类、蔬菜总量、深色蔬菜、鱼虾类得分中位数低于对照组(分别为0.9vs. 1.4、3.1 vs. 4.4、3.6 vs. 5.0、3.3 vs. 4.0),且得分达到满分(即推荐摄入量)的比例均低于对照组(分别为6.3%vs. 8.6%、32.6%vs. 42.0%、38.6%vs. 50.6%、34.0%vs. 40.3%,P <0.05)。多因素条件logistic回归分析后发现,与膳食质量不合格者比较,膳食质量合格和良好者PTC发病风险较低(合格者,OR=0.37,95%CI:0.23~0.62;良好者,OR=0.19,95%CI:0.10~0.36);去除有良性疾病史的患者后,结果仍然保持一致(合格者,OR=0.28,95%CI:0.15~0.52;良好者,OR=0.20,95%CI:0.09~0.43)。[结论]膳食质量合格和良好者PTC的发病风险低。病例组在水果类、奶豆类、全谷物和杂豆薯类、蔬菜类、鱼虾类等方面摄入不足。展开更多
文摘Objective: Irinotecan in combination with cisplatin for extensive-stage disease small-cell lung cancer (ED-SCLC) patients has gained wide interest. Varying results for this treatment underpin the need for a synthesis of evidence. Methods: We conducted a literature-based meta-analysis to quantify the magnitude of the benefit comparing irinotecan in combination with cisplatin (IP) with etoposide in combination with cisplatin (EP) in ED-SCLC patients. The primary outcome was overall survival (OS) and progression-free survival (PFS); secondary outcomes included overall response rate, 1- and 2-year survival rates, disease control rate and toxicity. Results: Four trials including 1,541 patients were identified in the analysis. No positive results (P<0.05) were seen: OS (HR=0.85, CI95%=0.71-1.01; P=0.08) with high heterogeneity (Chi 2 =7.76, df=3 P=0.05]; I 2 =61%), PFS (HR=0.91, CI95%=0.74-1.28; P=0.36) with high heterogeneity (Chi 2 =11.96, df=3 P=0.008]; I 2 =75%), overall response rate(OR=1.16; CI95%=0.79-1.70; P=0.45), disease control rate (OR=1.01; CI95%=0.74-1.38; P=0.95), 1-year survival rate (OR = 1.30; CI95%=0.98-1.72; P=0.07) and 2-year survival rate (OR=1.97; CI95%=0.95-4.09; P=0.07). Fewer patients who received IP suffered severe hematologic toxicities (grade≥3), such as neutropenia, thrombocytopenia and leucopenia. However, severe non-hematologic toxicities (grade≥3), such as diarrhea, nausea, vomiting, fatigue, anorexia, and dehydration, were more common among patients who received IP. Conclusion: IP does not lengthen the overall survival or progression-free survival compared with EP in patients with ED-SCLC. Fewer patients receiving IP had grade ≥ 3 hematological toxicities of neutropenia, leucopenia and thrombocytopenia, but more had grade≥3 diarrhea, nausea, vomiting, fatigue, anorexia and dehydration.
文摘[背景]目前关于甲状腺癌患者的膳食质量研究较少,膳食质量与甲状腺癌的关联尚不明确。[目的]应用中国健康膳食指数(CHDI)评估膳食质量,分析其与乳头状甲状腺癌(PTC)之间的关系。[方法]选取上海市肿瘤医院和仁济医院(东院)确诊的PTC新发病例为病例组,按性别、年龄1∶1匹配无甲状腺癌的健康人为对照组。采用统一设计的调查表收集研究对象的人口学信息、疾病史、膳食行为和生活方式等资料;采用经验证的食物频率法,调查研究对象过去一年的膳食情况。根据中国居民膳食指南选择CHDI构成指标,参照中国人群各类食物和营养素的推荐摄入量标准,确定每个构成指标的取值方法,运用CHDI评价两组人群的膳食质量,并利用多因素条件logistic回归模型分析膳食质量与PTC的关系。[结果] 350对PTC病例对照纳入研究,病例组CHDI得分中位数低于对照组(67.8 vs. 73.4,P <0.001)。在CHDI的各评分项中,病例组水果类、奶类、大豆类得分中位数低于对照组(分别为6.8 vs. 9.5、3.6 vs. 5.6、4.6 vs. 5.5,P <0.05);病例组精制谷物得分中位数高于对照组(5.0 vs. 4.9),且得分达满分(即推荐摄入量)的比例高于对照组(65.4%vs. 48.6%,P <0.05);病例组全谷物和杂豆薯类、蔬菜总量、深色蔬菜、鱼虾类得分中位数低于对照组(分别为0.9vs. 1.4、3.1 vs. 4.4、3.6 vs. 5.0、3.3 vs. 4.0),且得分达到满分(即推荐摄入量)的比例均低于对照组(分别为6.3%vs. 8.6%、32.6%vs. 42.0%、38.6%vs. 50.6%、34.0%vs. 40.3%,P <0.05)。多因素条件logistic回归分析后发现,与膳食质量不合格者比较,膳食质量合格和良好者PTC发病风险较低(合格者,OR=0.37,95%CI:0.23~0.62;良好者,OR=0.19,95%CI:0.10~0.36);去除有良性疾病史的患者后,结果仍然保持一致(合格者,OR=0.28,95%CI:0.15~0.52;良好者,OR=0.20,95%CI:0.09~0.43)。[结论]膳食质量合格和良好者PTC的发病风险低。病例组在水果类、奶豆类、全谷物和杂豆薯类、蔬菜类、鱼虾类等方面摄入不足。
