학술논문
Relative Dose Intensity of Chemotherapy and Survival in Patients with Advanced Stage Solid Tumor Cancer: A Systematic Review and Meta-Analysis
Health Outcomes and Economics of Cancer Care
Health Outcomes and Economics of Cancer Care
Document Type
Academic Journal
Source
The Oncologist. September 2021, Vol. 26 Issue 9, pe1609, 10 p.
Subject
Language
English
ISSN
1083-7159
Abstract
Implications for Practice: Chemotherapy-induced toxicities lead to dose reduction and/or treatment delay, thus affecting patient outcomes. Results of this systematic review and meta-analysis, evaluating the impact of relative dose intensity [...]
Background. Chemotherapy-induced toxicities lead to therapy dose reduction or delay, affecting patient outcomes. This systematic review and meta-analysis evaluated the impact of relative dose intensity (RDI) on survival in adult patients with solid tumor cancer on nonadjuvant-based chemotherapy regimens. Methods. PubMed, Embase, and Web of Science databases were searched for peer-reviewed English journal articles or congress abstracts evaluating association between RDI and survival; observational studies, case series of [greater than or equal to] 20 patients, and clinical trials published between 2013 and 2020 were eligible. Meta-analyses were conducted to quantify the association between RDI levels and overall survival (OS) among studies reporting a hazard ratio (HR) for OS by similar tumor types, regimens, and RDI. Forest plots represented summary HR and 95% confidence interval (CI); Cochran's Q and [I.sup.2] tests evaluated study heterogeneity. Results. Overall, 919 articles were reviewed and 22 included; seven were eligible for meta-analysis. Significantly shorter OS at RDI Conclusion. The results suggested longer OS with RDI [greater than or equal to] 80% or [greater than or equal to] 85% for both regimens, indicating that management of toxicities across treatment modalities may contribute to maintenance of higher RDI and benefit survival for patients with advanced solid tumors. Key Words. Carboplatin-based regimens * FOLFOX/FOLFIRI-based regimens * Meta- analysis * Overall survival * Progression-free survival * Relative dose intensity
Background. Chemotherapy-induced toxicities lead to therapy dose reduction or delay, affecting patient outcomes. This systematic review and meta-analysis evaluated the impact of relative dose intensity (RDI) on survival in adult patients with solid tumor cancer on nonadjuvant-based chemotherapy regimens. Methods. PubMed, Embase, and Web of Science databases were searched for peer-reviewed English journal articles or congress abstracts evaluating association between RDI and survival; observational studies, case series of [greater than or equal to] 20 patients, and clinical trials published between 2013 and 2020 were eligible. Meta-analyses were conducted to quantify the association between RDI levels and overall survival (OS) among studies reporting a hazard ratio (HR) for OS by similar tumor types, regimens, and RDI. Forest plots represented summary HR and 95% confidence interval (CI); Cochran's Q and [I.sup.2] tests evaluated study heterogeneity. Results. Overall, 919 articles were reviewed and 22 included; seven were eligible for meta-analysis. Significantly shorter OS at RDI Conclusion. The results suggested longer OS with RDI [greater than or equal to] 80% or [greater than or equal to] 85% for both regimens, indicating that management of toxicities across treatment modalities may contribute to maintenance of higher RDI and benefit survival for patients with advanced solid tumors. Key Words. Carboplatin-based regimens * FOLFOX/FOLFIRI-based regimens * Meta- analysis * Overall survival * Progression-free survival * Relative dose intensity