Abstract:
BACKGROUND:Small cell lung cancer (SCLC) accounts for approximately 20% of all cases of lung cancer. It tends to disseminate early in the course of its natural history and to grow quickly. Approximately 10% to 18% of patients present with brain metastases (BM) at the time of initial diagnosis, and an additional 40% to 50% will develop BM some time during the course of their disease. OBJECTIVES:The aim of this review was to evaluate the effectiveness and toxicity of systemic chemotherapy for the treatment of BM from SCLC. SEARCH METHODS:We searched the Cochrane Lung Cancer Review Group Specialised Register (July 2011), CENTRAL (2011, Issue 5), PubMed (1966 to July 2011), EMBASE (2005 to July 2011), LILACS (1982 to July 2011) and the International Clinical Trial Registry Platform (ICTRP). SELECTION CRITERIA:Randomized controlled trials (RCTs) comparing systemic chemotherapy (single agent or combination chemotherapy) with another chemotherapy regimen, palliative care, whole brain radiotherapy or any combination of these interventions for the treatment of BM as the only site of progression. DATA COLLECTION AND ANALYSIS:Data extraction and 'Risk of bias' assessment were carried out independently by two review authors. As the included studies evaluated three different treatment modalities meta-analysis was not possible. MAIN RESULTS:Three RCTs, involving 192 participants, met inclusion criteria for this review. No significant differences for overall survival (OS) were reported in any of the trials: in the first trial, 33 patients received whole brain radiation therapy and no significant difference was found between patients treated with topotecan and those not treated with topotecan. In a second trial, in which 120 patients were randomized to receive teniposide with or without brain radiation therapy, the authors reported that the median progression-free survival (brain-specific progression-free survival (PFS)) was 3.5 months in the combined modality arm and 3.2 in the teniposide alone arm. In a third trial, comparing sequential and concomitant chemoradiotherapy (teniposide plus cisplatin) in 39 participants, the survival difference between the two groups was not statistically significant. While the first trial reported no significant difference in PFS, the second RCT found a significant difference favoring combined therapy group. The second trial also found that patients receiving chemoradiotherapy (teniposide plus whole brain radiotherapy) had a higher complete response rate than those receiving only the topoisomerase inhibitor. AUTHORS' CONCLUSIONS:Given the paucity of robust studies assessing the clinical effects of treatments, available evidence is insufficient to judge the effectiveness and safety of chemotherapy for the treatment of BM from SCLC. Published studies are insufficient to address the objectives of this review. According to the available evidence included in this review, chemotherapy does not improve specific brain PFS and OS in patients with SCLC. The combined treatment of teniposide and brain radiation therapy contributed to outcome in terms of increased complete remission and shorter time to progression (though not OS).
journal_name
Cochrane Database Syst Revjournal_title
The Cochrane database of systematic reviewsauthors
Reveiz L,Rueda JR,Cardona AFdoi
10.1002/14651858.CD007464.pub2subject
Has Abstractpub_date
2012-06-13 00:00:00pages
CD007464issue
6issn
1469-493Xpub_type
杂志文章,meta分析,评审abstract:BACKGROUND:Community-acquired pneumonia (CAP) is caused by various pathogens, traditionally divided into 'typical' and 'atypical'. Initial antibiotic treatment of CAP is usually empirical, customarily covering both typical and atypical pathogens. To date, no sufficient evidence exists to support this broad coverage, wh...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD004418.pub4
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abstract:BACKGROUND:Cataract and glaucoma are leading causes of blindness worldwide, and their co-existence is common in elderly people. Glaucoma surgery can accelerate cataract progression, and performing both surgeries may increase the rate of postoperative complications and compromise the success of either surgery. However, ...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD008671.pub3
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abstract:BACKGROUND:Infection with head lice is a widespread condition in developed and developing countries. Infection occurs most commonly in children, but also affects adults. If left untreated the condition can become intensely irritating and skin infections may occur if the bites are scratched. OBJECTIVES:The aim of this ...
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doi:10.1002/14651858.CD001165
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abstract:BACKGROUND:Acute hypoxaemic respiratory failure (AHRF), defined as acute lung injury (ALI) and acute respiratory distress syndrome (ARDS), are critical conditions. AHRF results from a number of systemic conditions and is associated with high mortality and morbidity in all ages. Inhaled nitric oxide (INO) has been used ...
journal_title:The Cochrane database of systematic reviews
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doi:10.1002/14651858.CD002787.pub2
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abstract:BACKGROUND:The burden of asthma on patients and healthcare systems is substantial. Interventions have been developed to overcome difficulties in asthma management. These include chronic disease management programmes, which are more than simple patient education, encompassing a set of coherent interventions that centre ...
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doi:10.1002/14651858.CD007988.pub2
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abstract:BACKGROUND:Several studies have evaluated the clinical effectiveness of endocrine therapy alone in women aged 70 years or over and who are fit for surgery. OBJECTIVES:To identify and review the evidence from randomised trials comparing primary endocrine therapy (endocrine therapy alone) to surgery, with or without adj...
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pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD004272.pub2
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abstract:BACKGROUND:This is an updated version of the original Cochrane review published in Issue 4, 2010 (Kirthi 2010). Migraine is a common, disabling condition and a burden for the individual, health services and society. Many sufferers choose not to, or are unable to, seek professional help and rely on over-the-counter anal...
journal_title:The Cochrane database of systematic reviews
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doi:10.1002/14651858.CD008041.pub3
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abstract:BACKGROUND:Severe acute respiratory syndrome (SARS) is an acute respiratory disease caused by a novel coronavirus, which first appeared in Foshan City, China on 22 December 2002. Chinese herbs were used in its treatment. OBJECTIVES:To evaluate the possible effectiveness and safety of Chinese herbs combined with Wester...
journal_title:The Cochrane database of systematic reviews
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doi:10.1002/14651858.CD004882.pub3
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abstract:BACKGROUND:It is becoming commonplace for patients to be discharged earlier from acute hospital settings to their own homes and be required to manage various aspects of their own care. This has increased the need for detailed information to be given to patients and/or significant others to enable them to effectively ma...
journal_title:The Cochrane database of systematic reviews
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doi:10.1002/14651858.CD003716
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abstract:BACKGROUND:Previous research suggests that increasing dietary intakes of calcium, potassium or magnesium separately may reduce BP to a small degree over the short term. It is unclear whether increasing intakes of a combination of these minerals produces a larger reduction in BP. OBJECTIVES:To evaluate the effects of c...
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doi:10.1002/14651858.CD004805.pub2
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journal_title:The Cochrane database of systematic reviews
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doi:10.1002/14651858.CD001206.pub2
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abstract:BACKGROUND:Advances in cell culture media have led to a shift in in vitro fertilization (IVF) practice from early cleavage embryo transfer to blastocyst stage transfer. The rationale for blastocyst culture is to improve both uterine and embryonic synchronicity and enable self selection of viable embryos thus resulting ...
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doi:10.1002/14651858.CD002118.pub4
更新日期:2012-07-11 00:00:00
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pub_type: 杂志文章,评审
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journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析
doi:10.1002/14651858.CD001122.pub5
更新日期:2020-02-11 00:00:00
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journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,评审
doi:10.1002/14651858.CD001815
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abstract:BACKGROUND:Effective pharmacotherapies are available to help people who are trying to stop smoking, but quitting can still be difficult and providing higher levels of behavioural support may increase success rates further. OBJECTIVES:To evaluate the effect of increasing the intensity of behavioural support for people ...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD009670.pub2
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abstract:BACKGROUND:Antipsychotic drugs are the core treatment for schizophrenia. Treatment guidelines state that there is no difference in efficacy between any other antipsychotic compounds, however, low-potency antipsychotic drugs are often perceived as less efficacious than high-potency compounds by clinicians, and they also...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD009396.pub2
更新日期:2014-07-08 00:00:00
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journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD005481.pub3
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journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
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更新日期:2003-01-01 00:00:00
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abstract:BACKGROUND:Both paracetamol and ibuprofen are commonly used analgesics for the relief of pain following the surgical removal of lower wisdom teeth (third molars). In 2010, a novel analgesic (marketed as Nuromol) containing both paracetamol and ibuprofen in the same tablet was launched in the United Kingdom, this drug h...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
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abstract:BACKGROUND:Surgery on the abdominal aorta to treat aneurysms or occlusive disease is a major undertaking which requires intensive physiological support and fluid management. Blood products are often used but the main fluid replacement is with crystalloids or colloids. For years there has been controversy over which flu...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD000991.pub2
更新日期:2010-01-20 00:00:00
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更新日期:2016-01-05 00:00:00
abstract:BACKGROUND:Osteoporosis is a condition resulting in an increased risk of skeletal fractures due to a reduction in the density of bone tissue. Treatment of osteoporosis typically involves the use of pharmacological agents. In general it is thought that disuse (prolonged periods of inactivity) and unloading of the skelet...
journal_title:The Cochrane database of systematic reviews
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doi:10.1002/14651858.CD000333.pub2
更新日期:2011-07-06 00:00:00
abstract:BACKGROUND:This is an update of a review first published in The Cochrane Library in Issue 3, 2013. Cancer-related pain places a heavy burden on public health with related high expenditure. Severe pain is associated with a decreased quality of life in patients with cancer. A significant proportion of patients with cance...
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更新日期:2015-06-29 00:00:00
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更新日期:2016-05-27 00:00:00
abstract:BACKGROUND:Dental sealants were introduced in the 1960s to help prevent dental caries, mainly in the pits and fissures of occlusal tooth surfaces. Sealants act to prevent bacteria growth that can lead to dental decay. Evidence suggests that fissure sealants are effective in preventing caries in children and adolescents...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD001830.pub5
更新日期:2017-07-31 00:00:00