摘要
目的评价胰腺癌治疗的Cochrane系统评价证据,以及纳入系统评价的临床随机对照试验(RCT)的方法学质量。方法检索Cochrane Library数据库(2009年第4期)中有关胰腺癌治疗的系统评价,并运用RewMan5.0.21对所纳入研究的偏倚进行评估。结果共检索到胆道支架置入术姑息治疗梗阻型胰腺癌的系统评价、放化疗治疗不能手术的进展期胰腺癌的系统评价共2篇系统评价,共纳入79个RCT。依照Cochrane协作网推荐的质量评价方法,对所纳入RCT的偏倚进行评估,表明均存在不同程度的偏倚,方法学质量普遍较低。结论 Cochrane系统评价是公认的最高质量的研究证据,但目前缺少足够强度的证据来支持胆道支架置入术姑息治疗梗阻型胰腺癌的疗效。其他治疗手段的疗效如胰腺癌围手术期的营养支持治疗等还需要通过进一步的完成系统评价来评估。建议推行临床试验透明化,实施临床试验注册制度以及按照CONSORT声明严格规范RCT的报告,以便于总结胰腺癌治疗的临床证据。
Objective To assess the evidences of Cochrane systematic reviews of treatment of carcinoma of pancreas and the methodological quality of all randomized controlled trials （RCT） of the included systematic reviews.Methods Cochrane Library （Issue 4,2009） was searched for systematic reviews on treatment for carcinoma of pancreas.All randomized controlled trials of Cochrane systematic reviews in treating carcinoma of pancreas were evaluated.The risk of bias was assessed independently by two authors using the criteria which are described in the Cochrane Handbook for Systematic Reviews of Interventions 5.0.2.Results Two systematic reviews and seventy-nine RCTs were included.The results of the risk of bias of randomized controlled trials in treating carcinoma of pancreas were evaluated by RewMan5.0.21.The overall quality of randomized controlled trials in treating carcinoma of pancreas is generally low.Conclusions Cochrane systematic reviews are received as the highest quality of research evidences.There is insufficient,consistent evidence to support the use of palliative biliary stents for obstructing pancreatic carcinoma,chemotherapy and radiotherapy for inoperable advanced pancreatic cancer.Analysis of the included trials showed some trials had no clear description of random methods,allocation concealment,sample size calculation,intention-to-treat analysis.To improve the quality of reporting of RCTs,Clinical Trial Registration and Revised consolidated standards of reporting trial （CONSORT） statement should be introduced into the trial design and strictly performed.
出处
《中华临床医师杂志（电子版）》
CAS
2010年第9期124-126,共3页
Chinese Journal of Clinicians(Electronic Edition)
关键词
胰腺肿瘤
评价研究
随机对照试验
循证医学
Pancreatic neoplasms
Evaluation studies
Randomized controlled trial
Evidence-based medicine
