Meta AnalysisID 2426
口服依托泊苷在儿童肿瘤姑息治疗中的应用：单中心经验和系统评价
CRD42019126641
What is the evidence for oral etoposide’s use as palliation in paediatric oncology? Etoposide is a topoisomerase II inhibitor used to treat a wide range of malignancies intravenously. It is also often prescribed in a lo
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Record Fields
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- Meta Analysis Id
- 2426
- Evidence Id
- 10984
- Core Evidence Id
- 10984
- Source Meta Analysis Id
- 2375
- Herb2 Meta Analysis Id
- HBMA002375
- Crd Id
- CRD42019126641
- Title
- Use of oral etoposide as palliation in paediatric oncology - experience of a single institution and systematic review
- Review Question
- What is the evidence for oral etoposide’s use as palliation in paediatric oncology? Etoposide is a topoisomerase II inhibitor used to treat a wide range of malignancies intravenously. It is also often prescribed in a low dose oral form as a form of palliative chemotherapy due to its tolerability and ease of prescription in outpatient setting. However etoposide is not without side effects, and it is important to determine if there is benefit in prescribing it in palliative therapy, where the primary intentions are non-curative. Therefore in this systematic review we aim to review the literature on use of oral etoposide as palliation in paediatric solid tumours. The NCI defines palliative therapy as ‘treatment given to relieve the symptoms and reduce the suffering caused by cancer and other life-threatening diseases’ which can be ‘given together with other cancer treatments, from the time of diagnosis, through treatment, survivorship, recurrent or advanced disease, and at the end of life.’ To focus only on the palliative use of etoposide rather than as a first line therapy, we aim to review only studies that explicitly state the use as palliative, or that imply this, either by its use at end of life, or as salvage therapy for recurrent or refractory tumours resistant to all other therapy, with the aim of relieving symptoms and reducing suffering or other non- curative intent such as stabilisation of condition or prolongation of life.
- Study Type Included
- No restrictions on types of study design eligible for inclusion.
- Condition Being Studied
- Palliative treatment of children with solid tumours.
- Participant
- Inclusion: Paediatric patients (<25 years of age) with solid tumours, undergoing end of life/ palliative/salvage therapy with oral etoposide. Exclusion: Adults ((≥25 years), non-solid malignancies (e.g. leukemia), use of etoposide as first line or administered via any route other than oral.
- Animal
- Human Disease Modelled
- Intervention
- Use of oral etoposide as palliation.
- Comparator Control
- Paediatric patients with solid tumours that do not receive oral etoposide as palliation. Given the nature of our question, we do not expect to find many studies directly comparing these groups.
- Main Outcome
- A range of parameters have been used to attempt to determine the efficacy of palliation. Often studies will use biological parameters (e.g. imaging showing reduction in tumour size) but this in itself does not guarantee a reduction in suffering or symptoms. Given the range of quality of information available, we have decided to look at 4 outcomes that give some indication of the potential efficacy of oral etoposide as a palliative therapy. 1. Patient reported relief of cancer symptoms 2. Minimal side effects of oral etoposide therapy. 3. Tumour stabilisation/partial remission 4. Prolonged survival We will report on whether studies include information on any 4 of these outcomes, though do not expect many to cover all 4.
- Outcome Measure
- Additional Outcome
- Whilst collecting information on the above outcomes, we will also note any report of significant side effects of oral etoposide, particularly concerning the risk of developing AML.
- Study Method
- Narrative synthesis, Systematic review
- Keyword
- Child; Etoposide; Health Facilities; Humans; Medical Oncology; Palliative Care
- Contact
- Georgina Jones [email protected]
- Organisational Affiliation
- University of Cambridge
- Funding Source
- None.
- Other Selection Criteria
- Final Publication
- Same Topic Review
- Published Protocol
- Review Type
- Language
- English
- Country
- England
- Review Stage
- Review Ongoing
- First Submission Date
- 2019-02-26
- Registration Date
- 2019-03-06
- Anticipated Start Date
- 2019-02-26
- Anticipated Completion Date
- 2019-04-01
- Title Cn
- 口服依托泊苷在儿童肿瘤姑息治疗中的应用：单中心经验和系统评价
- Title En
- Use of oral etoposide as palliation in paediatric oncology - experience of a single institution and systematic review
- Bilingual Status
- complete