Gemcitabine fixed-dose rate infusion for the treatment of pancreatic carcinoma: a meta-analysis of randomized controlled trialsReport as inadecuate




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Diagnostic Pathology

, 9:214

First Online: 25 November 2014Received: 06 September 2014Accepted: 26 October 2014

Abstract

BackgroundPre-clinical evidence shows that fixed dose rate FDR infusion of gemcitabine could optimize plasma concentration of gemcitabine, while the clinical efficacy and toxicity of FDR infusion of gemcitabine in advanced pancreatic carcinoma has not been systematically investigated. Thus, this meta-analysis was designed to ascertain this issue.

MethodsDatabases of EMBASE, PubMed, and Cochrane Library were searched for eligible randomized controlled trials RCTs. RCTs comparing FDR and standard 30-min infusion of gemcitabine in advanced pancreatic carcinoma were included. The primary endpoints were treatment efficacy overall response rate, 1-year survival rate, median survival, and time to treatment failure and toxicities were secondary endpoints neutropenia, thrombocytopenia, anemia, and vomiting. Relative risks or mean differences and corresponding 95% confidence intervals CIs were calculated.

ResultAfter careful and rigorous selection, 3 eligible RCTs including 764 patients of advanced pancreatic adenocarcinoma were included in this meta-analysis. For treatment efficacy, FDR gemcitabine provided significantly longer median survival over standard gemcitabine Mean Difference = 1.24 months, 95% CI: 0.39-2.09, while there was no statistical difference in other endpoints of treatment efficacy. For toxicities, patients with FDR gemcitabine experienced significantly more grade 3-4 hematological toxicities than those received standard gemcitabine neutropenia, thrombocytopenia, and anemia, while there was no difference for vomiting.

ConclusionCompared with standard 30-min infusion, FDR gemcitabine provide longer median survival, but increased the risk of hematological toxicities for patients with advanced pancreatic adenocarcinoma.

Virtual SlidesThe virtual slides for this article can be found here: http:-www.diagnosticpathology.diagnomx.eu-vs-13000 2014 214

KeywordsGemcitabine Fixed-dose rate Pancreatic adenocarcinoma Meta-analysis Electronic supplementary materialThe online version of this article doi:10.1186-s13000-014-0214-8 contains supplementary material, which is available to authorized users.

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Author: Jiqing Xie - Jing Yuan - Laichun Lu

Source: https://link.springer.com/



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