Imadalou K, Cvitkovic E
CAC, Le Kremlin-Bicêtre.
Bull Cancer. 1999 Feb;86(2):143-7.
The randomised trial is the best context for the assessment of any new molecule in oncology. The authors emphasize the methodological aspects of randomised trials and suggest strategies to be adopted in phase III trials, based on the newly orthodox concept of evidence-based medicine, while underscoring the need for context specific adaptations to increase relevance and specificity of sought endpoints, including other means of controlling adequately the clinical experiment without randomization (patient as his own control models). The authors also suggest certain strategic changes. For example, restrictive but relevant eligibility criteria may help decrease the number of patients needed without compromising statistical power as well as other strategies aimed at proving the efficacy of a new molecule without carrying out large trials, which are too long and costly.
随机试验是评估肿瘤学中任何新分子的最佳环境。作者强调了随机试验的方法学方面,并基于循证医学的新正统概念,提出了在III期试验中应采用的策略,同时强调需要根据具体情况进行调整,以提高所寻求终点的相关性和特异性,包括其他在不进行随机分组的情况下充分控制临床实验的方法(患者自身对照模型)。作者还提出了某些战略变革。例如,严格但相关的入选标准可能有助于在不影响统计效力的情况下减少所需患者数量,以及其他旨在在不进行耗时且成本高昂的大型试验的情况下证明新分子疗效的策略。