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新诊断的儿童急性淋巴细胞白血病无试验效应的证据。

No evidence of a trial effect in newly diagnosed pediatric acute lymphoblastic leukemia.

作者信息

Koschmann Carl, Thomson Blythe, Hawkins Douglas S

机构信息

Seattle Children's Hospital, 4800 Sand Point Way NE, Seattle, WA 98105, USA.

出版信息

Arch Pediatr Adolesc Med. 2010 Mar;164(3):214-7. doi: 10.1001/archpediatrics.2009.282.

Abstract

OBJECTIVE

To determine whether clinical trial enrollment by itself is associated with improved outcome.

DESIGN

Retrospective cohort study.

SETTING

Seattle Children's Hospital from 1997 to 2005.

PARTICIPANTS

Data were drawn from 322 patients with newly diagnosed acute lymphoblastic leukemia. Main Exposure Enrollment in a Children's Oncology Group or Children's Cancer Group clinical trial.

MAIN OUTCOME MEASURES

(1) Demographic variables associated with trial participation. (2) Event-free survival, which was defined as the time from initial diagnosis to either leukemia recurrence or death from any cause.

RESULTS

No outcome advantage was found for participants in a clinical trial compared with nonparticipants. Additionally, there were not demographic factors associated with increased clinical trial participation.

CONCLUSIONS

Clinical trial participation does not, by itself, lead to improved outcome for pediatric patients with acute lymphoblastic leukemia in the current era. Discussions about participation in a clinical trial should focus on improvement of future therapy, not the direct benefit of the research participant.

摘要

目的

确定参与临床试验本身是否与改善预后相关。

设计

回顾性队列研究。

地点

1997年至2005年期间的西雅图儿童医院。

参与者

数据来自322例新诊断的急性淋巴细胞白血病患者。主要暴露因素为参加儿童肿瘤学组或儿童癌症组的临床试验。

主要结局指标

(1)与试验参与相关的人口统计学变量。(2)无事件生存期,定义为从初始诊断到白血病复发或任何原因导致死亡的时间。

结果

与未参与者相比,临床试验参与者未发现预后优势。此外,不存在与临床试验参与增加相关的人口统计学因素。

结论

在当前时代,参与临床试验本身并不会改善急性淋巴细胞白血病儿科患者的预后。关于参与临床试验的讨论应侧重于未来治疗的改善,而非研究参与者的直接获益。

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