Department of Medicine, University of Toronto, Toronto, Canada.
Support Care Cancer. 2011 Mar;19(3):315-22. doi: 10.1007/s00520-010-1069-5. Epub 2011 Jan 4.
Supportive care interventions can have a substantial impact on side effects of chemotherapy. Consequently, accurate reporting of such interventions is essential when interpreting clinical trial results. This study determined the prevalence and quality of reporting of supportive care treatment for common chemotherapy-induced toxicities in phase III, breast cancer chemotherapy trials.
A systematic review of phase III trials of breast cancer trials incorporating chemotherapy published in the last 5 years was undertaken. Trials were identified through MEDLINE, EMBASE, BIOSIS, and the Cochrane Library. Supportive treatments evaluated were use of antiemetics, colony-stimulating growth factors, and antibiotics. Reporting quality was rated as "good", "fair", "poor", or "absent" using predetermined criteria.
Sixty-two trials met inclusion criteria. In 41 studies (66%), details regarding prophylactic antiemetic treatment were not provided. Growth factor use was not reported in 20 trials (32%). Instructions for the use of prophylactic antibiotics were absent in 45 trials (72%).
There are significant deficiencies in reporting of use of prophylactic supportive care agents in breast cancer trials. Omission of supportive care instructions may impact substantially on patient management and health care system expenditure. Recommendations for the type, dose, and frequency of supportive care drugs should be provided and reported on in trials.
支持性护理干预措施可以对化疗的副作用产生重大影响。因此,在解释临床试验结果时,准确报告这些干预措施至关重要。本研究旨在确定最近 5 年内发表的 III 期乳腺癌化疗试验中,常见化疗诱导毒性的支持性护理治疗的报告频率和质量。
对过去 5 年内发表的 III 期乳腺癌化疗试验进行了系统评价。通过 MEDLINE、EMBASE、BIOSIS 和 Cochrane Library 确定了试验。评估的支持性治疗包括止吐药、集落刺激因子和抗生素的使用。使用预定的标准将报告质量评为“良好”、“中等”、“差”或“缺失”。
62 项试验符合纳入标准。在 41 项研究(66%)中,未提供关于预防性止吐治疗的详细信息。20 项研究(32%)未报告生长因子的使用情况。45 项研究(72%)未提供预防性抗生素使用说明。
乳腺癌试验中预防性支持性护理药物使用的报告存在重大缺陷。支持性护理说明的遗漏可能会对患者管理和医疗保健系统支出产生重大影响。建议在试验中提供和报告支持性护理药物的类型、剂量和频率。