Centre for Reviews and Dissemination, University of York, Heslington, York, YO10 5DD, UK.
Syst Rev. 2019 Jul 12;8(1):168. doi: 10.1186/s13643-019-1096-3.
This systemic review aims to synthesise the current literature surrounding off-therapy surveillance imaging in children and young people with extra-cranial solid tumours, with a view to establishing if routine imaging studies after treatment for childhood cancer increase overall survival, increase the psychological distress caused to patients and families, result in other harms to patients and are cost-effective strategies. Within this manuscript, we also describe how patient and public involvement has impacted upon the protocol.
The search will cover thirteen different databases, key conference proceedings and trial registers, as well as reference lists and forward citations of included papers. Prominent authors/clinicians in the field will be contacted. A full search strategy is provided. The study designs to be included in the review will be added in an iterative way (RCTs, quasi-randomised trials, prospective cohorts and retrospective cohorts). Qualitative studies will also be eligible for inclusion. We will include studies which examine a programme of surveillance imaging that aims to detect relapse in children or young people up to age 25 years who have completed treatment for a malignant extracranial solid tumour and have no evidence of active and ongoing disease at end of treatment. The primary outcome is overall survival, with secondary outcomes including psychological distress indicators, number of imaging tests performed, other harms of imaging and cost-effectiveness measures. Studies will be screened and data extracted by two researchers. Studies will be critically appraised using a stratified version of the ROBINS-I tool. Where appropriate, data will be synthesised using a random effects meta-analysis. A detailed analysis plan, including assessment of heterogeneity and publication bias, is provided.
The aim of routine surveillance imaging is to detect recurrence of disease before clinical symptoms and signs develop. Some studies have suggested that most relapses of childhood cancer are detected due to clinical symptoms or signs, particularly in those with extra-cranial solid tumours, and when these relapses are detected by imaging, there is no increase in survival. This review aims to establish whether routine surveillance imaging is beneficial, as well as evaluating the potential negative impacts of surveillance programmes.
PROSPERO CRD42018103764.
本系统综述旨在综合目前关于儿童和青少年颅外实体瘤治疗后监测成像的文献，以确定治疗后儿童癌症常规成像研究是否提高总生存率、增加患者和家庭的心理困扰、导致患者其他伤害以及是否具有成本效益的策略。在本文稿中，我们还描述了患者和公众参与如何影响方案。
搜索将涵盖十三个不同的数据库、主要会议记录和试验登记处，以及纳入论文的参考文献列表和前引文。该领域的知名作者/临床医生将被联系。提供了完整的搜索策略。将以迭代方式纳入综述的研究设计（RCT、准随机试验、前瞻性队列和回顾性队列）。合格的研究还包括定性研究。我们将纳入旨在检测已完成恶性颅外实体瘤治疗且治疗结束时无活动性和持续性疾病证据的 25 岁以下儿童或青少年复发的监测成像计划的研究。主要结局是总生存率，次要结局包括心理困扰指标、进行的影像学检查次数、影像学检查的其他危害和成本效益措施。两名研究人员将筛选和提取数据。研究将使用 ROBINS-I 工具的分层版本进行批判性评估。在适当的情况下，将使用随机效应荟萃分析对数据进行综合。提供了详细的分析计划，包括评估异质性和发表偏倚。
常规监测成像的目的是在出现临床症状和体征之前检测疾病的复发。一些研究表明，大多数儿童癌症的复发是由于临床症状或体征发现的，特别是在颅外实体瘤患者中，当这些复发通过影像学检测到，并没有增加生存率。本综述旨在确定常规监测成像是否有益，以及评估监测计划的潜在负面影响。
PROSPERO CRD42018103764。
