From the Departments of Medicine.
Health Science, University of Otago, Christchurch.
Pancreas. 2022 May 1;51(5):405-414. doi: 10.1097/MPA.0000000000002049.
Advanced pancreatic cancer has a poor prognosis globally. Patients often develop pancreatic exocrine insufficiency leading to malabsorption. This systematic literature review explores the impact of pancreatic enzyme replacement therapy (PERT) on patients with advanced pancreatic cancer. Data sources include MEDLINE, CINAHL, Embase, Cochrane (CENTRAL), PsychINFO, and Joanna Briggs Institute databases from inception to January 14, 2022, with reference list checking on Google Scholar. Narrative synthesis was used as the eligible studies were likely to be heterogeneous and hard to compare. This synthesis approach uses 4 steps: theory development, preliminary synthesis, exploration of relationships, and assessment of the robustness of the synthesis. Four themes arose from analyzing the study outcomes including PERT education, efficacy of PERT, the patient experience, and lack of awareness regarding enzyme replacement. The included studies did not use validated tools or standardized measurements, which made it difficult to compare or draw conclusions. Pancreatic enzyme replacement therapy shows the potential to improve symptoms, nutrition, weight loss, and survival, but high-quality studies with standardized outcomes have not been completed. Patient and health professional education is required because there seems to be a general lack of awareness about the use of PERT in pancreatic cancer.Systematic Review Registration: PROSPERO 2020 CRD42020195986.
全球范围内，晚期胰腺癌预后较差。患者常发生胰腺外分泌不足，导致吸收不良。本系统文献综述探讨了胰腺酶替代治疗（PERT）对晚期胰腺癌患者的影响。资料来源包括 MEDLINE、CINAHL、Embase、Cochrane（CENTRAL）、PsychINFO 和 Joanna Briggs 研究所数据库，检索时间截至 2022 年 1 月 14 日，并在 Google Scholar 上检查参考文献。由于合格研究可能存在异质性且难以比较，因此使用叙述性综合方法。这种综合方法使用 4 个步骤：理论发展、初步综合、关系探索和综合稳健性评估。通过分析研究结果得出了 4 个主题，包括 PERT 教育、PERT 的疗效、患者体验以及对酶替代缺乏认识。纳入的研究没有使用经过验证的工具或标准化测量方法，这使得比较或得出结论变得困难。胰腺酶替代治疗显示出改善症状、营养、体重减轻和生存的潜力，但尚未完成具有标准化结局的高质量研究。需要对患者和卫生专业人员进行教育，因为似乎普遍缺乏对 PERT 在胰腺癌中应用的认识。系统评价注册：PROSPERO 2020 CRD42020195986。
