Comparative analysis of systemic oncological treatments and best supportive care for advanced gastresophageal cancer : A comprehensive scoping review and evidence map

A Selva, Gerard Urrútia, X. (Xavier) Bonfill, Marilina Santero, Adriana Meade, Roberto Acosta-Dighero, Nicolás Meza, Maria Jesús Quintana Ruiz, Javier Bracchiglione, Carolina Requeijo, Josefina Salazar, Gerardo Rodríguez Grijalva, Ivan Solà

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Resum

To identify, describe, and organize the available evidence regarding systemic oncological treatments compared to best supportive care (BSC) for advanced gastresophageal cancer. We conducted a thorough search across MEDLINE (PubMed), EMbase (Ovid), The Cochrane Library, Epistemonikos, PROSPERO, and Clinicaltrials.gov. Our inclusion criteria encompassed systematic reviews, randomized controlled trials, quasi-experimental and observational studies involving patients with advanced esophageal or gastric cancer receiving chemotherapy, immunotherapy or biological/targeted therapy compared to BSC. The outcomes included survival, quality of life, functional status, toxicity, and quality of end-of-life care. We included and mapped 72 studies, comprising SRs, experimental and observational designs, 12 on esophageal cancer, 51 on gastric cancer, and 10 both locations. Most compared schemes including chemotherapy (47 studies), but did not report therapeutic lines. Moreover, BSC as a control arm was poorly defined, including integral support and placebo. Data favor the use of systemic oncological treatments in survival outcomes and BSC in toxicity. Data for outcomes including quality of life, functional status, and quality of end-of-life care were limited. We found sundry evidence gaps specifically in assessing new treatments such as immunotherapy and important outcomes such as functional status, symptoms control, hospital admissions, and the quality of end-life care for all the treatments. There are important evidence gaps regarding new for patients with advanced gastresophageal cancer and the effect of systemic oncological treatments on important patient-centered outcomes beyond survival. Future research should clearly describe the population included, specifying previous treatments and considering therapeutic, and consider all patient-centered outcomes. Otherwise, it will be complex to apply research results into practice.
Idioma originalEnglish
Pàgines (de-a)216-236
Nombre de pàgines21
RevistaJournal of Evidence-Based Medicine
Volum16
Número2
DOIs
Estat de la publicacióPublicada - de juny 2023

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