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Diagnostic Pathology

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Open Access 01-12-2014 | Research

Gemcitabine fixed-dose rate infusion for the treatment of pancreatic carcinoma: a meta-analysis of randomized controlled trials

Authors: Jiqing Xie, Jing Yuan, Laichun Lu

Published in: Diagnostic Pathology | Issue 1/2014

Abstract

Background

Pre-clinical evidence shows that fixed dose rate (FDR) infusion of gemcitabine could optimize plasma concentration of gemcitabine, while the clinical efficacy and toxicity of FDR infusion of gemcitabine in advanced pancreatic carcinoma has not been systematically investigated. Thus, this meta-analysis was designed to ascertain this issue.

Methods

Databases of EMBASE, PubMed, and Cochrane Library were searched for eligible randomized controlled trials (RCTs). RCTs comparing FDR and standard 30-min infusion of gemcitabine in advanced pancreatic carcinoma were included. The primary endpoints were treatment efficacy (overall response rate, 1-year survival rate, median survival, and time to treatment failure) and toxicities were secondary endpoints (neutropenia, thrombocytopenia, anemia, and vomiting). Relative risks or mean differences and corresponding 95% confidence intervals (CIs) were calculated.

Result

After careful and rigorous selection, 3 eligible RCTs including 764 patients of advanced pancreatic adenocarcinoma were included in this meta-analysis. For treatment efficacy, FDR gemcitabine provided significantly longer median survival over standard gemcitabine (Mean Difference = 1.24 months, 95% CI: 0.39-2.09), while there was no statistical difference in other endpoints of treatment efficacy. For toxicities, patients with FDR gemcitabine experienced significantly more grade 3/4 hematological toxicities than those received standard gemcitabine (neutropenia, thrombocytopenia, and anemia), while there was no difference for vomiting.

Conclusion

Compared with standard 30-min infusion, FDR gemcitabine provide longer median survival, but increased the risk of hematological toxicities for patients with advanced pancreatic adenocarcinoma.

Virtual Slides

The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/13000_2014_214

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Title: Gemcitabine fixed-dose rate infusion for the treatment of pancreatic carcinoma: a meta-analysis of randomized controlled trials
Authors: Jiqing Xie
Jing Yuan
Laichun Lu
Publication date: 01-12-2014
Publisher: BioMed Central
Published in: Diagnostic Pathology / Issue 1/2014
Electronic ISSN: 1746-1596
DOI: https://doi.org/10.1186/s13000-014-0214-8

At a glance: The STEP trials

Springer Medicine

Gemcitabine fixed-dose rate infusion for the treatment of pancreatic carcinoma: a meta-analysis of randomized controlled trials

Abstract

Background

Methods

Result

Conclusion

Virtual Slides

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Result

Conclusion

Virtual Slides

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