Palliative chemotherapy for advanced or metastatic colorectal cancer

摘要: Background Despite the increasing use of palliative chemotherapy for advanced colorectal cancer, there remains uncertainty as to true effectiveness this intervention. This review was therefore undertaken assess available evidence benefit in disease. Objectives To determine benefits and harms patients with locally or metastatic cancer. A secondary objective investigate outcomes younger elderly patients. Search methods Trials were identified by computerised hand searches literature, scanning references contacting investigators. Selection criteria All randomised controlled trials compared supportive care alone cancer. Both non-randomised studies considered when searching data on quality life, resource cost chemotherapy. Data collection analysis Investigators from all eligible asked supply individual patient data. Meta-analysis performed using both published Studies grouped according whether administered regionally systemically. Main results 13 representing a total 1365 met inclusion criteria. subset that provided demonstrated associated 35% (95% CI 24% 44%) reduction risk death. translates into an absolute improvement survival 16% at 6 months 12 median 3.7 months. The overall relating treatment toxicity, symptom control life poor. Authors' conclusions Chemotherapy is effective prolonging time disease progression may be underestimated meta-analysis, proportion arms some received chemotherapy. No age related differences found chemotherapy, but under represented trials. Treatment toxicity impact upon have been inadequately assessed majority further research needed clarify