High-dose chemotherapy as initial salvage chemotherapy in patients with relapsed or refractory testicular cancer: a systematic review and meta-analysis

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dc.catalogadorgrr
dc.contributor.authorBriones Carvajal, Juan Rodrigo
dc.contributor.authorDiaz Alvarez, Pamela Alejandra
dc.contributor.authorNicholson, Brian D.
dc.date.accessioned2024-12-03T14:15:30Z
dc.date.available2024-12-03T14:15:30Z
dc.date.issued2024
dc.description.abstractBackground: The role of high-dose chemotherapy followed by autologous hematopoietic cell transplantation in the management of patients with relapsed/refractory germ-cell tumors has not been established in prospective studies. Our aim was to estimate the benefits and harm of this treatment in men with relapsed/refractory germ-cell tumors. Methods: Electronic databases, conference proceedings, and trial registers until April 30, 2023, were searched. Randomized and non-randomized prospective controlled trials were included. Risk of bias assessments were performed using either RoB2 or ROBINS-I tools. The certainty of evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach. Time-to-event data were analyzed using the hazard ratio. The primary outcome was overall survival, and a meta-analysis was not conducted to assess it because non-randomized trials were judged to have a critical risk of bias. Categorical data were analyzed using a risk ratio. All results are presented with the corresponding 95% confidence interval. Results: Four out of 3,824 records met the inclusion criteria, and three out of four were used to assess primary and secondary outcomes. Based on the IT94 study (N = 263 participants), single high-dose chemotherapy followed by autologous hematopoietic cell transplantation may have little to no effect on overall survival [hazard ratio (HR) 0.98, 95%CI 0.68 to 1.42; p = 0.916]. Non-randomized trials (N = 43 participants) showed contrasting results, which may be explained by the number of cycles of high-dose chemotherapy administered in each study. Regarding secondary outcomes, information was only provided for event-free survival, response rate, and acute toxicities. Conclusions: Based on prospective data, there is insufficient evidence to support or refute the proposal that high-dose chemotherapy with autologous hematopoietic cell transplantation improves survival in men with relapsed/refractory germ-cell tumors. If this treatment is considered essential, the choice should be made by experienced clinicians at high-volume cancer centers.
dc.fechaingreso.objetodigital2024-12-03
dc.format.extent17 páginas
dc.fuente.origenWOS
dc.identifier.doi10.3389/fonc.2024.1437574
dc.identifier.issn2234-943X
dc.identifier.pubmedid39411122
dc.identifier.scopusidSCOPUS_ID:2-s2.0-85208606154
dc.identifier.urihttps://doi.org/10.3389/fonc.2024.1437574
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/88770
dc.identifier.wosidWOS:001334334800001
dc.information.autorucEscuela de Medicina; Briones Carvajal, Juan Rodrigo; 0000-0003-4373-0014; 218631
dc.information.autorucEscuela de Medicina; Diaz Alvarez, Pamela Alejandra; 0000-0001-9630-5439; 209525
dc.language.isoen
dc.nota.accesocontenido completo
dc.revistaFrontiers in Oncology
dc.rightsacceso abierto
dc.rights.licenseCC BY 4.0 Attribution 4.0 International
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/
dc.subjectRefractory germ cell tumors
dc.subjectRelapsed germ cell tumor
dc.subjectHigh dose chemotherapy with autologous stem cell transplantation
dc.subjectChemotherapy
dc.subjectSurvival
dc.subjectAdverse (side) effects
dc.subject.ddc610
dc.subject.deweyMedicina y saludes_ES
dc.subject.ods03 Good Health and Well-being
dc.subject.odspa03 Salud y bienestar
dc.titleHigh-dose chemotherapy as initial salvage chemotherapy in patients with relapsed or refractory testicular cancer: a systematic review and meta-analysis
dc.typeartículo
dc.volumen14
sipa.codpersvinculados218631
sipa.codpersvinculados209525
sipa.trazabilidadWOS;2024-11-09
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