Difference between revisions of "Zhang"

(Weak evidence that the addition of hyperbaric oxygen may improve the effectiveness of radio-iodine stent placement for the treatment of advanced oesophageal cancer. Clinical bottom line: 1. There was no statistically significant improvement in tumour resp)
 
 
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<span style="line-height:normal">'''<span style="font-size:18.0pt"><span style="font-family:" times="" new="" roman",serif"=""><span style="color:black">Weak evidence that the addition of hyperbaric oxygen may improve the effectiveness of radio-iodine stent placement for the treatment of advanced oesophageal cancer.</span></span></span>'''</span>
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<span style="line-height:normal">'''<span style="font-size:18.0pt"><span style="font-family:"><span style="color:black">Weak evidence that the addition of hyperbaric oxygen may improve the effectiveness of radio-iodine stent placement for the treatment of advanced oesophageal cancer.</span></span></span>'''</span>
  
<span style="line-height:normal">'''<span style="font-size:14.0pt"><span style="font-family:" times="" new="" roman",serif"=""><span style="color:black">Clinical bottom line:</span></span></span>'''</span>
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<span style="line-height:normal">'''<span style="font-size:14.0pt"><span style="font-family:"><span style="color:black">Clinical bottom line:</span></span></span>'''</span>
  
 
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<span style="line-height:normal"><span style="font-size:14.0pt"><span style="font-family:" times="" new="" roman",serif"="">1. There was no statistically significant improvement in tumour response to radio-iodine with the addition of hyperbaric oxygen.<br/> 2. There was no important difference in the Karnofsky Performance Score after treatment in the two groups.</span></span></span>
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<span style="line-height:normal"><span style="font-size:14.0pt"><span style="font-family:">1. There was no statistically significant improvement in tumour response to radio-iodine with the addition of hyperbaric oxygen.<br/> 2. There was no important difference in the Karnofsky Performance Score after treatment in the two groups.</span></span></span>
  
 
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<span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"=""><span style="color:black">Citation/s:</span></span></span>'''<span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"=""><span style="color:black">1. Zhang QZ, Li GL, Shang JB, Ren YM, Xie JL. Clinical study of a 125I particle-integrated esophageal covered stent and hyperbaric oxygen in the treatment of advanced esophageal cancer. Rev Esp Enferm Dig. 2021 Aug;113(8):576-579. doi: 10.17235/reed.2020.7377/2020. PMID: 33261505.<br/> '''Lead author's name and fax: '''Qizhou Zhang: zh_qizhou854694@126.com</span></span></span></span>
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<span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:"><span style="color:black">Citation/s:</span></span></span>'''<span style="font-size:12.0pt"><span style="font-family:"><span style="color:black">1. Zhang QZ, Li GL, Shang JB, Ren YM, Xie JL. Clinical study of a 125I particle-integrated esophageal covered stent and hyperbaric oxygen in the treatment of advanced esophageal cancer. Rev Esp Enferm Dig. 2021 Aug;113(8):576-579. doi: 10.17235/reed.2020.7377/2020. PMID: 33261505.<br/> '''Lead author's name and fax: '''Qizhou Zhang: zh_qizhou854694@126.com</span></span></span></span>
  
<span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"=""><span style="color:black">Three-part Clinical Question:</span></span></span>'''<span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"=""><span style="color:black">For patients with oesophageal cancer, does the addition of hyperbaric oxygen to the implantation of an oesophageal stent with radio-iodine result in any improved outcome?<br/> '''Search Terms:''' Radioactive iodine seeds, Coated stent, Oesophageal cancer</span></span></span></span>
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<span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:"><span style="color:black">Three-part Clinical Question:</span></span></span>'''<span style="font-size:12.0pt"><span style="font-family:"><span style="color:black">For patients with oesophageal cancer, does the addition of hyperbaric oxygen to the implantation of an oesophageal stent with radio-iodine result in any improved outcome?<br/> '''Search Terms:''' Radioactive iodine seeds, Coated stent, Oesophageal cancer</span></span></span></span>
  
<span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"=""><span style="color:black">The Study:</span></span></span>'''<span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"=""><span style="color:black">Non-blinded randomised controlled trial with intention-to-treat.<br/> '''The Study Patients:''' Adult patients with advanced oesophageal cancer and no radiotherapy or chemotherapy in the past 3 months.<br/> '''Control group''' (N = 19; 19 analysed): Placement of a radio-iodine implanted stent under local anaesthesia.<br/> '''Experimental group''' (N = 26; 26 analysed): As above plus 100% oxygen breathing at 2 ATA for 60 minutes daily to a total of 30 sessions. Very slow compression and decompression periods.</span></span></span></span>
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<span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:"><span style="color:black">The Study:</span></span></span>'''<span style="font-size:12.0pt"><span style="font-family:"><span style="color:black">Non-blinded randomised controlled trial with intention-to-treat.<br/> '''The Study Patients:''' Adult patients with advanced oesophageal cancer and no radiotherapy or chemotherapy in the past 3 months.<br/> '''Control group''' (N = 19; 19 analysed): Placement of a radio-iodine implanted stent under local anaesthesia.<br/> '''Experimental group''' (N = 26; 26 analysed): As above plus 100% oxygen breathing at 2 ATA for 60 minutes daily to a total of 30 sessions. Very slow compression and decompression periods.</span></span></span></span>
  
<span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"=""><span style="color:black">The Evidence:</span></span></span>'''</span>
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<span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:"><span style="color:black">The Evidence:</span></span></span>'''</span>
  
 
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| style="border: 1pt solid windowtext; width: 185px;" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">Outcome</span></span>'''</span></p>  
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| style="border: 1pt solid windowtext; width: 185px;" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">Outcome</span></span>'''</span></p>  
| style="border: 1pt solid windowtext; width: 91px;" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">Time to Outcome</span></span>'''</span></p>  
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| style="border: 1pt solid windowtext; width: 91px;" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">Time to Outcome</span></span>'''</span></p>  
| style="border: 1pt solid windowtext; width: 82px;" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">Control group</span></span>'''</span></p>  
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| style="border: 1pt solid windowtext; width: 82px;" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">Control group</span></span>'''</span></p>  
| style="border: 1pt solid windowtext; width: 69px;" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">HBO group</span></span>'''</span></p>  
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| style="border: 1pt solid windowtext; width: 69px;" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">HBO group</span></span>'''</span></p>  
| style="border: 1pt solid windowtext; width: 120px;" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">Relative risk reduction</span></span>'''</span></p>  
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| style="border: 1pt solid windowtext; width: 120px;" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">Relative risk reduction</span></span>'''</span></p>  
| style="border: 1pt solid windowtext; width: 113px;" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">Absolute risk reduction</span></span>'''</span></p>  
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| style="border: 1pt solid windowtext; width: 113px;" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">Absolute risk reduction</span></span>'''</span></p>  
| style="border: 1pt solid windowtext; width: 224px;" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">NNT</span></span>'''</span></p>  
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| style="border: 1pt solid windowtext; width: 224px;" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">NNT</span></span>'''</span></p>  
 
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| rowspan="2" style="border: 1pt solid windowtext; width: 185px;" |  
 
| rowspan="2" style="border: 1pt solid windowtext; width: 185px;" |  
<span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">Proportion with complete or partial response</span></span>'''</span>
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<span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">Proportion with complete or partial response</span></span>'''</span>
  
| style="border: 1pt solid windowtext; width: 91px;" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">2 weeks</span></span></span></p>  
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| style="border: 1pt solid windowtext; width: 91px;" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">2 weeks</span></span></span></p>  
| style="border: 1pt solid windowtext; width: 82px;" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">0.6</span></span></span></p>  
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| style="border: 1pt solid windowtext; width: 82px;" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">0.6</span></span></span></p>  
| style="border: 1pt solid windowtext; width: 69px;" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">0.8</span></span></span></p>  
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| style="border: 1pt solid windowtext; width: 69px;" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">0.8</span></span></span></p>  
| style="border: 1pt solid windowtext; width: 120px;" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">28%</span></span></span></p>  
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| style="border: 1pt solid windowtext; width: 120px;" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">28%</span></span></span></p>  
| style="border: 1pt solid windowtext; width: 113px;" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">0.2</span></span></span></p>  
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| style="border: 1pt solid windowtext; width: 113px;" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">0.2</span></span></span></p>  
| style="border: 1pt solid windowtext; width: 224px;" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">6</span></span></span></p>  
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| style="border: 1pt solid windowtext; width: 224px;" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">6</span></span></span></p>  
 
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| colspan="3" style="border: 1pt solid windowtext; width: 256px;" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">95% CIs:</span></span></span></p>  
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| colspan="3" style="border: 1pt solid windowtext; width: 256px;" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">95% CIs:</span></span></span></p>  
| style="border: 1pt solid windowtext; width: 120px;" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">-70% to 14%</span></span></span></p>  
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| style="border: 1pt solid windowtext; width: 120px;" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">-70% to 14%</span></span></span></p>  
| style="border: 1pt solid windowtext; width: 113px;" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">-0.1 to 0.4</span></span></span></p>  
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| style="border: 1pt solid windowtext; width: 113px;" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">-0.1 to 0.4</span></span></span></p>  
| style="border: 1pt solid windowtext; width: 224px;" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">NNT = 2 to INF</span></span></span></p> <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">NNH = 11 to INF</span></span></span></p>  
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| style="border: 1pt solid windowtext; width: 224px;" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">NNT = 2 to INF</span></span></span></p> <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">NNH = 11 to INF</span></span></span></p>  
 
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| rowspan="2" style="border: 1pt solid windowtext; width: 185px;" |  
 
| rowspan="2" style="border: 1pt solid windowtext; width: 185px;" |  
<span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">Proportion with complete tumour response</span></span>'''</span>
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<span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">Proportion with complete tumour response</span></span>'''</span>
  
| style="border: 1pt solid windowtext; width: 91px;" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">2 weeks</span></span></span></p>  
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| style="border: 1pt solid windowtext; width: 91px;" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">2 weeks</span></span></span></p>  
| style="border: 1pt solid windowtext; width: 82px;" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">0.1</span></span></span></p>  
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| style="border: 1pt solid windowtext; width: 82px;" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">0.1</span></span></span></p>  
| style="border: 1pt solid windowtext; width: 69px;" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">0.2</span></span></span></p>  
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| style="border: 1pt solid windowtext; width: 69px;" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">0.2</span></span></span></p>  
| style="border: 1pt solid windowtext; width: 120px;" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">83%</span></span></span></p>  
+
| style="border: 1pt solid windowtext; width: 120px;" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">83%</span></span></span></p>  
| style="border: 1pt solid windowtext; width: 113px;" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">0.1</span></span></span></p>  
+
| style="border: 1pt solid windowtext; width: 113px;" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">0.1</span></span></span></p>  
| style="border: 1pt solid windowtext; width: 224px;" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">11</span></span></span></p>  
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| style="border: 1pt solid windowtext; width: 224px;" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">11</span></span></span></p>  
 
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| colspan="3" style="border: 1pt solid windowtext; width: 256px;" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">95% CIs:</span></span></span></p>  
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| colspan="3" style="border: 1pt solid windowtext; width: 256px;" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">95% CIs:</span></span></span></p>  
| style="border: 1pt solid windowtext; width: 120px;" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">-100 to 278%</span></span></span></p>  
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| style="border: 1pt solid windowtext; width: 120px;" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">-100 to 278%</span></span></span></p>  
| style="border: 1pt solid windowtext; width: 113px;" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">-0.1 to 0.3</span></span></span></p>  
+
| style="border: 1pt solid windowtext; width: 113px;" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">-0.1 to 0.3</span></span></span></p>  
| style="border: 1pt solid windowtext; width: 224px;" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">NNT = 3 to INF</span></span></span></p> <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">NNH = 3 to INF</span></span></span></p>  
+
| style="border: 1pt solid windowtext; width: 224px;" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">NNT = 3 to INF</span></span></span></p> <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">NNH = 3 to INF</span></span></span></p>  
 
|}
 
|}
  
Line 66: Line 66:
 
{| class="Table" style="border:solid windowtext 1.0pt"
 
{| class="Table" style="border:solid windowtext 1.0pt"
 
|-
 
|-
| rowspan="2" style="border: 1pt solid windowtext; width: 323px;" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">Measure</span></span>'''</span></p>  
+
| rowspan="2" style="border: 1pt solid windowtext; width: 323px;" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">Measure</span></span>'''</span></p>  
| colspan="2" style="border: 1pt solid windowtext; width: 160px;" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">Control Group</span></span>'''</span></p>  
+
| colspan="2" style="border: 1pt solid windowtext; width: 160px;" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">Control Group</span></span>'''</span></p>  
| colspan="2" style="border: 1pt solid windowtext; width: 122px;" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">HBO Group</span></span>'''</span></p>  
+
| colspan="2" style="border: 1pt solid windowtext; width: 122px;" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">HBO Group</span></span>'''</span></p>  
| rowspan="2" style="border: 1pt solid windowtext; width: 138px;" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">Difference</span></span>'''</span></p>  
+
| rowspan="2" style="border: 1pt solid windowtext; width: 138px;" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">Difference</span></span>'''</span></p>  
| rowspan="2" style="border: 1pt solid windowtext; width: 145px;" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">95% CI</span></span>'''</span></p>  
+
| rowspan="2" style="border: 1pt solid windowtext; width: 145px;" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">95% CI</span></span>'''</span></p>  
 
|-
 
|-
| style="border: 1pt solid windowtext; width: 78px;" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">Mean</span></span>'''</span></p>  
+
| style="border: 1pt solid windowtext; width: 78px;" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">Mean</span></span>'''</span></p>  
| style="border: 1pt solid windowtext; width: 75px;" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">SD</span></span>'''</span></p>  
+
| style="border: 1pt solid windowtext; width: 75px;" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">SD</span></span>'''</span></p>  
| style="border: 1pt solid windowtext; width: 58px;" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">Mean</span></span>'''</span></p>  
+
| style="border: 1pt solid windowtext; width: 58px;" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">Mean</span></span>'''</span></p>  
| style="border: 1pt solid windowtext; width: 57px;" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">SD</span></span>'''</span></p>  
+
| style="border: 1pt solid windowtext; width: 57px;" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">SD</span></span>'''</span></p>  
 
|-
 
|-
 
| style="border: 1pt solid windowtext; width: 323px;" |  
 
| style="border: 1pt solid windowtext; width: 323px;" |  
<span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">Functional score (Karnofsky performance score, 0 worst to 100 best) at 2 weeks</span></span>'''</span>
+
<span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">Functional score (Karnofsky performance score, 0 worst to 100 best) at 2 weeks</span></span>'''</span>
  
| style="border: 1pt solid windowtext; width: 78px;" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">89.7</span></span></span></p>  
+
| style="border: 1pt solid windowtext; width: 78px;" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">89.7</span></span></span></p>  
| style="border: 1pt solid windowtext; width: 75px;" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">9.3</span></span></span></p>  
+
| style="border: 1pt solid windowtext; width: 75px;" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">9.3</span></span></span></p>  
| style="border: 1pt solid windowtext; width: 58px;" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">91.6</span></span></span></p>  
+
| style="border: 1pt solid windowtext; width: 58px;" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">91.6</span></span></span></p>  
| style="border: 1pt solid windowtext; width: 57px;" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">8.2</span></span></span></p>  
+
| style="border: 1pt solid windowtext; width: 57px;" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">8.2</span></span></span></p>  
| style="border: 1pt solid windowtext; width: 138px;" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">2.0</span></span></span></p>  
+
| style="border: 1pt solid windowtext; width: 138px;" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">2.0</span></span></span></p>  
| style="border: 1pt solid windowtext; width: 145px;" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">-43.8 to 47.7</span></span></span></p>  
+
| style="border: 1pt solid windowtext; width: 145px;" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">-43.8 to 47.7</span></span></span></p>  
 
|}
 
|}
  
<span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"=""><span style="color:black">Comments:</span></span></span>'''<br/> <span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"=""><span style="color:black">1. Stents relieve dysphagia and have been palliative in the past. Stents implanted with radio-iodine may effectively treat the oesophageal cancer but have not been fully evaluated.<br/> 2. No description of randomisation process or explanation of difference in the numbers allocated to the two groups.<br/> 3. The authors report a statistically significant benefit in response rate of tumours with the addition of HBOT. Our statistics do not confirm this finding.<br/> 4. Our results suggest a non-significant benefit from HBO that would be clinically important if confirmed.<br/> 5. Dysphagia relieved and minor discomfort only reported in both groups.<br/> 6. Authors hypothesise the intermittent reversal of hypoxic areas of tumour improves the effect of radiotherapy here.</span></span></span></span>
+
<span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:"><span style="color:black">Comments:</span></span></span>'''<br/> <span style="font-size:12.0pt"><span style="font-family:"><span style="color:black">1. Stents relieve dysphagia and have been palliative in the past. Stents implanted with radio-iodine may effectively treat the oesophageal cancer but have not been fully evaluated.<br/> 2. No description of randomisation process or explanation of difference in the numbers allocated to the two groups.<br/> 3. The authors report a statistically significant benefit in response rate of tumours with the addition of HBOT. Our statistics do not confirm this finding.<br/> 4. Our results suggest a non-significant benefit from HBO that would be clinically important if confirmed.<br/> 5. Dysphagia relieved and minor discomfort only reported in both groups.<br/> 6. Authors hypothesise the intermittent reversal of hypoxic areas of tumour improves the effect of radiotherapy here.</span></span></span></span>
  
<span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"=""><span style="color:black">Appraised by:</span></span></span>'''<span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"=""><span style="color:black">Mike Bennett m.bennett@unsw.edu.au ; Saturday, 9 April 2022<br/> '''Kill or Update By:''' April 2024</span></span></span></span>
+
<span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:"><span style="color:black">Appraised by:</span></span></span>'''<span style="font-size:12.0pt"><span style="font-family:"><span style="color:black">Mike Bennett m.bennett@unsw.edu.au&nbsp;; Saturday, 9 April 2022<br/> '''Kill or Update By:''' April 2024</span></span></span></span>
 +
<p style="text-align: center;">&nbsp;</p> <p style="text-align: center;">[[File:Sumhorsa.gif|center|Sumhorsa.gif]]</p> <p style="text-align: center;"><span style="font-size:xx-large;">[[Radiotherapy_enhancement|BACK]]</span></p>

Latest revision as of 23:32, 8 April 2022

Weak evidence that the addition of hyperbaric oxygen may improve the effectiveness of radio-iodine stent placement for the treatment of advanced oesophageal cancer.

Clinical bottom line:

1. There was no statistically significant improvement in tumour response to radio-iodine with the addition of hyperbaric oxygen.
2. There was no important difference in the Karnofsky Performance Score after treatment in the two groups.


Citation/s:1. Zhang QZ, Li GL, Shang JB, Ren YM, Xie JL. Clinical study of a 125I particle-integrated esophageal covered stent and hyperbaric oxygen in the treatment of advanced esophageal cancer. Rev Esp Enferm Dig. 2021 Aug;113(8):576-579. doi: 10.17235/reed.2020.7377/2020. PMID: 33261505.
Lead author's name and fax: Qizhou Zhang: zh_qizhou854694@126.com

Three-part Clinical Question:For patients with oesophageal cancer, does the addition of hyperbaric oxygen to the implantation of an oesophageal stent with radio-iodine result in any improved outcome?
Search Terms: Radioactive iodine seeds, Coated stent, Oesophageal cancer

The Study:Non-blinded randomised controlled trial with intention-to-treat.
The Study Patients: Adult patients with advanced oesophageal cancer and no radiotherapy or chemotherapy in the past 3 months.
Control group (N = 19; 19 analysed): Placement of a radio-iodine implanted stent under local anaesthesia.
Experimental group (N = 26; 26 analysed): As above plus 100% oxygen breathing at 2 ATA for 60 minutes daily to a total of 30 sessions. Very slow compression and decompression periods.

The Evidence:

Outcome

Time to Outcome

Control group

HBO group

Relative risk reduction

Absolute risk reduction

NNT

Proportion with complete or partial response

2 weeks

0.6

0.8

28%

0.2

6

95% CIs:

-70% to 14%

-0.1 to 0.4

NNT = 2 to INF

NNH = 11 to INF

Proportion with complete tumour response

2 weeks

0.1

0.2

83%

0.1

11

95% CIs:

-100 to 278%

-0.1 to 0.3

NNT = 3 to INF

NNH = 3 to INF

 

Measure

Control Group

HBO Group

Difference

95% CI

Mean

SD

Mean

SD

Functional score (Karnofsky performance score, 0 worst to 100 best) at 2 weeks

89.7

9.3

91.6

8.2

2.0

-43.8 to 47.7

Comments:
1. Stents relieve dysphagia and have been palliative in the past. Stents implanted with radio-iodine may effectively treat the oesophageal cancer but have not been fully evaluated.
2. No description of randomisation process or explanation of difference in the numbers allocated to the two groups.
3. The authors report a statistically significant benefit in response rate of tumours with the addition of HBOT. Our statistics do not confirm this finding.
4. Our results suggest a non-significant benefit from HBO that would be clinically important if confirmed.
5. Dysphagia relieved and minor discomfort only reported in both groups.
6. Authors hypothesise the intermittent reversal of hypoxic areas of tumour improves the effect of radiotherapy here.

Appraised by:Mike Bennett m.bennett@unsw.edu.au ; Saturday, 9 April 2022
Kill or Update By: April 2024

 

Sumhorsa.gif

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