scholarly journals Interventions to Improve Self-Efficacy in Colorectal Cancer Patients and/or Caregivers: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 2021 ◽  
pp. 1-12
Author(s):  
Jiali Gong ◽  
Caiping Hu ◽  
Meizhen Chen ◽  
Qian Cao ◽  
Qiuping Li
Keyword(s):  
Colorectal Cancer ◽  
Self Efficacy ◽  
Chinese Literature ◽  
Meta Analysis ◽  
Emotional Arousal ◽  
Cochrane Library ◽  
Sources Of Information ◽  
Positive Effects ◽  
Colorectal Cancer Patients ◽  
Different Sources

Objective. High levels of self-efficacy (SE) in colorectal cancer (CRC) patients and/or caregivers enable patients to cope with cancer, reduce caregiver burden, and promote quality of life (QOL) in patients and caregivers alike. This review aims to (a) identify the SE theory sources covered by SE interventions or interventions, including targeting improved SE for CRC patients and/or caregivers, to guide future development of SE interventions; and (b) explore intervention effects based on SE theory through meta-analysis. Methods. Using five electronic databases—CINAHL, Cochrane Library, Embase, PsycINFO, and PubMed—a systematic search was performed in April 2021 to identify English or Chinese literature that studied improving SE interventions for CRC patients and/or caregivers. Manual screening of the articles’ references list was also performed. Results. A total of 18 studies were found to be suitable and included in this review. Of the 18 studies that were included, 10 randomized controlled trials (RCTs) studies with 917 participants were eligible for meta-analysis. Interventions provide support for SE drawing on different sources of information. Performance accomplishment (PA) is the key source, with vicarious experience (VE) and verbal persuasion (VP) assisting in improving PA. Reducing negative emotional arousal (NEA) and improving positive emotional arousal (PEA) are also indispensable factors in improving SE. The meta-analysis results show that interventions based on the SE theory can bring about positive effects for CRC patients and/or caregivers. Conclusions. Different sources of information aimed at improving SE, covered by the interventions, including PA, VE, VP, NEA, and PEA, have been explored. Positive intervention outcomes that focused on improving SE for CRC patients and/or caregivers were identified and highlighted. For future SE interventions, we advocate choosing combination sources of SE information to design interventions. It is recommended that future SE improvement interventions should focus on improving PA, supplemented by increasing VE, while reducing NEA and providing useful VP.

scholarly journals Improved Overall Survival of Colorectal Cancer under Multidisciplinary Team: A Meta-Analysis

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Dong Peng ◽  
Yu-Xi Cheng ◽  
Yong Cheng
Keyword(s):  
Colorectal Cancer ◽  
Overall Survival ◽  
Multidisciplinary Team ◽  
Meta Analysis ◽  
Postoperative Mortality ◽  
Stage Iv ◽  
Cochrane Library ◽  
Stage Iv Colorectal Cancer ◽  
Significant Difference ◽  
Colorectal Cancer Patients

Purpose. The purpose of the current meta-analysis was to evaluate whether multidisciplinary team improved overall survival of colorectal cancer. Methods. PubMed, EMBASE, and Cochrane Library database were searched from inception to October 25, 2020. The hazard ratio (HR) and 95% confidence (CI) of overall survival (OS) were calculated. Results. A total of 11 studies with 30814 patients were included in this meta-analysis. After pooling the HRs, the MDT group was associated with better OS compared with the non-MDT group ( HR = 0.81 , 95% CI 0.69-0.94, p = 0.005 ). In subgroup analysis of stage IV colorectal cancer, the MDT group was associated with better OS as well ( HR = 0.73 , 95% CI 0.59-0.90, p = 0.004 ). However, in terms of postoperative mortality, no significant difference was found between MDT and non-MDT groups ( OR = 0.84 , 95% CI 0.44-1.61, p = 0.60 ). Conclusion. MDT could improve OS of colorectal cancer patients.

scholarly journals Bevacizumab improves survival in metastatic colorectal cancer patients with primary tumor resection: A meta-analysis

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Dedong Cao ◽  
Yongfa Zheng ◽  
Huilin Xu ◽  
Wei Ge ◽  
Ximing Xu
Keyword(s):  
Colorectal Cancer ◽  
Metastatic Colorectal Cancer ◽  
Primary Tumor ◽  
Meta Analysis ◽  
Tumor Resection ◽  
Progression Free Survival ◽  
Primary Tumor Resection ◽  
Cochrane Library ◽  
Colorectal Cancer Patients ◽  
Resected Primary Tumor

AbstractIt is not well determined whether primary tumor resection is associated with better outcomes in metastatic colorectal cancer (mCRC) patients treated with bevacizumab. In this meta-analysis, we aimed to assess the prognostic role of primary tumor resection in mCRC treated with bevacizumab. Electronic databases including the Cochrane library, Embase, and Pubmed were searched until April 2018. Clinical studies assessing the influence of primary tumor resection on the efficacy of bevacizumab in patients with mCRC were identified. The primary endpoint was overall survival (OS), and the secondary endpoint was progression-free survival (PFS). Seven studies including 2760 mCRC patients were finally included. The results of the meta-analysis were in favor of bevacizumab to patients with resected primary tumor in terms of OS (HR = 0.50, 95%CI: 0.39–0.64; p < 0.01), and PFS (HR = 0.65, 95%CI: 0.51–0.81; p < 0.01). Administration of bevacizumab in mCRC patients with resected primary tumor had a better OS (HR = 0.65, 95%CI: 0.56–0.74; p < 0.01), when compared to chemotherapy(CT). Adding bevacizumab to mCRC patients without resection of primary tumor also had a better OS (HR = 0.78, 95%CI: 0.65–0.94; p < 0.01) and PFS (HR = 0.71, 95%CI: 0.57–0.88; p < 0.01) compared to chemotherapy alone. In conclusion, mCRC patients with resected primary tumor have better survival than those without surgery of primary tumor when treated with bevacizumab. Primary tumor resection status should be taken into consideration when using bevacizumab in mCRC.

scholarly journals Association of UGT1A1*6 polymorphism with irinotecan-based chemotherapy reaction in colorectal cancer patients: a systematic review and a meta-analysis

2020 ◽  
Vol 40 (10) ◽  
Author(s):  
Xiaoyun Zhu ◽  
Ruchao Ma ◽  
Xin Ma ◽  
Gang Yang
Keyword(s):  
Colorectal Cancer ◽  
Systematic Review ◽  
Lower Risk ◽  
Web Of Science ◽  
Late Onset ◽  
Meta Analysis ◽  
Cochrane Library ◽  
The World ◽  
Colorectal Cancer Patients ◽  
Allele Model

Abstract Colorectal cancer (CRC) is a leading cause of cancer-related deaths across the world. Irinotecan (IRI) is commonly used to treat CRC, and IRI-based chemotherapy is linked with adverse reaction and the efficacy of the treatment regimen. The gene UGT1A1 plays a central role in the IRI metabolic pathway. A polymorphism UGT1A1*6 has been widely researched which may be related to response of IRI-based chemotherapy in CRC. All relevant studies were strictly searched from PubMed, Embase, Cochrane Library and Web of Science databases to explore the associations between UGT1A1*6 and response of IRI-based chemotherapy with CRC. Nine articles comprising 1652 patients were included in the final combination. Meta-analysis showed G allele or GG had a lower risk of severe late-onset diarrhea compared with A/AA in allele model and homozygote model (G vs. A: OR = 0.53, 95% CI: 0.28–0.99, P=0.05; GG vs. AA: OR = 0.48, 95% CI: 0.23–0.99, P=0.05), no significant association was observed in other models. In addition, a significant association between UGT1A1*6 and neutropenia was observed in all models (G vs. A: OR = 0.57, 95% CI: 0.46–0.71, P=0.00; GG vs. AA: OR = 0.28, 95% CI: 0.17–0.45, P=0.01; GA vs. AA: OR = 0.42, 95% CI: 0.26–0.70, P=0.00; GG+GA vs. AA: OR = 0.32, 95% CI: 0.20–0.52, P=0.00; GG vs. AA+GA: OR = 0.40, 95% CI: 0.22–0.71, P=0.00), whereas, no relationship was found between UGT1A1*6 and clinical response among the different genotypes. UGT1A1*6 may be considered as a biomarker for IRI-based chemotherapy in CRC.

Effect of KRAS and BRAF mutations in metastatic colorectal cancer patients: A systematic review and meta-analysis based on tumor sidedness and KRAS subtypes

2021 ◽  
pp. 1-10
Author(s):  
Khadijeh Saravani ◽  
Morteza Salarzaei ◽  
Fateme Parooie
Keyword(s):  
Colorectal Cancer ◽  
Metastatic Colorectal Cancer ◽  
Cancer Patients ◽  
Braf Mutation ◽  
Meta Analysis ◽  
Tumor Location ◽  
Cochrane Library ◽  
Braf Mutations ◽  
The Right ◽  
Colorectal Cancer Patients

INTRODUCTION: Metastatic or recurrent colorectal cancer (MRCRC) has a poor prognosis. The aim of the present meta-analysis was to assess the prevalence of different subtypes of KRAS mutation and BRAF mutation in metastatic CRC patients, and evaluate the relationship between the tumor sidedness and prevalence of KRAS and BRAF mutation. METHODS: We searched MEDLINE/PubMed, the Cochrane Library, and ClinicalTrials.gov from January 2010 to July 2020. The data were extracted independently according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The statistical analysis was done using STATA and Meta-Disk 1.4 applications. RESULTS: Overall, 6699 colorectal cancer patients were included. KRAS and BRAF mutation was reported in 28% and 6% of patients, respectively. The overall prevalence of right primary and left primary metastatic CRC patients with mutated KRAS was 40% and 60%. However, the prevalence BRAF mutated right primary and left primary metastatic CRC patients was 37% and 63%. The overall HR was 2.38 for patients with metastatic CRC who had a mutated type of KRAS. Our study showed a mean overall survival of 35.4 month for KRAS mutant and a 10.12 month survival for BRAF mutant patients with metastatic colorectal cancer patients. CONCLUSION: The prevalence of KRAS and BRAF mutations varied significantly according to the location of the tumor. BRAF mutations are more commonly found in metastatic colorectal cancers on the right side. Liver was the most common site of metastases in patients with mutant KRAS and the mortality of patients with mutant KRAS was 2.3 times higher than the patients with wild types. These results help to better describe the population of mCRC patients and can have implications for improving and organizing anti-EGFR therapies. Further research is needed to assess differences in survival through mutation status and primary tumor location.

scholarly journals Metformin Improves Overall Survival of Colorectal Cancer Patients with Diabetes: A Meta-Analysis

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Fanqiang Meng ◽  
Li Song ◽  
Wenyue Wang
Keyword(s):  
Colorectal Cancer ◽  
Overall Survival ◽  
Cohort Studies ◽  
Meta Analysis ◽  
Good Choice ◽  
Cochrane Library ◽  
Cancer Specific Survival ◽  
Incidence And Mortality ◽  
Patients With Diabetes ◽  
Colorectal Cancer Patients

Introduction. Diabetic population has a higher risk of colorectal cancer (CRC) incidence and mortality than nondiabetics. The role of metformin in CRC prognosis is still controversial. The meta-analysis aims to investigate whether metformin improves the survival of diabetic CRC patients.Methods. PubMed, EMBASE, and Cochrane Library were searched till July 1, 2016. Cohort studies were included. All articles were evaluated by Newcastle-Ottawa Scale. Hazard Ratios (HRs) with 95% confidence intervals (CIs) for each study were calculated and pooled HRs with corresponding 95% CIs were generated using the random-effects model. Heterogeneity and publication bias were assessed.Results. We included seven cohort studies with a medium heterogeneity (I2= 56.1% andp=0.033) in our meta-analysis. An improved overall survival (OS) for metformin users over nonusers among colorectal cancers with diabetes was noted (HR 0.75; 95% CI 0.65 to 0.87). However, metformin reveals no benefits for cancer-specific survival (HR 0.79, 95%, CI 0.58 to 1.08).Conclusions. Metformin prolongs the OS of diabetic CRC patients, but it does not affect the CRC-specific survival. Metformin may be a good choice in treating CRC patients with diabetes mellitus in clinical settings.

Effectiveness of Colorectal Cancer Screening Promotion Using E-Media Decision-Aids: A Systematic Review and Meta-Analysis (Preprint)

2021 ◽  
Author(s):  
Nur Suhada Ramli ◽  
Mohd Rizal Abdul Manaf ◽  
Mohd Rohaizat Hassan ◽  
Muhamad Izwan Ismail ◽  
Azmawati Mohammed Nawi
Keyword(s):  
Colorectal Cancer ◽  
Screening Test ◽  
Meta Analysis ◽  
Decision Aids ◽  
Completion Rate ◽  
Cochrane Library ◽  
Screening Programs ◽  
Crc Screening ◽  
Positive Effects ◽  
Secondary Outcomes

BACKGROUND Colorectal cancer (CRC) screening reduces mortality yet remains underutilized. Low health literacy may contribute to this underutilization by interfering with patients' ability to understand and receive preventive health services. E-media decision-aids approach have been shown to improve saliency and foster informed decision making. OBJECTIVE This systematic literature review aims to determine the effectiveness of CRC screening promotion using e-media decision-aids in primary health care (PHC) settings. METHODS Three databases (Medline, Web of Science, and Cochrane Library) were used to search for eligible studies, published from January 2010 until December 2020. Reviewers independently selected studies that quantitatively evaluated e-media decision-aids compared to usual care or other conditions. Cochrane’s tools were applied for quality assessment. Effectiveness of CRC screening e-media decision-aids was primarily measured by CRC screening completion rate. Secondary outcomes were spoiled kit return rate, CRC screening awareness and belief, ability to state screening test preference, readiness to receive and ordered CRC screening test. Meta‐analysis were conducted to calculate pooled estimates of CRC screening completion rate by using RevMan 5.4.1 software. RESULTS Ten studies comprising of 9393 patients were included in this review. Follow-ups were from three to twenty-four months. Most studies focused to improve screening in vulnerable populations that tend to be under-screened. Two types of decision-aid interventions used were video and interactive multimedia program, with duration between six to fifteen minutes. Data from nine feasible studies with low or some risk of bias were synthesized for meta-analysis. Random‐effects model revealed CRC screening promotions using e-media decision aids were almost twice likely to have screening completion than their comparisons (OR 1.62, 95% CI: 1.03‐2.62, p<0.05). All secondary outcomes showed positive effects of CRC screening interventions, despite some were not significant. CONCLUSIONS CRC screening promotion through e-media have great potential to increase screening participation in PHC settings. Development of culturally tailored decision aids aiming for CRC screening completion should be prioritized, and made integrated into existing CRC screening programs. CLINICALTRIAL Prospero (registration ID CRD42020220301)

scholarly journals The effects of clinical decision support system for prescribing medication on patient outcomes and physician practice performance: a systematic review and meta-analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sharare Taheri Moghadam ◽  
Farahnaz Sadoughi ◽  
Farnia Velayati ◽  
Seyed Jafar Ehsanzadeh ◽  
Shayan Poursharif
Keyword(s):  
Systematic Review ◽  
Decision Support ◽  
Patient Outcomes ◽  
Clinical Decision Support ◽  
Meta Analysis ◽  
Clinical Decision ◽  
Cochrane Library ◽  
Physician Practice ◽  
Positive Effects ◽  
Practice Performance

Abstract Background Clinical Decision Support Systems (CDSSs) for Prescribing are one of the innovations designed to improve physician practice performance and patient outcomes by reducing prescription errors. This study was therefore conducted to examine the effects of various CDSSs on physician practice performance and patient outcomes. Methods This systematic review was carried out by searching PubMed, Embase, Web of Science, Scopus, and Cochrane Library from 2005 to 2019. The studies were independently reviewed by two researchers. Any discrepancies in the eligibility of the studies between the two researchers were then resolved by consulting the third researcher. In the next step, we performed a meta-analysis based on medication subgroups, CDSS-type subgroups, and outcome categories. Also, we provided the narrative style of the findings. In the meantime, we used a random-effects model to estimate the effects of CDSS on patient outcomes and physician practice performance with a 95% confidence interval. Q statistics and I2 were then used to calculate heterogeneity. Results On the basis of the inclusion criteria, 45 studies were qualified for analysis in this study. CDSS for prescription drugs/COPE has been used for various diseases such as cardiovascular diseases, hypertension, diabetes, gastrointestinal and respiratory diseases, AIDS, appendicitis, kidney disease, malaria, high blood potassium, and mental diseases. In the meantime, other cases such as concurrent prescribing of multiple medications for patients and their effects on the above-mentioned results have been analyzed. The study shows that in some cases the use of CDSS has beneficial effects on patient outcomes and physician practice performance (std diff in means = 0.084, 95% CI 0.067 to 0.102). It was also statistically significant for outcome categories such as those demonstrating better results for physician practice performance and patient outcomes or both. However, there was no significant difference between some other cases and traditional approaches. We assume that this may be due to the disease type, the quantity, and the type of CDSS criteria that affected the comparison. Overall, the results of this study show positive effects on performance for all forms of CDSSs. Conclusions Our results indicate that the positive effects of the CDSS can be due to factors such as user-friendliness, compliance with clinical guidelines, patient and physician cooperation, integration of electronic health records, CDSS, and pharmaceutical systems, consideration of the views of physicians in assessing the importance of CDSS alerts, and the real-time alerts in the prescription.

scholarly journals Efficacy and safety of anti-epidermal growth factor receptor agents for the treatment of oesophageal cancer: a systematic review and meta-analysis

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e046352
Author(s):  
Lijuan Zhang ◽  
Yanli Song ◽  
Nan Jiang ◽  
Yaqi Huang ◽  
Bo Dong ◽  
...  
Keyword(s):  
Systematic Review ◽  
Growth Factor ◽  
Outcome Measures ◽  
Oesophageal Cancer ◽  
Meta Analysis ◽  
Growth Factor Receptor ◽  
Cochrane Library ◽  
Secondary Outcome ◽  
Efficacy And Safety ◽  
Positive Effects

ObjectivesDespite remarkable advances in the treatment of oesophageal cancer (OC), the role of antiepidermal growth factor receptor (anti-EGFR) agents in treating OC remains controversial. Herein, a systematic review and meta-analysis were conducted to elucidate the efficacy and safety of anti-EGFR agents in patients with OC.DesignMeta-analysis of randomised controlled trials (RCTs) identified by searching the PubMed, Embase, Web of Science, ClinicalTrials.gov, Cochrane Library, Chinese Biology Medicine, China National Knowledge Infrastructure and Wanfang Data Knowledge Service Platform databases from inception to December 2019. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.SettingRCTs from any country and healthcare setting.ParticipantsPatients with OC.InterventionsCombination therapy with anti-EGFR agents and conventional treatments versus conventional treatments alone in patients with OC.Primary and secondary outcome measuresOverall survival (OS) and progression-free survival (PFS) were primary outcome measures, and objective response rate (ORR), disease control rate (DCR) and treatment toxicities were secondary outcome measures.ResultsIn total, 25 RCTs comprising 3406 patients with OC were included. Overall, anti-EGFR treatment significantly improved the OS (HR: 0.81, 95% CI 0.74 to 0.89, p<0.00001), ORR (relative risk (RR): 1.33, 95% CI 1.16 to 1.52, p<0.0001) and DCR (RR: 1.22, 95% CI 1.11 to 1.34, p<0.0001) but not PFS (HR: 0.91, 95% CI 0.76 to 1.08, p=0.26). Anti-EGFR treatment was significantly associated with higher incidences of myelosuppression, diarrhoea, acne-like rash and hypomagnesaemia.ConclusionsOverall, anti-EGFR agents have positive effects on OS, the ORR and DCR in OC. However, considering the high incidence of adverse effects, such as myelosuppression, diarrhoea, acne-like rashes and hypomagnesaemia, careful monitoring of patients with OC is recommended during anti-EGFR treatment.Trial registration numberCRD42020169230.

S-1 and Capecitabine for the Treatment of Colorectal Cancer: A Meta-Analysis

2021 ◽  
Vol 11 (6) ◽  
pp. 1144-1152
Author(s):  
Ping Huang ◽  
Zhenfen Wang ◽  
Qian Liu ◽  
Guohao Cai
Keyword(s):  
Colorectal Cancer ◽  
Web Of Science ◽  
Advanced Colorectal Cancer ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Therapeutic Effects ◽  
Chemotherapeutic Drugs ◽  
The Third ◽  
Hand Foot Syndrome ◽  
The Cochrane Library

Colorectal cancers common tumors that develop in the large intestines. The incidence of colorectal cancer is second only to gastric and esophageal cancers. Both S-1 and capecitabine are the third-generation fluorouracil-based chemotherapeutic drugs. We hope to summarize the therapeutic effects of tecotae and capecitabine in patients with colorectal cancer through this Meta-analysis. We performed a meta-analysis of the findings in the current literature. We performed a systematic review of outcomes associated with S-1 and capecitabine used to treat advanced colorectal cancer based on findings from both English and Chinese publications listed in PubMed, Embase, CNKI, Wanfang, EBSCO, Web of Science and the Cochrane Library. End-points included ORR, DCR, OS, and PFS; adverse events (grades 1–2 and 3–4) were also evaluated. Statistical analysis was performed using RevMan 5.3. A total of 12 studies were eventually included, involving a total of 3,375 patients. Of this group, 1,683 and 1,692 patients underwent treatment with S-1 or capecitabine, respectively. There were no greatly differences with respect to ORR, DCR, or OS; however, PFS was bettered in the group of S-1 compared to those treated with capecitabine. The incidence of leukopenia, diarrhea and anorexia were all higher among those in S-1 group compared to the capecitabine group, but a higher incidence of hand-foot syndrome was linked with use of capecitabine. Use of S-1 for the treatment of colorectal cancer may result in superior outcomes when compared to use of capecitabine.

scholarly journals Prevalence of Human Papilloma Virus in Patients With Colorectal Cancer: A Systematic Review and Meta-analysis

2019 ◽  
Vol 7 (4) ◽  
pp. 106-112
Author(s):  
Masoud Dadashi ◽  
Shaian Tavakolian ◽  
Ebrahim Faghihloo
Keyword(s):  
Colorectal Cancer ◽  
Meta Analysis ◽  
Scientific Information ◽  
Random Effect ◽  
Random Effect Model ◽  
Hpv Infection ◽  
High Rate ◽  
Cochrane Library ◽  
High Risk Behaviors ◽  
The World

Background: Human papillomavirus (HPV) is considered as one of the most common carcinogenic viruses in humans throughout the world and is mostly associated with gynecologic malignancies. However, it is also one of the environmental factors that is involved in colorectal cancer (CRC). Objective: A meta-analysis was performed to investigate the prevalence of HPV infection in patients suffering from the CRC. Methods: The frequency of the HPV in patients with CRC was studied from 2001 to 2016. To this end, several databases were reviewed, including PubMed, Web of Science, Embase, Cochrane Library, Google Scholar, Iranmedex, and the Scientific Information Database. Then, the analysis was done by Comprehensive Meta-Analysis (V2.0, Biostat) software. Considering heterogeneity between different studies, the random effect model was used and then the results were checked with Cochran’s Q-statistic. Results: The meta-analysis revealed that the frequency of HPV infection in patients with CRC was 33.7% (a 95% CI of 28.4-39.5). The additional stratified analysis also showed that HPV infection in CRC patients was more widespread in European countries compared to Asian and American countries. Conclusion: The high rate of HPV infection is a major concern in sexually transmitted diseases around the world, therefore, controlling high-risk behaviors, vaccination, screening, and HPV subtyping can be useful in managing HPV infections.

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