Cochrane Db Syst Rev
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Cochrane Db Syst Rev · Jul 2006
Review Meta AnalysisPurine antagonists for chronic lymphocytic leukaemia.
Recent trials suggest improved response rates for purine antagonists compared to alkylator-based regimens in the treatment of B-CLL. However, none was able to show a survival advantage. ⋯ Despite significantly increased overall response and complete remission rates and longer progression-free survival with first-line treatment of B-CLL patients with single-agent purine antagonists, we were not able to detect a statistically significant improvement of overall survival compared to alkylator-based regimens. Furthermore, the use of purine antagonists also augments the risk for grade III/IV infections and hemolytic anemia.
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Cochrane Db Syst Rev · Jul 2006
Review Meta AnalysisChemotherapy and radiotherapy for inoperable advanced pancreatic cancer.
Pancreatic cancer has a poor prognosis. The benefit of chemotherapy, radiotherapy or both as a palliative treatment of advanced or relapsed disease is uncertain. ⋯ Chemotherapy appears to prolong survival in people with advanced pancreatic cancer and can confer clinical benefits and improve quality of life. Combination chemotherapy did not improve overall survival compared to single-agent chemotherapy. Gemcitabine is an acceptable control arm for future trials investigating scheduling and combinations with novel agents. There is insufficient evidence to recommend chemoradiation in patients with locally advanced inoperable pancreatic cancer as a superior alternative to chemotherapy alone.
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Cochrane Db Syst Rev · Jul 2006
Review Meta AnalysisPsychostimulants for hypersomnia (excessive daytime sleepiness) in myotonic dystrophy.
Excessive daytime sleepiness is a common symptom of myotonic dystrophy. Psychostimulants are drugs increasingly used to treat hypersomnia in myotonic dystrophy. ⋯ There is no evidence to support the routine use of psychostimulants to treat hypersomnia in myotonic dystrophy. There is some evidence from two studies that modafinil may improve daytime sleepiness. More randomised trials are needed to evaluate the efficacy and safety of psychostimulants.
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Cochrane Db Syst Rev · Jul 2006
Review Meta AnalysisPreoperative chemotherapy for resectable thoracic esophageal cancer.
Surgery has been the treatment of choice for localized esophageal cancer. A number of studies have investigated whether preoperative chemotherapy followed by surgery leads to an improvement in cure rates but the individual reports have been conflicting. An explicit systematic update of the role of preoperative chemotherapy in the treatment of resectable thoracic esophageal cancer is, therefore, warranted. ⋯ In summary, preoperative chemotherapy plus surgery may offer a survival advantage compared to surgery alone for resectable thoracic esophageal cancer, but the evidence is inconclusive. There is some evidence of toxicity and preoperative mortality associated with chemotherapy.
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Cochrane Db Syst Rev · Jul 2006
Review Meta AnalysisPotassium containing toothpastes for dentine hypersensitivity.
Dentine hypersensitivity may be defined as the pain arising from exposed dentine, typically in response to external stimuli, and which cannot be explained by any other form of dental disease. Many treatment regimens have been recommended over the years, and in recent years particular attention has been focused on toothpastes containing various potassium salts. ⋯ The evidence generated by this review is based on a small number of individuals. Furthermore, the effect varies with the methods applied for assessing the sensitivity. Thus no clear evidence is available for the support of potassium containing toothpastes for dentine hypersensitivity.