Toxicity data were retrieved, as avail able, in the publication

Toxicity data were retrieved, as avail able, in the publication. The hazard ratios of time to event data were directly extracted from the original study or were estimated indirectly using either the reported num ber of events and the corresponding selleck chemicals P value for the log rank statistics, or by reading off survival curves, as sug gested by Parmar and colleagues. The calculations were carried out using the spreadsheet provided by Tierney and colleagues. The number of events and number under risk were abstracted for toxicity comparison. Statistical analysis and synthesis Details regarding the main methodological dimensions empirically related to bias Inhibitors,Modulators,Libraries were extracted, and the methodological quality of each selected trial was assessed by two reviewers.

Inhibitors,Modulators,Libraries Special attention was given to the generation and concealment of the sequence Inhibitors,Modulators,Libraries of randomization, blinding, whether an intention to treat analysis was performed or not, use of placebo, and source of funding. These data were applied in a subgroup, and sensitivity analyses were performed to test the stability of our conclusions. All meta analyses were performed using Review Man ager 5 Inhibitors,Modulators,Libraries with a fixed effect model. Time to event outcomes were com pared using HR while an odds ratio was used for toxicity evaluation. The effect of the treatment was expressed as a ratio of active therapy arm over the pla cebo observation arm. Thus, in OS and DFS evaluations, an HR value less than 1 favored active therapy, whereas an HR greater than 1 favored observation. Respective 95% confidence intervals were calculated for each estimate.

In the safety analyses, an OR less than 1 favored active therapy Inhibitors,Modulators,Libraries while an OR greater than 1 favored observation. The number needed to harm for risks, derived from the inverse of the absolute risk difference, was also used to measure toxicity risk. Statistical heterogeneity of the results of the trials was assessed by the chi square test, and was expressed as the I2 index, as described by Higgins and colleagues. When a considerable heterogeneity was detected, a possible explanation for it was pur sued. When a reasonable cause was found, then a sepa rate analysis was performed. If the cause was not apparent and heterogeneity was caused by divergent data in terms of direction of results, we chose not to pool the data. Publication bias was evaluated by Eggers test.

All different therapies hormonal, biochemotherapy, chemotherapy, vaccine, and immunotherapy were ana lyzed separately to access their impact in survival selleck chemicals llc and safety. Results Literature Search The systematic search is summarized in the QUOROM flowchart. Twelve trials were identified that were published or presented between 1987 and 2009.Two studies enrolled metastatic and non metastatic patients but no separate information of non metastatic was provided, which precluded their inclusion in analyses. The remaining ten trials comprised 2609 patients.

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