B175
Is adjuvant chemotherapy adequate as a general treatment approach to cancer? A qualitative systematic review
Khalid Hussain, Julien Al-Shakarchi
Birmingham University Medical School, Birmingham, UK
Although adjuvant chemotherapy is now an established mode of treatment, there is currently little literature comparing its efficacy among the various types of cancers. We aimed to evaluate whether adjuvant chemotherapy is effective across all cancers.
We searched the Cochrane Database of Systematic Reviews and Pubmed for meta-analyses comparing the use of adjuvant chemotherapy against surgery alone in the treatment of epithelial cancers. Strict inclusion criteria and thorough appraisal of the reviews was required to ensure comparability of the included papers.
Our dataset comprised of individual data on 62,852 patients from 12 meta-analyses that compared local surgical treatment alone with the same treatment plus adjuvant chemotherapy in different types of tumours. The cancers included are lung, breast, gastric, colon, bladder, pancreas and soft tissue sarcoma. Eleven of the papers showed statistically significant improvement in survival ranging from 0.75 to 0.88 HR. The point estimate favours adjuvant chemotherapy in all studies. The remaining paper showed a non-significant improvement (0.86HR).
From the data we have gathered it may be reasonable to postulate that providing chemotherapy to post surgical cancer patients will result in roughly a 20% reduction in mortality. Therefore assuming minimal impact on quality of life, adjuvant chemotherapy appears to be a suitable mainstay in the treatment of cancers.
