What do systematic reviews say?

Chemotherapy vs gemcitabine

Various types of chemotherapy showed no clear difference in overall survival ‐ ZD9331 compared with gemcitabine (moderate certainty).

• Chemotherapy and radiotherapy for advanced pancreatic cancer 2018 · Cochrane Headline outcomes only
  HR 0.86 [0.42, 1.76]
  1 study · 55 participants
  Moderate

Chemotherapy vs gemcitabine

Various types of chemotherapy showed no clear difference in overall survival ‐ Exatecan compared with gemcitabine (moderate certainty).

• Chemotherapy and radiotherapy for advanced pancreatic cancer 2018 · Cochrane Headline outcomes only
  HR 1.27 [0.96, 1.68]
  1 study · 339 participants
  Moderate

Gemcitabine combinations vs gemcitabine

Gemcitabine combinations showed no clear difference in overall survival ‐ Gemcitabine plus platinum agent compared with gemcitabine alone (low certainty).

• Chemotherapy and radiotherapy for advanced pancreatic cancer 2018 · Cochrane Headline outcomes only
  HR 0.94 [0.81, 1.08]
  6 studies · 1140 participants
  Low

Gemcitabine combinations vs gemcitabine

Gemcitabine combinations leads to lower overall survival ‐ Gemcitabine plus fluoropyrimidine compared with gemcitabine alone (high certainty).

• Chemotherapy and radiotherapy for advanced pancreatic cancer 2018 · Cochrane Headline outcomes only
  HR 0.89 [0.81, 0.97]
  10 studies · 2718 participants
  High

Summary of findings: Conformal RT vs conventional dose RT

• Interventions to reduce acute and late adverse gastrointestinal effects of pelvic radiotherapy for primary pelvic… 2018 · Cochrane Headline outcomes only
  no estimate extracted
  0 participants
  GRADE not reported

Summary of findings: BT vs external beam radiotherapy (EBRT)

The review found no eligible studies for this question.

• Interventions to reduce acute and late adverse gastrointestinal effects of pelvic radiotherapy for primary pelvic… 2018 · Cochrane Headline outcomes only
  no estimate extracted
  Studies not reported
  No studies found

Probiotics vs placebo or control

Summary of findings: Probiotics may leads to lower diarrhoea (grade 2+) compared with control (placebo or no intervention) (low certainty).

• Interventions to reduce acute and late adverse gastrointestinal effects of pelvic radiotherapy for primary pelvic… 2018 · Cochrane Headline outcomes only
  RR 0.43 [0.22, 0.82]
  5 studies · 923 participants
  Low

Probiotics vs placebo or control

The review found no eligible studies for this question.

• Interventions to reduce acute and late adverse gastrointestinal effects of pelvic radiotherapy for primary pelvic… 2018 · Cochrane Headline outcomes only
  no estimate extracted
  Studies not reported
  No studies found

Summary of findings: Proteolytic enzymes vs placebo or control

The review found no eligible studies for this question.

• Interventions to reduce acute and late adverse gastrointestinal effects of pelvic radiotherapy for primary pelvic… 2018 · Cochrane Headline outcomes only
  no estimate extracted
  Studies not reported
  No studies found

Summary of findings: Proteolytic enzymes vs placebo or control

Summary of findings: Proteolytic enzymes may leads to lower acute and late GI toxicity (grade 2+) compared with control (placebo or no intervention) (low certainty).

• Interventions to reduce acute and late adverse gastrointestinal effects of pelvic radiotherapy for primary pelvic… 2018 · Cochrane Headline outcomes only
  RR 0.45 [0.24, 0.88]
  1 study · 120 participants
  Low

Summary of findings: Proteolytic enzymes vs placebo or control

It is very uncertain whether summary of findings: Proteolytic enzymes changes diarrhoea (grade 2+) compared with control (placebo or no intervention) (very low certainty).

• Interventions to reduce acute and late adverse gastrointestinal effects of pelvic radiotherapy for primary pelvic… 2018 · Cochrane Headline outcomes only
  RR 1.6 [0.89, 2.89]
  1 study · 56 participants
  Very low

Summary of findings: Proteolytic enzymes vs placebo or control

The review found no eligible studies for this question.

• Interventions to reduce acute and late adverse gastrointestinal effects of pelvic radiotherapy for primary pelvic… 2018 · Cochrane Headline outcomes only
  no estimate extracted
  Studies not reported
  No studies found

Glutamine vs placebo

The review found no eligible studies for this question.

• Interventions to reduce acute and late adverse gastrointestinal effects of pelvic radiotherapy for primary pelvic… 2018 · Cochrane Headline outcomes only
  no estimate extracted
  Studies not reported
  No studies found

Glutamine vs placebo

Summary of findings: Glutamine showed no clear difference in acute and late GI toxicity (grade 2+) compared with placebo (low certainty).

• Interventions to reduce acute and late adverse gastrointestinal effects of pelvic radiotherapy for primary pelvic… 2018 · Cochrane Headline outcomes only
  RR 2.4 [0.68, 8.53]
  1 study · 69 participants
  Low

Glutamine vs placebo

Summary of findings: Glutamine showed no clear difference in diarrhoea (grade 2+) compared with placebo (high certainty).

• Interventions to reduce acute and late adverse gastrointestinal effects of pelvic radiotherapy for primary pelvic… 2018 · Cochrane Headline outcomes only
  RR 0.98 [0.78, 1.24]
  4 studies · 289 participants
  High

Glutamine vs placebo

The review found no eligible studies for this question.

• Interventions to reduce acute and late adverse gastrointestinal effects of pelvic radiotherapy for primary pelvic… 2018 · Cochrane Headline outcomes only
  no estimate extracted
  Studies not reported
  No studies found

Summary of findings: BT vs external beam radiotherapy (EBRT)

• Interventions to reduce acute and late adverse gastrointestinal effects of pelvic radiotherapy for primary pelvic… 2018 · Cochrane Headline outcomes only
  no estimate extracted
  0 participants
  GRADE not reported

Counselling vs no intervention

Summary of findings: Counselling showed no clear difference in mean GI symptom scores (lower is better) compared with no intervention (low certainty).

• Interventions to reduce acute and late adverse gastrointestinal effects of pelvic radiotherapy for primary pelvic… 2018 · Cochrane Headline outcomes only
  MD 0.08
  1 study · 152 participants
  Low

Counselling vs no intervention

The review found no eligible studies for this question.

• Interventions to reduce acute and late adverse gastrointestinal effects of pelvic radiotherapy for primary pelvic… 2018 · Cochrane Headline outcomes only
  no estimate extracted
  Studies not reported
  No studies found

Counselling vs no intervention

Summary of findings: Counselling may leads to lower diarrhoea (grade 2+) compared with no intervention (low certainty).

• Interventions to reduce acute and late adverse gastrointestinal effects of pelvic radiotherapy for primary pelvic… 2018 · Cochrane Headline outcomes only
  RR 0.12 [0.03, 0.47]
  1 study · 74 participants
  Low