Cochrane · systematic review · CD005048
Interventions for dysphagia in oesophageal cancer
Yang, C, Li, J, Fu, W, et al. · Cochrane Database of Systematic Reviews · 2014 · Cochrane Library
GutAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
26
current version
GRADE rated
26
No studies
0
Included studies
NR
No studies 0 · 0%Ungraded 0 · 0%Very low 0 · 0%Low 0 · 0%Moderate 19 · 73.1%High 7 · 26.9%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
SEMS compared to plastic tube (main analysis) for dysphagia in oesophageal cancer
Population: patients with dysphagia in oesophageal cancer
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Dysphagia improvement SEMS vs plastic tube (main analysis) | no estimate extracted | 2 studies · 231 participants | Moderate Downgraded: inconsistency |
Subgroup analysis dysphagia improvement SEMS vs plastic tube (main analysis) | no estimate extracted | 2 studies · 178 participants | Moderate |
Persistent or recurrent dysphagia SEMS vs plastic tube (main analysis) | OR 0.41 [0.2, 0.85] | 7 studies · 433 participants | High |
All major adverse effects SEMS vs plastic tube (main analysis) | OR 0.25 [0.16, 0.39] | 7 studies · 433 participants | Moderate Downgraded: inconsistency |
SEMS compared to laser for dysphagia in oesophageal cancer
Population: patients with dysphagia in oesophageal cancer
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Persistent or recurrent dysphagia SEMS vs laser | OR 0.67 [0.3, 1.54] | 2 studies · 125 participants | High |
Interventions for recurrent dysphagia SEMS vs laser | OR 0.27 [0.12, 0.6] | 2 studies · 125 participants | High |
Adverse effects ‐ All adverse effects SEMS vs laser | OR 2.26 [0.96, 5.33] | 2 studies · 125 participants | Moderate Downgraded: inconsistency |
Laser compared to plastic tube for dysphagia in oesophageal cancer
Population: patients with dysphagia in oesophageal cancer
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Dysphagia improvement Laser vs plastic tube | OR 3.22 [0.78, 13.37] | 2 studies · 80 participants | Moderate Downgraded: inconsistency |
Recurrent dysphagia Laser vs plastic tube | OR 2.89 [0.02, 461.22] | 2 studies · 80 participants | High |
Technical success of procedure Laser vs plastic tube | OR 1 [0.21, 4.75] | 2 studies · 80 participants | Moderate Downgraded: inconsistency |
All adverse effects Laser vs plastic tube | OR 2.33 [0.87, 6.24] | 2 studies · 80 participants | Moderate Downgraded: inconsistency |
Laser compared to laser plus brachytherapy for dysphagia in oesophageal cancer
Population: patients with dysphagia in oesophageal cancer
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Recurrent dysphagia Laser vs laser plus brachytherapy | OR 0.22 [0.06, 0.87] | 3 studies · 87 participants | Moderate |
Adverse effects ‐ All adverse effects Laser vs laser plus brachytherapy | OR 0.74 [0.31, 1.77] | 4 studies · 124 participants | Moderate Downgraded: inconsistency |
Laser compared to photodynamic therapy (PDT) for dysphagia in oesophageal cancer
Population: patients with dysphagia in oesophageal cancer
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Dysphagia improvement (2‐point grade or more) Laser vs photodynamic therapy (PDT) | OR 0.92 [0.57, 1.5] | 2 studies · 278 participants | Moderate Downgraded: inconsistency |
Adverse effects ‐ All adverse effects Laser vs photodynamic therapy (PDT) | OR 0.6 [0.33, 1.07] | 2 studies · 278 participants | Moderate Downgraded: inconsistency |
Covered Ultraflex SEMS compared to covered Wallstent for dysphagia in oesophageal cancer
Population: patients with dysphagia in oesophageal cancer
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Dysphagia improvement Covered Ultraflex SEMS vs covered Wallstent | no estimate extracted | 2 studies · 120 participants | Moderate Downgraded: inconsistency |
Persistent or recurrent dysphagia Covered Ultraflex SEMS vs covered Wallstent | OR 1.27 [0.49, 3.31] | 2 studies · 120 participants | Moderate Downgraded: inconsistency |
All adverse effects Covered Ultraflex SEMS vs covered Wallstent | OR 0.61 [0.27, 1.38] | 2 studies · 120 participants | Moderate Downgraded: inconsistency |
SEMS compared to plastic tube (degree of concealment) for dysphagia in oesophageal cancer
Population: patients with dysphagia in oesophageal cancer
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Persistent or recurrent dysphagia (analysis by concealment of allocation) ‐ Concealment of allocation A SEMS vs plastic tube (degree of concealment) | OR 0.49 [0.19, 1.28] | 4 studies · 323 participants | High |
Persistent or recurrent dysphagia (analysis by concealment of allocation) ‐ Concealment of allocation non‐A SEMS vs plastic tube (degree of concealment) | OR 0.29 [0.07, 1.21] | 3 studies · 110 participants | High |
All major side effects (analysis by concealment of allocation) ‐ Concealment of allocation A SEMS vs plastic tube (degree of concealment) | OR 0.23 [0.13, 0.39] | 4 studies · 303 participants | Moderate Downgraded: inconsistency |
All major side effects (analysis by concealment of allocation) ‐ Concealment of allocation non‐A SEMS vs plastic tube (degree of concealment) | OR 0.25 [0.1, 0.65] | 3 studies · 110 participants | Moderate Downgraded: inconsistency |
Anti‐reflux compared to standard open stent for dysphagia in oesophageal cancer
Population: patients with dysphagia in oesophageal cancer
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Dysphagia improvement Anti‐reflux vs standard open stent | no estimate extracted | 2 studies · 106 participants | Moderate Downgraded: inconsistency |
All adverse effects Anti‐reflux vs standard open stent | OR 0.86 [0.38, 1.94] | 2 studies · 106 participants | Moderate Downgraded: inconsistency |
Brachytherapy compared to brachytherapy plus radiotherapy for dysphagia in oesophageal cancer
Population: patients with dysphagia in oesophageal cancer
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Adverse effects Brachytherapy vs brachytherapy plus radiotherapy | OR 1.17 [0.44, 3.15] | 2 studies · 554 participants | Moderate Downgraded: inconsistency |
Adverse effects ‐ stricture Brachytherapy vs brachytherapy plus radiotherapy | OR 1.43 [0.16, 12.85] | 2 studies · 277 participants | High |