Study designs of evaluations included in the review
Only randomised controlled trials (RCTs) or meta-analyses were reviewed. Phase I and II studies were specifically excluded, as were letters and editorials.
Specific interventions included in the review
Studies of combination chemotherapy, radiotherapy and/or immunotherapy were eligible for inclusion in the review. Each intervention studied had to be compared with another intervention or with standard care. The interventions investigated in the included studies were:
chemoradiotherapy (5-fluorouracil, 5-FU) versus radiotherapy alone;
chemoradiotherapy versus chemotherapy alone, with both arms using the same chemotherapy (5-FU and/or streptozocin);
two chemoradiotherapy regimens comparing different chemotherapy (methyl lomustine plus 5-FU versus methyl lomustine, 5-FU plus testolactone; 5-FU versus doxorubicin; and 5-FU versus hycanthone); and
comparisons of different types of radiation beams (photons, mixed and neutrons).
Participants included in the review
Studies of patients with locally advanced pancreatic cancer were reviewed. Studies that also included patients with metastatic disease were included only if the data on patients with locally advanced cancer could be extracted separately. Details of the patients populations in the included studies were not reported in the review.
Outcomes assessed in the review
Only studies that reported overall survival data were included. Other outcomes of interest were disease-free survival, local control, adverse effects and quality of life. The outcome data reported in the review were median survival, percentage one-year survival, and adverse events including treatment-related deaths.
How were decisions on the relevance of primary studies made?
Each reviewer selected and reviewed relevant articles and abstracts independently.