Cancer symptom clusters in adult patients undergoing chemotherapy: A systematic review and meta-analysis protocol

Luís Carlos Lopes-Júnior; Taiani Ferrarini; Luciana Bicalho Cevolani Pires; Jonathan Grassi Rodrigues; Luciane Bresciani Salaroli; Karolini Zuqui Nunes

doi:10.1371/journal.pone.0273411

Peer Review History

Original SubmissionAugust 17, 2021
6 May 2022 Decision Letter - Senthilnathan Palaniyandi, Editor PONE-D-21-25793Cancer symptom clusters in adult patients undergoing chemotherapy: a systematic review protocolPLOS ONE Dear Dr. Lopes-Junior, Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process. We have now received reports from our referees of your manuscript, as agree with reviewers comments raised a few concerns about this study. After careful consideration, we invite you to submit a revised version of the manuscript. Please submit your revised manuscript by Jun 20 2022 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file. Please include the following items when submitting your revised manuscript: A rebuttal letter that responds to each point raised by the academic editor and reviewer(s). You should upload this letter as a separate file labeled 'Response to Reviewers'. A marked-up copy of your manuscript that highlights changes made to the original version. You should upload this as a separate file labeled 'Revised Manuscript with Track Changes'. An unmarked version of your revised paper without tracked changes. You should upload this as a separate file labeled 'Manuscript'. If you would like to make changes to your financial disclosure, please include your updated statement in your cover letter. Guidelines for resubmitting your figure files are available below the reviewer comments at the end of this letter. If applicable, we recommend that you deposit your laboratory protocols in protocols.io to enhance the reproducibility of your results. Protocols.io assigns your protocol its own identifier (DOI) so that it can be cited independently in the future. For instructions see: https://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols. Additionally, PLOS ONE offers an option for publishing peer-reviewed Lab Protocol articles, which describe protocols hosted on protocols.io. Read more information on sharing protocols at https://plos.org/protocols?utm_medium=editorial-email&utm_source=authorletters&utm_campaign=protocols. We look forward to receiving your revised manuscript. Kind regards, Senthilnathan Palaniyandi, Ph.D Academic Editor PLOS ONE Journal requirements: When submitting your revision, we need you to address these additional requirements. 1. Please ensure that your manuscript meets PLOS ONE's style requirements, including those for file naming. The PLOS ONE style templates can be found at https://journals.plos.org/plosone/s/file?id=wjVg/PLOSOne_formatting_sample_main_body.pdf and https://journals.plos.org/plosone/s/file?id=ba62/PLOSOne_formatting_sample_title_authors_affiliations.pdf. [Note: HTML markup is below. Please do not edit.] Reviewers' comments: Reviewer's Responses to Questions Comments to the Author 1. Does the manuscript provide a valid rationale for the proposed study, with clearly identified and justified research questions? The research question outlined is expected to address a valid academic problem or topic and contribute to the base of knowledge in the field. Reviewer #1: Yes Reviewer #2: No Reviewer #3: Yes ******** 2. Is the protocol technically sound and planned in a manner that will lead to a meaningful outcome and allow testing the stated hypotheses? The manuscript should describe the methods in sufficient detail to prevent undisclosed flexibility in the experimental procedure or analysis pipeline, including sufficient outcome-neutral conditions (e.g. necessary controls, absence of floor or ceiling effects) to test the proposed hypotheses and a statistical power analysis where applicable. As there may be aspects of the methodology and analysis which can only be refined once the work is undertaken, authors should outline potential assumptions and explicitly describe what aspects of the proposed analyses, if any, are exploratory. Reviewer #1: Yes Reviewer #2: Partly Reviewer #3: Yes ****** 3. Is the methodology feasible and described in sufficient detail to allow the work to be replicable? Descriptions of methods and materials in the protocol should be reported in sufficient detail for another researcher to reproduce all experiments and analyses. The protocol should describe the appropriate controls, sample size calculations, and replication needed to ensure that the data are robust and reproducible. Reviewer #1: Yes Reviewer #2: Yes Reviewer #3: Yes ****** 4. Have the authors described where all data underlying the findings will be made available when the study is complete? The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception, at the time of publication. The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified. Reviewer #1: Yes Reviewer #2: Yes Reviewer #3: Yes ****** 5. Is the manuscript presented in an intelligible fashion and written in standard English? PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here. Reviewer #1: Yes Reviewer #2: No Reviewer #3: Yes ****** 6. Review Comments to the Author Please use the space provided to explain your answers to the questions above and, if applicable, provide comments about issues authors must address before this protocol can be accepted for publication. You may also include additional comments for the author, including concerns about research or publication ethics. You may also provide optional suggestions and comments to authors that they might find helpful in planning their study. (Please upload your review as an attachment if it exceeds 20,000 characters) Reviewer #1: I appreciate the opportunity to review this article protocol. This systematic review is important in clinical practice, especially in the developing countries that have high mortality rates in cancer patients.There are currently no comments on the study protocol, but there is the systematic review (Skye Tian Dong, et al 2014 "Symptom Clusters in Patients With Advanced Cancer: A Systematic Review of Observational Studies"), I hope to return to. I wish the researchers success and await such the important systematic review. No need to chart1 Reviewer #2: The authors aim to identify and gather evidence on the prevalence, composition, severity, and predictors of cancer symptom clusters in adult cancer patients undergoing chemotherapy. However, a similar study has recently been carried out elsewhere and the results have been published: Harris CS, Kober KM, Conley YP, et alSymptom clusters in patients receiving chemotherapy: A systematic review; BMJ Supportive & Palliative Care 2022;12:10-21. Hence, this study is not warranted. Reviewer #3: The present is a protocol aiming to capture clusters of symptoms of patients undergoing chemiotherapy. The paper is very clear regarding goal source of participants and outcomes Some issues are needed 1) Abstract and full paper>why will search be stopped on August 2021? 2) Introduction and methods>authors spoke correctly about physical and physiological symptoms. Do they think subgroup analysis may be needed? 3) Methods: elderly patients should be defined with a clear cut off or reported according to definition of each papers 4) Methods: regarding features of the studies I’m not sure that impact factor may be so relevant (just a comments) as IF does not always relate with quality of the paper 5) Conflict of interests>please define better 6) Methods>do authors think that a subgroup analysis for kinf of cancer and for protocol of chemiptherapy may be useful? 7) Moreover, do they think that some quantitative analysis (e.g meta-regression to evaluate impact of gender, age,) on clusters may be of interest? 8) Methods: primary and secondary end points should be better defined ****** 7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files. If you choose “no”, your identity will remain anonymous but your review may still be made public. Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy. Reviewer #1: No Reviewer #2: No Reviewer #3: Yes:** Fabrizio D'Ascenzo [NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.] While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email PLOS at figures@plos.org. Please note that Supporting Information files do not need this step. https://doi.org/10.1371/journal.pone.0273411.r001
Revision 1
17 May 2022 Author Response Vitoria,ES, May 15, 2022 Dear Dr. Senthilnathan Palaniyandi, We would like to thank you for the opportunity to review the manuscript after the reviewers' suggestions and recommendations. All points were addressed and/or clarified in this new version. In addition, we responded item by item to the questions raised by the reviewers in this letter. Comments to the Author 1. Does the manuscript provide a valid rationale for the proposed study, with clearly identified and justified research questions? The research question outlined is expected to address a valid academic problem or topic and contribute to the base of knowledge in the field. Reviewer #1: Yes Reviewer #2: No Reviewer #3: Yes 2. Is the protocol technically sound and planned in a manner that will lead to a meaningful outcome and allow testing the stated hypotheses? The manuscript should describe the methods in sufficient detail to prevent undisclosed flexibility in the experimental procedure or analysis pipeline, including sufficient outcome-neutral conditions (e.g. necessary controls, absence of floor or ceiling effects) to test the proposed hypotheses and a statistical power analysis where applicable. As there may be aspects of the methodology and analysis which can only be refined once the work is undertaken, authors should outline potential assumptions and explicitly describe what aspects of the proposed analyses, if any, are exploratory. Reviewer #1: Yes Reviewer #2: Partly Reviewer #3: Yes 3. Is the methodology feasible and described in sufficient detail to allow the work to be replicable? Descriptions of methods and materials in the protocol should be reported in sufficient detail for another researcher to reproduce all experiments and analyses. The protocol should describe the appropriate controls, sample size calculations, and replication needed to ensure that the data are robust and reproducible. Reviewer #1: Yes Reviewer #2: Yes Reviewer #3: Yes 4. Have the authors described where all data underlying the findings will be made available when the study is complete? The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception, at the time of publication. The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified. Reviewer #1: Yes Reviewer #2: Yes Reviewer #3: Yes 5. Is the manuscript presented in an intelligible fashion and written in standard English? PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here. Reviewer #1: Yes Reviewer #2: No Reviewer #3: Yes 6. Review Comments to the Author Reviewer #1: I appreciate the opportunity to review this article protocol. This systematic review is important in clinical practice, especially in the developing countries that have high mortality rates in cancer patients.There are currently no comments on the study protocol, but there is the systematic review (Skye Tian Dong, et al 2014 "Symptom Clusters in Patients With Advanced Cancer: A Systematic Review of Observational Studies"), I hope to return to. I wish the researchers success and await such the important systematic review. No need to chart1 Response: Thank you so much for your comments! We have added a paragraph mentioning this review (Dong et al., 2014) in the introduction and specified how ours differs from this one as well as the current one by Harris et al., 2022. In addition, we have removed the chart 1 as per suggested. Thanks! Reviewer #2: The authors aim to identify and gather evidence on the prevalence, composition, severity, and predictors of cancer symptom clusters in adult cancer patients undergoing chemotherapy. However, a similar study has recently been carried out elsewhere and the results have been published: Harris CS, Kober KM, Conley YP, et alSymptom clusters in patients receiving chemotherapy: A systematic review; BMJ Supportive & Palliative Care 2022;12:10-21. Hence, this study is not warranted. Response: We have added a paragraph mentioning this review (Dong et al., 2014) in the introduction and specified how ours differs from this one. “Recently, a systematic review was published with the objective of evaluating the progress in symptom clusters research in adults receiving primary or adjuvant chemotherapy since 2016, and showed that psychological, gastrointestinal, and nutritional clusters were the most commonly identified clusters. Only the psychological clusters remained relatively stable over time [19]. It is stand out that our review study differs from the latter in the following aspects: we will not specify a publication date or language limit (in order to minimize publication bias). Furthermore, we will explore beyond observational studies, as we will include experimental studies and also, we will expand the number of databases to 8, besides the access gray literature and pre-prints for Health Sciences. Another difference is that both previous reviews used only generic tools for methodological appraisal and that assess the report of the study more than the risk of bias (in terms of internal validity and external validity of the studies). Here, we will use valid and design-specific tools, following the recommendations of the Cochrane Collaboration [20]. Additionally, there is still no systematic review and metanalysis taking into account a robust assessment of the risk of bias in studies involving cancer symptom clusters with validated and design-specific tools, which justifies our study for a potential contribution to the area”. Reviewer #3: The present is a protocol aiming to capture clusters of symptoms of patients undergoing chemiotherapy. The paper is very clear regarding goal source of participants and outcomes Response: Thank you so much! Some issues are needed 1) Abstract and full paper>why will search be stopped on August 2021? Response: In fact, we put August, 2021 because that was the date when we submitted the article to PLOS ONE. However, we will update the search once the protocol is accepted. We edit this in the paper. Thank you! 2) Introduction and methods>authors spoke correctly about physical and physiological symptoms. Do they think subgroup analysis may be needed? Response: This is an important point to consider. Thank you very much! Yes, probably depending on the results we will find we will do subgroup analysis. We really appreciated this comment. I have added one paragraph on the sub-item “Data synthesis” into the methods section. 3) Methods: elderly patients should be defined with a clear cut off or reported according to definition of each papers Response: Thanks for this comment. We have added one sentence in order to make it clearer. “Aged in this study is defined according to MeSH term “Aged”: a person 65 through 79 years of age or more”. Aged A person 65 through 79 years of age. For a person older than 79 years, AGED, 80 AND OVER is available. Year introduced: 1966 4) Methods: regarding features of the studies I’m not sure that impact factor may be so relevant (just a comments) as IF does not always relate with quality of the paper Response: Indeed, we agreed with you. So, we have removed. Thanks! 5) Conflict of interests>please define better Response: The Committee on Publication Ethics (COPE) states in its Guidelines on Good Publication Practice (2003) that: 'Conflicts of interest arise when authors, reviewers, or editors have interests that are not fully apparent and that may influence their judgments on what is published. 6) Methods>do authors think that a subgroup analysis for kind of cancer and for protocol of chemiptherapy may be useful? Response: This point is very interesting. Studies with cancer symptom clusters are quite heterogeneous around the target population, types of cancers included in the analyses, tumor staging and chemotherapy protocol. Thus, this stratification can be carried out depending on the evidence that we will find, especially if the meta-analysis is feasible. I have added this on “Data Synthesis”. Many Thanks! 7) Moreover, do they think that some quantitative analysis (e.g meta-regression to evaluate impact of gender, age,) on clusters may be of interest? Response: Yes. I specified this in the topic “Data Syjthesis”. Thank you so much for your valuable contribuitions. 8) Methods: primary and secondary end points should be better defined Response: We have edited this in the chart 1. Actually, our outcomes are including: “Prevalence /composition/stability/ severity/ predictors of cancer symptom clusters, as stated in the PECO acronym. 7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files. If you choose “no”, your identity will remain anonymous but your review may still be made public. Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy. Reviewer #1: No Reviewer #2: No Reviewer #3: Yes: Fabrizio D'Ascenzo Attachments Attachment Submitted filename: Response to Reviewers .docx https://doi.org/10.1371/journal.pone.0273411.r002
12 Jul 2022 Decision Letter - Joseph Donlan, Editor PONE-D-21-25793R1Cancer symptom clusters in adult patients undergoing chemotherapy: a systematic review and metanalysis protocolPLOS ONE Dear Dr. Lopes-Júnior, Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process. Your manuscript has been reassessed by the three reviewers from the previous round, whose reports can be found below. As you will see from the comments, the reviewers acknowledge that the manuscript has improved significantly. While assessing your manuscript, we noticed several errors in the use of spelling, punctuation and grammar throughout the manuscript. So that your manuscript meets our publication criterion requiring that 'the article is presented in an intelligible fashion and is written in standard English.', we request that you thoroughly copyedit your manuscript to fix these errors. You may wish to use a professional scientific editing service to do this. Please submit your revised manuscript by Aug 20 2022 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file. Please include the following items when submitting your revised manuscript: A marked-up copy of your manuscript that highlights changes made to the original version. You should upload this as a separate file labeled 'Revised Manuscript with Track Changes'. An unmarked version of your revised paper without tracked changes. You should upload this as a separate file labeled 'Manuscript'. If you would like to make changes to your financial disclosure, please include your updated statement in your cover letter. Guidelines for resubmitting your figure files are available below the reviewer comments at the end of this letter. If applicable, we recommend that you deposit your laboratory protocols in protocols.io to enhance the reproducibility of your results. Protocols.io assigns your protocol its own identifier (DOI) so that it can be cited independently in the future. For instructions see: https://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols. Additionally, PLOS ONE offers an option for publishing peer-reviewed Lab Protocol articles, which describe protocols hosted on protocols.io. Read more information on sharing protocols at https://plos.org/protocols?utm_medium=editorial-email&utm_source=authorletters&utm_campaign=protocols. We look forward to receiving your revised manuscript. Kind regards, Joseph Donlan Editorial Office PLOS ONE Journal Requirements: Please review your reference list to ensure that it is complete and correct. If you have cited papers that have been retracted, please include the rationale for doing so in the manuscript text, or remove these references and replace them with relevant current references. Any changes to the reference list should be mentioned in the rebuttal letter that accompanies your revised manuscript. If you need to cite a retracted article, indicate the article’s retracted status in the References list and also include a citation and full reference for the retraction notice. [Note: HTML markup is below. Please do not edit.] Reviewers' comments: Reviewer's Responses to Questions Comments to the Author 1. Does the manuscript provide a valid rationale for the proposed study, with clearly identified and justified research questions? The research question outlined is expected to address a valid academic problem or topic and contribute to the base of knowledge in the field. Reviewer #1: Yes Reviewer #2: Partly Reviewer #3: Yes ******** 2. Is the protocol technically sound and planned in a manner that will lead to a meaningful outcome and allow testing the stated hypotheses? The manuscript should describe the methods in sufficient detail to prevent undisclosed flexibility in the experimental procedure or analysis pipeline, including sufficient outcome-neutral conditions (e.g. necessary controls, absence of floor or ceiling effects) to test the proposed hypotheses and a statistical power analysis where applicable. As there may be aspects of the methodology and analysis which can only be refined once the work is undertaken, authors should outline potential assumptions and explicitly describe what aspects of the proposed analyses, if any, are exploratory. Reviewer #1: Yes Reviewer #2: Partly Reviewer #3: Yes ****** 3. Is the methodology feasible and described in sufficient detail to allow the work to be replicable? Descriptions of methods and materials in the protocol should be reported in sufficient detail for another researcher to reproduce all experiments and analyses. The protocol should describe the appropriate controls, sample size calculations, and replication needed to ensure that the data are robust and reproducible. Reviewer #1: Yes Reviewer #2: Yes Reviewer #3: Yes ****** 4. Have the authors described where all data underlying the findings will be made available when the study is complete? The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception, at the time of publication. The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified. Reviewer #1: Yes Reviewer #2: Yes Reviewer #3: Yes ****** 5. Is the manuscript presented in an intelligible fashion and written in standard English? PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here. Reviewer #1: Yes Reviewer #2: No Reviewer #3: Yes ****** 6. Review Comments to the Author Please use the space provided to explain your answers to the questions above and, if applicable, provide comments about issues authors must address before this protocol can be accepted for publication. You may also include additional comments for the author, including concerns about research or publication ethics. You may also provide optional suggestions and comments to authors that they might find helpful in planning their study. (Please upload your review as an attachment if it exceeds 20,000 characters) Reviewer #1: When mentioning this review(...2014), this review was not intended in itself, but rather the intent was, the authors should clarify the strengths of their study and its difference from what preceded it, especially since the authors indicated in the study protocol that (this systematic review and comprehensive analysis will be the first to identify and evaluate Evidence about prevalence, composition, and severity ....) I wish you success in publication a valuable study. Reviewer #2: Thank you for addressing the earlier comments. The manuscript needs a thorough proof reading for syntactic errors and grammars, especially in the paragraphs that have been added now to address the reviewers' comments. Reviewer #3: all comments have been addressed. i have no further comments, because the authors cleary detailed all the comments ****** 7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files. If you choose “no”, your identity will remain anonymous but your review may still be made public. Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy. Reviewer #1: Yes: Rania E Moustafa Reviewer #2: No Reviewer #3: Yes: Fabrizio D'Ascenzo ******** [NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.] While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email PLOS at figures@plos.org. Please note that Supporting Information files do not need this step. https://doi.org/10.1371/journal.pone.0273411.r003
Revision 2
15 Jul 2022 Author Response Response to Reviewers Vitória, ES, Brazil, July 15th, 2022 Minor revision PONE-D-21-25793R1 Cancer symptom clusters in adult patients undergoing chemotherapy: a systematic review and metanalysis protocol Dear Dr. Lopes-Júnior, Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process. Your manuscript has been reassessed by the three reviewers from the previous round, whose reports can be found below. As you will see from the comments, the reviewers acknowledge that the manuscript has improved significantly. Response: Dear Dr. Joseph Donlan, Thank you for the opportunity to review the manuscript after the reviewers' suggestions and recommendations. All points were addressed and/or clarified in this new version. In addition, we responded item by item to the questions raised by the reviewers in this letter. While assessing your manuscript, we noticed several errors in the use of spelling, punctuation and grammar throughout the manuscript. So that your manuscript meets our publication criterion requiring that 'the article is presented in an intelligible fashion and is written in standard English.', we request that you thoroughly copyedit your manuscript to fix these errors. You may wish to use a professional scientific editing service to do this. Response: Ok. As suggested, we have done it. So, we have paid an English proofreading to Editage (https://www.editage.com) for polishing the text and correct grammar and spelling mistakes according to the cultured language. Therefore, an extensive review of English was carried out. We look forward to receiving your revised manuscript. Kind regards, Joseph Donlan Editorial Office PLOS ONE Journal Requirements: Please review your reference list to ensure that it is complete and correct. If you have cited papers that have been retracted, please include the rationale for doing so in the manuscript text, or remove these references and replace them with relevant current references. Any changes to the reference list should be mentioned in the rebuttal letter that accompanies your revised manuscript. If you need to cite a retracted article, indicate the article’s retracted status in the References list and also include a citation and full reference for the retraction notice. Response: We have carefully reviewed the reference list and we ensure that it is complete and correct. Also, we have no papers retracted cited in this manuscript. Review Comments to the Author Reviewer #1: When mentioning this review(...2014), this review was not intended in itself, but rather the intent was, the authors should clarify the strengths of their study and its difference from what preceded it, especially since the authors indicated in the study protocol that (this systematic review and comprehensive analysis will be the first to identify and evaluate Evidence about prevalence, composition, and severity ....) I wish you success in publication a valuable study. Response: OK. We addressed this in the introduction. Thank you so much! Reviewer #2: Thank you for addressing the earlier comments. The manuscript needs a thorough proof reading for syntactic errors and grammars, especially in the paragraphs that have been added now to address the reviewers' comments. Response: Thank you so much! We have paid an English proofreading to Editage (https://www.editage.com) for polishing the text and correct grammar and spelling mistakes according to the cultured language. Therefore, an extensive review of English was carried out. Reviewer #3: all comments have been addressed. i have no further comments, because the authors cleary detailed all the comments Response: Thank you so much! Reviewer #1: Yes: Rania E Moustafa Reviewer #2: No Reviewer #3: Yes: Fabrizio D'Ascenzo Yours Sincerely, The authors, Attachments Attachment Submitted filename: Response to Reviewers.docx https://doi.org/10.1371/journal.pone.0273411.r004
9 Aug 2022 Decision Letter - James Mockridge, Editor Cancer symptom clusters in adult patients undergoing chemotherapy: a systematic review and metanalysis protocol PONE-D-21-25793R2 Dear Dr. Lopes-Júnior, We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements. Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication. An invoice for payment will follow shortly after the formal acceptance. To ensure an efficient process, please log into Editorial Manager at http://www.editorialmanager.com/pone/, click the 'Update My Information' link at the top of the page, and double check that your user information is up-to-date. If you have any billing related questions, please contact our Author Billing department directly at authorbilling@plos.org. If your institution or institutions have a press office, please notify them about your upcoming paper to help maximize its impact. If they’ll be preparing press materials, please inform our press team as soon as possible -- no later than 48 hours after receiving the formal acceptance. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information, please contact onepress@plos.org. Kind regards, James Mockridge Staff Editor PLOS ONE Reviewers' comments: Reviewer's Responses to Questions Comments to the Author 1. Does the manuscript provide a valid rationale for the proposed study, with clearly identified and justified research questions? The research question outlined is expected to address a valid academic problem or topic and contribute to the base of knowledge in the field. Reviewer #1: Yes Reviewer #3: Yes ******** 2. Is the protocol technically sound and planned in a manner that will lead to a meaningful outcome and allow testing the stated hypotheses? The manuscript should describe the methods in sufficient detail to prevent undisclosed flexibility in the experimental procedure or analysis pipeline, including sufficient outcome-neutral conditions (e.g. necessary controls, absence of floor or ceiling effects) to test the proposed hypotheses and a statistical power analysis where applicable. As there may be aspects of the methodology and analysis which can only be refined once the work is undertaken, authors should outline potential assumptions and explicitly describe what aspects of the proposed analyses, if any, are exploratory. Reviewer #1: Yes Reviewer #3: Yes ****** 3. Is the methodology feasible and described in sufficient detail to allow the work to be replicable? Descriptions of methods and materials in the protocol should be reported in sufficient detail for another researcher to reproduce all experiments and analyses. The protocol should describe the appropriate controls, sample size calculations, and replication needed to ensure that the data are robust and reproducible. Reviewer #1: Yes Reviewer #3: Yes ****** 4. Have the authors described where all data underlying the findings will be made available when the study is complete? The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception, at the time of publication. The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified. Reviewer #1: Yes Reviewer #3: Yes ****** 5. Is the manuscript presented in an intelligible fashion and written in standard English? PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here. Reviewer #1: Yes Reviewer #3: Yes ****** 6. Review Comments to the Author Please use the space provided to explain your answers to the questions above and, if applicable, provide comments about issues authors must address before this protocol can be accepted for publication. You may also include additional comments for the author, including concerns about research or publication ethics. You may also provide optional suggestions and comments to authors that they might find helpful in planning their study. (Please upload your review as an attachment if it exceeds 20,000 characters) Reviewer #1: Thanks for reviewing this article. for There are no comments. Because the authors made all points clear. Reviewer #3: All comments have been addressed. Authors should be complimented for performing such an accurate analysis ****** 7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files. If you choose “no”, your identity will remain anonymous but your review may still be made public. Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy. Reviewer #1: Yes: Rania E Moustafa Reviewer #3: Yes: Fabrizio D'Ascenzo ******** https://doi.org/10.1371/journal.pone.0273411.r005
Formally Accepted
23 Aug 2022 Acceptance Letter - James Mockridge, Editor PONE-D-21-25793R2 Cancer symptom clusters in adult patients undergoing chemotherapy: a systematic review and meta-analysis protocol Dear Dr. Lopes-Júnior: I'm pleased to inform you that your manuscript has been deemed suitable for publication in PLOS ONE. Congratulations! Your manuscript is now with our production department. If your institution or institutions have a press office, please let them know about your upcoming paper now to help maximize its impact. If they'll be preparing press materials, please inform our press team within the next 48 hours. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information please contact onepress@plos.org. If we can help with anything else, please email us at plosone@plos.org. Thank you for submitting your work to PLOS ONE and supporting open access. Kind regards, PLOS ONE Editorial Office Staff on behalf of Dr Joseph Donlan Staff Editor PLOS ONE https://doi.org/10.1371/journal.pone.0273411.r006

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