scholarly journals Trastuzumab in the Adjuvant Treatment of HER2-Positive Early Breast Cancer Patients: A Meta-Analysis of Published Randomized Controlled Trials

PLoS ONE ◽  
2011 ◽  
Vol 6 (6) ◽  
pp. e21030 ◽  
Author(s):  
Wenjin Yin ◽  
Yiwei Jiang ◽  
Zhenzhou Shen ◽  
Zhimin Shao ◽  
Jinsong Lu
Keyword(s):  
Breast Cancer ◽  
Randomized Controlled Trials ◽  
Cancer Patients ◽  
Early Breast Cancer ◽  
Adjuvant Treatment ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Breast Cancer Patients ◽  
Her2 Positive ◽  
Randomized Controlled

Does Adjuvant Bisphosphonate in Early Breast Cancer Modify the Natural Course of the Disease? A Meta-Analysis of Randomized Controlled Trials

2010 ◽  
Vol 8 (3) ◽  
pp. 279-286 ◽  
Author(s):  
Davide Mauri ◽  
Antonis Valachis ◽  
Nikolaos P. Polyzos ◽  
Lamprini Tsali ◽  
Dimitris Mavroudis ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Zoledronic Acid ◽  
Randomized Controlled Trials ◽  
Early Breast Cancer ◽  
Adjuvant Treatment ◽  
Meta Analysis ◽  
Natural Course ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Randomized Controlled

To address whether the use of bisphosphonates in the adjuvant setting of breast cancer might have any effect on the natural course of the disease, a meta-analysis was conducted of published and unpublished randomized controlled trials found in PubMed, the Cochrane Central Register of Controlled Trials, the ISI Web of Knowledge, and abstracts of major international conferences up to January 2009. All trials that randomized patients with primary breast cancer to undergo adjuvant treatment with any bisphosphonate versus non-use were considered eligible. Analysis included data from 13 eligible trials involving 6886 patients randomized to treatment with bisphosphonates (n = 3414) or either placebo or no treatment (n = 3472). Compared with no use, adjuvant breast cancer treatment with bisphosphonates did not reduce the overall number of deaths (odds ratio [OR], 0.708; 95% CI, 0.482–1.041; P = .079), bone metastases (OR, 0.925; 95% CI, 0.768–1.114; P = .413), overall disease recurrences (OR, 0.843; 95% CI, 0.602–1.181; P = .321), distant relapse (OR, 0.896; 95% CI, 0.674–1.192; P = .453), visceral recurrences (OR, 1.051; 95% CI, 0.686–1.609; P = .820), or local relapses (OR, 1.056; 95% CI, 0.750–1.487; P = .756). No significant heterogeneity was observed among the trials except for estimates of deaths and disease recurrences (P = .034 and P = .016, respectively). In subgroup analyses, use of zoledronic acid was associated with a statistically significant lower risk for disease recurrence (OR, 0.675; 95% CI, 0.479–0.952; P = .025). However, these results should be interpreted with caution because the statistical significance for this association was weak and might be attributed to chance from multi-test analyses. Use of zoledronic acid was not associated with any significant difference in death (OR, 0.642; 95% CI, 0.388–1.063) and bone metastasis rates (OR, 0.661; 95% CI, 0.379–1.151). Currently available evidence does not support the hypothesis that use of bisphosphonates in adjuvant treatment of early breast cancer will alter the natural course of the disease. Nonetheless, a nonsignificant trend seems to exist for better outcomes in patients undergoing bisphosphonate treatment. Until further evidence from new clinical trials becomes available, adjuvant bisphosphonates should not be recommended routinely.

scholarly journals The Effect of Acupuncture in Breast Cancer–Related Lymphoedema (BCRL): A Systematic Review and Meta-Analysis

2019 ◽  
Vol 18 ◽  
pp. 153473541986691 ◽  
Author(s):  
Tsai-Ju Chien ◽  
Chia-Yu Liu ◽  
Ching-Ju Fang
Keyword(s):  
Breast Cancer ◽  
Systematic Review ◽  
Randomized Controlled Trials ◽  
Large Scale ◽  
Meta Analysis ◽  
Lymphatic Drainage ◽  
Controlled Trials ◽  
Breast Cancer Patients ◽  
Eligibility Criteria ◽  
Randomized Controlled

Background: Breast cancer–related lymphedema (BCRL) is hard to control. Management may include lymphatic drainage, skin care, bandaging, or even surgery. Since acupuncture has been proven to affect the neurophysiology and neuroendocrine systems, it has the potential to control BCRL. Aim: To evaluate the effect of acupuncture in BCRL in randomized controlled trials. Design: A literature search was performed, following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement and without language restrictions. Data Sources: Five databases were searched from inception tthrough September 2018. Only studies that fulfilled the eligibility criteria of evaluating the effect of acupuncture on lymphedema in breast cancer were included. The methodological quality of these trials was assessed using the Cochrane criteria, and meta-analysis software (RevMan 5.3) was used for analysis. Results: We examined 178 breast cancer patients from 6 trials. All included randomized controlled trials had medium to high quality, based on the modified Jadad scale. The systematic review showed that acupuncture is safe and has a trend to improve symptoms, but trials did not consistently measure outcomes. The meta-analysis showed that acupuncture produced no significant improvement in the extent of lymphedema as compared with the control intervention (−1.90; 95% confidence interval = −5.39 to 1.59, P = .29). None of the studies reported severe adverse events. Conclusions: Acupuncture is safe and has a trend to improve the lymphedema related to breast cancer, yet it did not significantly change arm circumference in BCRL. Future studies should include both subjective and objective measurements and large-scale studies are warranted.

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