Prognostic value of endocrine treatment-related symptoms in patients with breast cancer: a meta-analysis
Prognostic value of endocrine treatment-related symptoms in patients with breast cancer: a meta-analysis
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乳腺癌患者内分泌治疗相关症状的预后价值：荟萃分析
DOI：
10.1007/s10549-016-3995-5
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发表时间：
2016-09
期刊：
影响因子：
--
通讯作者：
Wang S
中科院分区：
文献类型：
--
作者：
Qin T;Shi Y;Yuan Z;Wang S
目的：内分泌治疗与激素受体阳性乳腺癌患者无病生存期（DFS）的改善相关，但也与许多不良事件相关。本研究的目的是阐明接受辅助内分泌治疗的患者的内分泌治疗相关症状与治疗效果之间的关系。我们检索了MethodEMBASE、Web of Science、PubMed和CENTRAL数据库，以比较激素治疗期间发生和未发生不良事件的患者的治疗效果。使用随机效应模型对DFS和总生存率的风险比（hr）和相关的95%置信区间（ci）进行估计和汇总。在4665篇被引用的文献中，有10篇研究纳入了32192名患者。内分泌治疗相关症状的出现与DFS的改善相关（HR 0.76; 95% CI 0.68-0.85）。在有血管舒张症状（HR 0.76; 95% CI 0.66-0.87）或肌肉骨骼症状（HR 0.75; 95% CI 0.60-0.94）、服用芳香化酶抑制剂（HR 0.69; 95% CI 0.57-0.85）或他莫西芬（HR 0.74; 95% CI 0.60-0.93）以及在3个月（HR 0.74; 95% CI 0.66-0.83）、6个月（HR 0.80; 95% CI 0.66-0.96）或12个月随访时出现症状的患者（HR 0.75; 95% CI 0.68-0.83）中也观察到类似的结果。然而，有无内分泌治疗相关症状的患者的总生存率无显著差异（HR 0.82; 95% CI 0.60-1.11）。排除异质因素的敏感性分析得出一致的结果。未观察到发表偏倚的证据。结论在我们的荟萃分析中，内分泌治疗相关症状显示与较好的DFS相关，因此可能有助于预测接受激素治疗的乳腺癌患者的治疗效果。
PurposeEndocrine therapy is associated with improved disease-free survival (DFS) in hormone receptor-positive breast cancer, but it is also associated with many adverse events. The aim of this study was to clarify the association between endocrine treatment-related symptoms and treatment efficacy in patients receiving adjuvant endocrine therapy.MethodEMBASE, Web of Science, PubMed, and CENTRAL databases were searched for studies that compared treatment efficacy between patients in whom adverse events did and did not occur during hormone therapy. Hazard ratios (HRs) and associated 95 % confidence intervals (CIs) for DFS and overall survival were estimated and pooled using random-effects models.ResultsOf 4665 citations identified, ten studies incorporating 32,192 patients were included in the meta-analysis. The presence of endocrine treatment-related symptoms was associated with improved DFS (HR 0.76; 95 % CI 0.68–0.85). Similar results were observed in patients with vasomotor symptoms (HR 0.76; 95 % CI 0.66–0.87) or musculoskeletal symptoms (HR 0.75; 95 % CI 0.60–0.94), in patients taking an aromatase inhibitor (HR 0.69; 95 % CI 0.57–0.85) or tamoxifen (HR 0.74; 95 % CI 0.60–0.93), and in patients with symptoms at 3-month (HR 0.74; 95 % CI 0.66–0.83), 6-month (HR 0.80; 95 % CI 0.66–0.96), or 12-month follow-up visits (HR 0.75; 95 % CI 0.68–0.83). However, no significant difference in overall survival was observed between patients with or without endocrine treatment-related symptoms (HR 0.82; 95 % CI 0.60–1.11). Sensitivity analysis excluding studies with heterogeneous factors yielded consistent results. No evidence of publication bias was observed.ConclusionIn our meta-analysis, endocrine treatment-related symptoms were shown to correlate with superior DFS and may therefore be useful in predicting treatment efficacy in patients with breast cancer receiving hormone therapy.
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DOI：
10.1016/s1470-2045(11)70270-4
发表时间：
2011-11
期刊：
The Lancet. Oncology
影响因子：
--
作者：
Regan MM;Neven P;Giobbie-Hurder A;Goldhirsch A;Ejlertsen B;Mauriac L;Forbes JF;Smith I;Láng I;Wardley A;Rabaglio M;Price KN;Gelber RD;Coates AS;Thürlimann B;BIG 1-98 Collaborative Group;International Breast Cancer Study Group (IBCSG)
通讯作者：
International Breast Cancer Study Group (IBCSG)
影响因子：
10.3
作者：
Rae, James M.;Drury, Suzy;Dowsett, Mitch
通讯作者：
Dowsett, Mitch
影响因子：
10.3
作者：
Regan, Meredith M.;Leyland-Jones, Brian;Viale, Giuseppe
通讯作者：
Viale, Giuseppe
影响因子：
8.8
作者：
R. Peto
通讯作者：
R. Peto
DOI：
10.1093/jnci/djr329
发表时间：
2011-10
期刊：
Journal of the National Cancer Institute
影响因子：
--
作者：
B. Rini;D. Cohen;D. Lu;I. Chen;S. Hariharan;M. Gore;R. Figlin;M. Baum;R. Motzer
通讯作者：
B. Rini;D. Cohen;D. Lu;I. Chen;S. Hariharan;M. Gore;R. Figlin;M. Baum;R. Motzer