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Nonhormonal Hot Flash Management for Breast Cancer Survivors: A Systematic Review and Network Meta-Analysis.
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- Author(s): Liu, Jian (AUTHOR); Nie, Guangning (AUTHOR); Li, Yang (AUTHOR); Wen, Zehuai (AUTHOR); Lu, Liming (AUTHOR); Xie, Li (AUTHOR); Cao, Dongdong (AUTHOR); Lai, Yafang (AUTHOR); Yang, Hongyan (AUTHOR)
- Source:
Evidence-based Complementary & Alternative Medicine (eCAM). 4/28/2020, p1-13. 13p. 4 Diagrams, 3 Charts. - Source:
- Additional Information
- Subject Terms: ALTERNATIVE medicine; BEHAVIOR modification; BREAST tumors; CANCER patients; DIETARY supplements; HEALTH behavior; INFORMATION storage & retrieval systems; MEDICAL databases; MEDICAL information storage & retrieval systems; MEDLINE; META-analysis; MIND & body therapies; ONLINE information services; PATIENT safety; SEROTONIN uptake inhibitors; SYSTEMATIC reviews; TREATMENT effectiveness; HOT flashes
- Abstract: Aim of the Study. Hot flashes impair the quality of life of breast cancer survivors. Nonhormonal management is an important consideration. The objective of this network meta-analysis (NMA) is to compare the therapeutic efficacy and safety of nonhormonal hot flash treatments for breast cancer survivors. Materials and Methods. We conducted a systematic literature search in PubMed, Cochrane Central Register of Controlled Trials, Embase, Chinese Biomedicine Database (CBM), China National Knowledge Infrastructure (CNKI), Wan Fang, and VIP up to May 2018. Randomized controlled trials (RCTs) reporting nonhormonal hot flash treatments for breast cancer survivors were included. Primary outcome measurements were hot flash frequency and hot flash score of posttreatment. The methodological quality of each study was assessed with Cochrane's risk of bias tool. Results. 16 RCTs involving 2,349 participants were included. The nonhormonal therapies used in the included studies were classified as follows: lifestyle changes, mind-body techniques, dietary/supplements, SSRIs/SNRIs, other medications, and other therapies. Pairwise meta-analysis showed that the general effect of nonhormonal management was statistically more effective than no treatment/placebo/sham in reducing hot flash frequency (SMD = −0.60, 95% CI [−1.13, −0.06]; P = 0.03)) and hot flash score (SMD = −0.38, 95% CI [−0.68, −0.08]). For hot flash frequency, results from the NMA showed that there was no statistically significant difference between any two of the nonhormonal treatments. Another NMA result indicated that acupuncture (other therapies) was 16.05 points more effective in reducing hot flash scores than no treatment/waitlist (SMD = −16.05, 95% CI [−30.2, −1.99]). These results were statistically significant. Acupuncture was also ranked the optimal nonhormonal therapy for both hot flash frequency and hot flash score. The safety analysis showed that there were few related adverse events during acupuncture and that drug related adverse reactions could have also occurred in studies using drug interventions Conclusions. This network meta-analysis comparing nonhormonal treatments suggested that acupuncture might be more effective in improving hot flashes for breast cancer survivors. A pronounced placebo response was found during hot flash treatments. The evidence of safety for nonhormonal therapies was also insufficient. Therefore, at present, we cannot make confirmative recommendations of nonhormonal hot flash management for breast cancer survivors. This study is registered with PROSPERO (CRD42018082008). [ABSTRACT FROM AUTHOR]
- Abstract: Copyright of Evidence-based Complementary & Alternative Medicine (eCAM) is the property of Hindawi Limited and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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