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| Les deux révisions précédentes Révision précédente Prochaine révision | Révision précédente | ||
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acupuncture:evaluation:gyneco-obstetrique:07. cancer du sein [11 Oct 2022 07:56] Nguyen Johan [1.2.1. Hot Flushes in breast cancer] |
acupuncture:evaluation:gyneco-obstetrique:07. cancer du sein [31 Jan 2024 18:34] (Version actuelle) Nguyen Johan [1.2.3.1. Kannan 2022] |
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| ====== Breast Cancer ====== | ====== Breast Cancer ====== | ||
| - | ====== Cancer du sein : évaluation de l'acupuncture ====== | + | ====== Cancer du sein ====== |
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| ^Results|A total of **12 studies** including a total of **1084 participants** were included. The results showed that AT had a beneficial effect compared with sham AT (n = 256, SMD = -0.26, 95% CI [-0.51, -0.01], p = 0.04, I2 = 0%) and a long-term effect on fatigue score (n = 209, MD = -0.32, 95% CI [-0.59, -0.04], p = 0.02, I2 = 0%). Meta-analysis showed that AT had a beneficial effect compared with usual care (UC) on fatigue scores (n = 238, SMD = -0.39, 95% CI [-0.66 to -0.12], p = 0.005, I2 = 0%). Of the 12 articles, 3 articles were judged as having a low risk of bias in all domains and hence were of high quality. No serious adverse effects were identified. | | ^Results|A total of **12 studies** including a total of **1084 participants** were included. The results showed that AT had a beneficial effect compared with sham AT (n = 256, SMD = -0.26, 95% CI [-0.51, -0.01], p = 0.04, I2 = 0%) and a long-term effect on fatigue score (n = 209, MD = -0.32, 95% CI [-0.59, -0.04], p = 0.02, I2 = 0%). Meta-analysis showed that AT had a beneficial effect compared with usual care (UC) on fatigue scores (n = 238, SMD = -0.39, 95% CI [-0.66 to -0.12], p = 0.005, I2 = 0%). Of the 12 articles, 3 articles were judged as having a low risk of bias in all domains and hence were of high quality. No serious adverse effects were identified. | | ||
| ^Conclusions|AT is an effective and safe treatment for CRF, and AT is more effective than sham AT or UC or wait-list control (WLC). Nevertheless, the methodological quality of most of these studies was low, and the included studies/sample sizes were small, so the ability to derive decisive implications was limited. Further research is needed to confirm these findings.| | ^Conclusions|AT is an effective and safe treatment for CRF, and AT is more effective than sham AT or UC or wait-list control (WLC). Nevertheless, the methodological quality of most of these studies was low, and the included studies/sample sizes were small, so the ability to derive decisive implications was limited. Further research is needed to confirm these findings.| | ||
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| + | == Pan 2020 == | ||
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| + | Pan Yuanqing, Tang Yong, Liang Haiqian, Chen Gen, Xiping Shen, Jin Dong, Cui Qi, Qi Miaomiao. Acupuncture for Hormone Therapy-Related Side Effects in Breast Cancer Patients: A GRADE-Assessed Systematic Review and Updated Meta-Analysis. Integr Cancer Ther. 2020. {{:medias securises:acupuncture:evaluation:gyneco-obstetrique:pan-212315.pdf|[212315]}}. [[https://doi.org/10.1177/1534735420940394|doi]] | ||
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| + | ^Purpose| To determine the efficacy of acupuncture on the management of hormone therapy-related side effects in breast cancer patients. | | ||
| + | ^Methods| Randomized controlled trials of acupuncture versus a control or placebo in breast cancer patients that examined reductions in therapy-related side effects were retrieved from PubMed, EMBASE, Web of Science, and the Cochrane Library through April 2020. Data on patient symptoms (hot flashes, fatigue, pain, stiffness, and gastrointestinal symptoms), physical capacity, cytokines, and general psychosomatic well-being were analyzed. We evaluated and analyzed the quality of all included studies with the 5.2 Cochrane Handbook standards using Stata software (version 10.0) and Revman software (version 5.2), respectively. We assessed the risk of bias using the Cochrane Risk of Bias tool and evaluated the quality of evidence using the GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) approach. | | ||
| + | ^ Results| The pooled results suggested that **acupuncture led to moderate improvements** in hot flashes, **fatigue**, and stiffness. No significant differences were observed in pain, gastrointestinal symptoms, Kupperman index scores, Overall quality of life, tumor necrosis factor levels, and interleukin levels. | | ||
| + | ^Conclusions| Evidence for outcome indicators of symptom management were downgraded by the GRADE system for inconsistency, indirectness, and imprecision in the included RCTs. Nonetheless, acupuncture is a moderately appropriate alternative therapy for hormone therapy-related side effects in breast cancer patients. However, it still lacks large-sample, multicenter, prospective RCTs. Future research should focus on standardizing comparison groups and treatment methods, be at least single-blinded, assess biologic mechanisms, have adequate statistical power, and involve multiple acupuncturists. | | ||
| === Post-mastectomy pain syndrome === | === Post-mastectomy pain syndrome === | ||
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| ^Results|Eighteen trials were included in the review. The pooled analysis of the four exercise trials revealed a significant effect of the intervention on general [standardized mean difference [SMD]: 0.87 (95%CI: 0.36, 1.37); p = 0.001], physical [SMD: 0.34 (95%CI: 0.01, 0.66); p = 0.044], and mental health components [SMD: 0.27 (95%CI: 0.03, 0.51); p = 0.027] of QoL compared with the control condition. Meta-analyses of six exercise trials, two myofascial release trials, and **two acupuncture trials** revealed a significant improvement in pain severity in the treatment group than in the control group. However, meta-analyses of two studies revealed a non-significant effect of compression therapy compared to control on pain severity.| | ^Results|Eighteen trials were included in the review. The pooled analysis of the four exercise trials revealed a significant effect of the intervention on general [standardized mean difference [SMD]: 0.87 (95%CI: 0.36, 1.37); p = 0.001], physical [SMD: 0.34 (95%CI: 0.01, 0.66); p = 0.044], and mental health components [SMD: 0.27 (95%CI: 0.03, 0.51); p = 0.027] of QoL compared with the control condition. Meta-analyses of six exercise trials, two myofascial release trials, and **two acupuncture trials** revealed a significant improvement in pain severity in the treatment group than in the control group. However, meta-analyses of two studies revealed a non-significant effect of compression therapy compared to control on pain severity.| | ||
| ^Conclusion|Our meta-analyses found that exercise is beneficial for improving the QoL and pain severity of women with PMPS. Future studies are needed to determine the optimal parameters for exercise interventions designed to improve QoL and pain severity in women with PMPS. The effect of **acupuncture**, myofascial release, and compression therapy remains inconclusive, and future research is required to validate the effect of these interventions on PMPS.| | ^Conclusion|Our meta-analyses found that exercise is beneficial for improving the QoL and pain severity of women with PMPS. Future studies are needed to determine the optimal parameters for exercise interventions designed to improve QoL and pain severity in women with PMPS. The effect of **acupuncture**, myofascial release, and compression therapy remains inconclusive, and future research is required to validate the effect of these interventions on PMPS.| | ||
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| + | === Stress in breast cancer patients === | ||
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| + | == Ding 2024 == | ||
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| + | Ding X, Zhao F, Zhu M, Wang Q, Wei S, Xue J, Li Z. A systematic review and meta-analysis of interventions to reduce perceived stress in breast cancer patients. Complement Ther Clin Pract. 2024 Feb;54:101803. https://doi.org/10.1016/j.ctcp.2023.101803 | ||
| + | ^Purpose| Breast cancer (BC) patients commonly face stress that causes severe psychological and physiological problems. The main objective of the review was to confirm the effect of interventions on breast cancer patients' perceived stress, and the secondary objective was to explore the impact of interventions on anxiety, depression, and inflammatory markers.| | ||
| + | ^Methods| A systematic and comprehensive search for randomized controlled trials (RCTs) that reported interventions' effects on perceived stress in breast cancer patients was performed in nine databases.| | ||
| + | ^Results| **Twenty-four RCTs, including 1887 participants**, met the inclusion criteria, summarizing six categories for the intervention group: mindfulness and yoga, exercise, cognitive-behavioral stress management, self-regulation, relaxation training, and acupuncture. Compared with usual care or other types of care, mindfulness and yoga had excellent effects against perceived stress, anxiety, and depression; self-regulation could reduce perceived stress and anxiety; exercise could reduce perceived stress; acupuncture could reduce the level of depression; mindfulness could improve the TNF-α level, and yoga can reduce the level of salivary cortisol and DNA damage.| | ||
| + | ^Conclusion| This systematic review indicated that nondrug interventions, such as mindfulness and yoga, effectively reduce perceived stress, anxiety, and depression. Rigorous studies with large sample sizes are needed to address the limitations of small sample sizes and shortcomings in methodology in this area.| | ||
| ===== Overviews of Systematic Reviews ===== | ===== Overviews of Systematic Reviews ===== | ||
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| - | + | ==== Institut National du Cancer (INC, France) 2023 ⊕ ==== | |
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| + | Prévention et gestion des effets indésirables des anticancéreux - Hormonothérapies dans le traitement adjuvant des cancers du sein. Institut National du Cancer. 2023. https://www.e-cancer.fr/Expertises-et-publications/Catalogue-des-publications/Prevention-et-gestion-des-effets-indesirables-des-anticancereux-Hormonotherapies-dans-le-traitement-adjuvant-des-cancers-du-sein | ||
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| + | |//Douleurs articulaires et musculosquelettiques// (Inhibiteurs de l’aromatase. Agonistes de la GNRH. Tamoxifène). Discuter les approches non pharmacologiques telles que kinésithérapie, physiothérapie, balnéothérapie, **acupuncture**, techniques de relaxation.\\ //Bouffées de chaleur// (tamoxifène, agonistes de la GNRH). En complément, selon le groupe de travail, le recours au yoga, à l’hypnose et à la thérapie cognitivocomportementale peut être envisagé selon les possibilités du patient. Des essais cliniques ont évalué l’impact de l’**acupuncture** sur les bouffées de chaleur sous hormonothérapie. Cependant leurs résultats ne permettent pas de conclure sur son efficacité dans cette situation. L’activité physique adaptée n’a pas montré d’effet significatif sur la gestion des bouffées de chaleur.| | ||
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| + | <wrap lo>Ref. \\ | ||
| + | - Liu X, et al. Acupuncture for Arthralgia Induced by Aromatase Inhibitors in Patients with Breast Cancer: A Systematic Review and Meta-analysis. Integr Cancer Ther. 2021 Jan-Dec ; 20:1534735420980811 \\ | ||
| + | - Hershman DL, et al. Effect of Acupuncture vs Sham Acupuncture or Waitlist Control on Joint Pain Related to Aromatase Inhibitors Among Women With Early-Stage Breast Cancer: A Randomized Clinical Trial. JAMA. 2018 Jul 10 ; 320(2):167-176</wrap> | ||
| ==== Cancer Australia (CA, Australia) 2020 ⊕ ==== | ==== Cancer Australia (CA, Australia) 2020 ⊕ ==== | ||
