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Evidence summaries

Cytotoxic and Hormonal Treatment for Metastatic Breast Cancer

Combined cytotoxic and hormonal treatment appears to be effective for survival benefit (a survival gain of 9% at 1 year) compared to less intensive treatment schedules in metastatic breast cancer. Level of evidence: "B"

A systematic review 1 including 189 studies with a total of 31 150 subjects was abstracted in DARE. Overall survival analysis showed better results of polychemotherapy (PCHT) versus single agent single-agent (CHT) (hazard ratio (HR) 0.82, 95% CI 0.75 to 0.90), CHT with doxorubicin versus CHT with epirubicin (HR 1.13, 95% CI 1.00 to 1.27), CHT versus the same CHT delivered with less intensive schedules (HR 0.90, 95% CI 0.83 to 0.97), endocrine therapy versus the same endocrine therapy at a lower dose (HR 0.86, 95% CI 0.77 to 0.97).

Comment: The quality of evidence is downgraded by inconsistency of results. Quality of life was not reported.

    References

    • Fossati R, Confalonieri C, Torri V, Ghislandi E, Penna A, Pistotti V, Tinazzi A, Liberati A. Cytotoxic and hormonal treatment for metastatic breast cancer: a systematic review of published randomized trials involving 31,510 women. J Clin Oncol 1998 Oct;16(10):3439-60. [PubMed][DARE]

Primary/Secondary Keywords