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26.03.2016 | Review

Informing hot flash treatment decisions for breast cancer survivors: a systematic review of randomized trials comparing active interventions

verfasst von: Claire Johns, Susan M. Seav, Sally A. Dominick, Jessica R. Gorman, Hongying Li, Loki Natarajan, Jun James Mao, H. Irene Su

Erschienen in: Breast Cancer Research and Treatment | Ausgabe 3/2016

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Abstract

Patient-centered decision making about hot flash treatments often incorporates a balance of efficacy and side effects in addition to patient preference. This systematic review examines randomized controlled trials (RCTs) comparing at least two non-hormonal hot flash treatments in breast cancer survivors. In July 2015, PubMed, SCOPUS, CINAHL, Cochrane, and Web of Science databases were searched for RCTs comparing active, non-hormonal hot flash treatments in female breast cancer survivors. Thirteen trials were included after identifying 906 potential studies. Four trials were dose comparison studies of pharmacologic treatments citalopram, venlafaxine, gabapentin, and paroxetine. Hot flash reduction did not differ by tamoxifen or aromatase inhibitor use. Citalopram 10, 20, and 30 mg daily had comparable outcomes. Venlafaxine 75 mg daily improved hot flashes without additional side effects from higher dosing. Gabapentin 900 mg daily improved hot flashes more than 300 mg. Paroxetine 10 mg daily had fewer side effects than 20 mg. Among four trials comparing different pharmacologic treatments, venlafaxine alleviated hot flash symptoms faster than clonidine; participants preferred venlafaxine over gabapentin. Five trials compared pharmacologic to non-pharmacologic treatments. Acupuncture had similar efficacy to venlafaxine and gabapentin but may have longer durability after completing treatment and fewer side effects. We could not perform a pooled meta-analysis because outcomes were not reported in comparable formats. Clinical trial data on non-hormonal hot flash treatments provide comparisons of hot flash efficacy and other patient important outcomes to guide clinical management. Clinicians can use the information to help patients select hot flash interventions.

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Titel: Informing hot flash treatment decisions for breast cancer survivors: a systematic review of randomized trials comparing active interventions
verfasst von: Claire Johns
Susan M. Seav
Sally A. Dominick
Jessica R. Gorman
Hongying Li
Loki Natarajan
Jun James Mao
H. Irene Su
Publikationsdatum: 26.03.2016
Verlag: Springer US
Erschienen in: Breast Cancer Research and Treatment / Ausgabe 3/2016
Print ISSN: 0167-6806
Elektronische ISSN: 1573-7217
DOI: https://doi.org/10.1007/s10549-016-3765-4

Springer Medizin

Informing hot flash treatment decisions for breast cancer survivors: a systematic review of randomized trials comparing active interventions

Abstract

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Springer Medizin

Abstract

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