Background
Methods
Literature search
Paper selection
Data extraction
Quality assessment
Statistical analysis
Results
Characteristics of the participants and study designs
First author, year of publication | Year of enrolment | Study design | Sample (sample size, key characteristics) | Type of chemotherapy | Follow-up | Mean weight gain in kg (se) in total group | Subgroup analysis Mean weight gain in kg (se) |
---|---|---|---|---|---|---|---|
Foltz, 1985 [32] | UN | Prospective |
n = 34, pre- and postmenopausal, stage II, adjuvant | CMF | pretreatment - 6 months | 2.99 (2.85) | |
Heasman, 1985 [33] | 1975–1981 | Retrospective Chart review |
n = 237, pre- and postmenopausal, adjuvant |
n = 46 single agent chemotherapy
n = 112 CMF
n = 79 CMF + prednisone | Pre – posttreatment | 4.32 (0.23) | Single agent: 2.72 (0.33) CMF: 3.65 (0.32) CMF + prednisone: 6.20 (0.4) |
Huntington, 1985 [34] | UN | Retrospective Chart review |
n = 29, pre- and postmenopausal, adjuvant |
n = 18 CMF
n = 11 CMFVP | Pre – posttreatment | 4.58 (0.58) | Premenopausal: 7.67 (0.89) Postmenopausal: 2.63 (0.72) Perimenopausal: 4.76 (0.12) |
Goodwin, 1988 [35] | 1960–1984 | Retrospective Chart review |
n = 193, pre- and postmenopausal, adjuvant |
n = 113 CMF
n = 80 CMF + prednison | Pretreatment - 12 months | CMF: 2.51 (0.24) CMF+ prednison 5.55 (0.62) | |
Demark–Wahnefried, 1997 [13] | 1993–1995 | Prospective |
n = 18, premenopausal, adjuvant |
n = 9 AC
n = 5 CAF
n = 1 CMF
n = 1 CMF + leucovorin
n = 1 A + CMF
n = 1 AC + leucovorin | Pre- posttreatment | 0 (3.48) | |
Aslani, 1999 [36] | UN | Prospective |
n = 25, pre- and postmenopausal, adjuvant | CMF | Pre- posttreatment | 2.35 (0.62) | |
Goodwin, 1999 [37] | 1989–1996 | Prospective |
n = 176, pre- and postmenopausal, adjuvant |
n = 128 non-antracyclines
n = 48 antracyclines | Pretreatment - 12 months | 2.5 (0.36) | |
Kutynec, 1999 | UN | Prospective |
n = 8, pre- and perimenopausal, adjuvant | AC | Pre- posttreatment | 0 (2.85) | |
Demark-Wahnefried, 2001 [12] | 1995–1999 | Prospective |
n = 36, premenopausal, adjuvant |
n = 17 doxorubicin regimens
n = 12 doxorubicin regimens + tamoxifen,
n = 6 CMF
n = 1 CMF + tamoxifen | Pretreatment - 6 months | 2.2 (0.37) | |
McInnes, 2001 [1] | UN | Retrospective Chart review |
n = 44, pre- and postmenopausal, adjuvant |
n = 19 CMF - oral n = 6 CMF - iv n = 2 CAF - oral n = 9 CAF - iv n = 8 Other | Pretreatment - 6 months | 3.4 (0.33) | |
Del Rio, 2002 [39] | UN | Prospective |
n = 30, premenopausal, adjuvant | CMF | Pretreatment - 6 months | 2.8 (0.56) | |
Lankester, 2002 [40] | 1998 | Retrospective Chart review |
n = 100, pre- and postmenopausal, adjuvant + neo-adjuvant |
n = 69 FEC
n = 31 CMF | Pretreatment-before last cycle | 3.68 (0.4) | |
Freedman, 2004 [7] | 1999–2001 | Prospective |
n = 20, pre- and posttreatment, adjuvant |
n = 8 AC
n = 10 AC + paclitaxel
n = 2 AC + docetaxel | Pre- posttreatment | −0.83 (0.81) | |
Harvie, 2004 [18] | UN | Prospective |
n = 17, pre- and postmenopausal, adjuvant |
n = 12 FEC
n = 5 CMF | Pre- posttreatment | 3.3 (1.02) | |
Ingram, 2004 [6] | UN | Prospective |
n = 76, premenopausal, adjuvant |
n = 39 AC
n = 33 CEF
n = 4 CMF | Pre- posttreatment | 1.4 (0.39) | AC: 1 (0.34) CEF: 1.5 (0.77) CMF: 5 (1.8) |
Kumar, 2004 [41] | UN | Prospective |
n = 170, pre- and postmenopausal, adjuvant |
n = 107 CA
n = 45 CA + taxol
n = 17 other | Pre- posttreatment | 0.4 (1.13) | |
Campbell, 2007 [19] | 2001–2003 | Prospective |
n = 10, pre- and postmenopausal, adjuavnt |
n = 5 CEF
n = 5 AC | Pre- posttreatment | 1.98 (5.06) | |
Courneya, 2007 [42] | 2003–2005 | Trial |
n = 82 pre- and postmenopausal, adjuvant |
n = 23 FE100C n = 20 AC n = 8 CE120F n = 3 other non-taxanen n = 10 TAC n = 14 AC-Taxanen n = 4 other taxanen | Pre- posttreatment | 1.2 (1.71) | |
Makari-Judson, 2007 [20] | 1997–2002 | Retrospective Chart review |
n = 123, pre- and postmenopausal, adjuvant | AC, AC + taxanen, CAF, Doxorubicin + CMF, CMF or MF
n = 109 antracycline containing CT
n = 14 non antracycline | Pretreatment - 12 months | 2.6 (0.57) | |
Heideman, 2009 [8] | 1974–2006 | Retrospective |
n = 31 (CT only), pre- and postmenopausal, adjuvant | AC, EC, CMF, FAC, FEC, other incl herceptin | Pretreatment - 12 months | 2.2 (2.07) | |
Heideman, 2009 [8] | 1974–2006 | Retrospective |
n = 67 (Combined), pre- and postmenopausal, adjuvant | AC, EC, CMF, FAC, FEC, other incl herceptin | Pretreatment - 12 months | 2.6 (1.69) | |
Biglia, 2010 | 2007–2008 | Prospective |
n = 34, premenopausal, adjuvant |
n = 17 FEC
n = 17 FEC + taxotere | After surgery-end CT | 2.07 (0.45) | |
Tredan, 2010 [44] | 2004–2006 | Prospective |
n = 242, pre- and postmenopausal, adjuvant |
n = 110 anthracycline without taxane n = 156 anthracycline + taxane n = 2 taxane (1%)n = 4 missing data | Pretreatment – 6 months after CT | 0.7 (0.23) | Premenopausal: 1.2 (0.31) Postmenopausal: 0.2 (0.33) |
Basaran, 2011 [45] | 2003–2004 | Retrospective Chart review |
n = 171, pre- and postmenopausal, adjuvant |
N = 111 Antracycline based
N = 55 Antracycline/taxane
N = 5 No CT | Pre- posttreatment | 1.7 (0.94) | |
Jeon, 2014 [46] | 2005–2010 | Retrospective Chart review |
N = 108, pre- and postmenopausal, adjuvant | TAC | Pre- posttreatment | 3.64 (3.7) | |
Winkels, 2014 [47] | 2001–2010 | Retrospective Chart review |
N = 483, re and postmenopausal |
n = 289 antracycline based n = 170 antracycline + taxane n = 10 CMF n = 14 other | Pre-posttreatment | 1.2 (0.25) |
First author, year of publication | Representativeness of sample (2 points) | Loss to follow-up of participants (1 point) | Information about exposure (1 point) | Measurement of outcome (2 points) | Total score |
---|---|---|---|---|---|
Foltz, 1985 [32] | 2 | 1 | 1 | 1 | 5/6 |
Heasman, 1985 [33] | 2 | 1 | 1 | 1 | 5/6 |
Huntington, 1985 [34] | 1 | 0 | 1 | 1 | 3/6 |
Goodwin, 1988 [35] | 2 | 1 | 1 | 1 | 5/6 |
Demark-Wahnefried, 1997 [13] | 1 | 1 | 0 | 1 | 3/6 |
Aslani, 1999 [36] | 1 | 1 | 1 | 1 | 4/6 |
Goodwin, 1999 [37] | 1 | 1 | 0 | 2 | 4/6 |
Kutynec, 1999 [38] | 2 | 1 | 1 | 1 | 5/6 |
Demark-Wahnefried, 2001 [12] | 2 | 1 | 0 | 2 | 5/6 |
McInnes, 2001 [1] | 1 | 1 | 0 | 1 | 3/6 |
Del Rio, 2002 [39] | 1 | 1 | 1 | 0 | 3/6 |
Lankester, 2002 [40] | 1 | 1 | 0 | 1 | 3/6 |
Freedman, 2004 [7] | 1 | 1 | 0 | 2 | 4/6 |
Harvie, 2004 [18] | 1 | 1 | 0 | 2 | 4/6 |
Ingram, 2004 [6] | 2 | 1 | 1 | 2 | 6/6 |
Kumar, 2004 [41] | 2 | 1 | 0 | 1 | 4/6 |
Campbell, 2007 [19] | 1 | 1 | 0 | 2 | 4/6 |
Courneya, 2007 [27] | 2 | 1 | 0 | 1 | 4/6 |
Makari-Judson, 2007 [20] | 2 | 1 | 0 | 1 | 4/6 |
Heideman, 2009 [8] | 2 | 1 | 0 | 1 | 4/6 |
Biglia, 2010 | 1 | 1 | 0 | 0 | 2/6 |
Tredan, 2010 [44] | 1 | 1 | 0 | 1 | 3/6 |
Basaran, 2011 [45] | 1 | 0 | 0 | 1 | 2/6 |
Jeon, 2014 [46] | 1 | 1 | 1 | 1 | 4/6 |
Winkels, 2014 [47] | 2 | 1 | 1 | 1 | 5/6 |
Overall estimate
Stratified and sensitivity analyses
No of estimates | Pooled weight change kg | 95% CIa
| I2b
| |
---|---|---|---|---|
Overall | ||||
All | 34 | 2.7 | 2.0, 7.5 | 94.2 |
Type Chemotherapy | ||||
CMF included | 20 | 3.5 | 2.7, 4.3 | 93.7 |
No CMF | 14 | 1.4 | 0.7, 2.0 | 74.7 |
Menopausal status | ||||
Premenopausal | 9 | 2.6 | 1.5, 3.6 | 86.9 |
Postmenopausal | 2 | 1.3 | −1.1, 3.7 | 89.4 |
Perimenopausal | 1 | 4.8 | 4.5, 5.0 | |
Combination | 22 | 2.7 | 2.0, 3.4 | 88.3 |
Baseline mean BMI | ||||
20.0–24.9 | 6 | 0.5 | −0.4; 1.3 | 45.1 |
25.0–29.9 | 15 | 2.4 | 1.8; 3.6 | 73.2 |
Unknown | 13 | 3.5 | 2.6; 4.5 | 95.4 |
Follow-up | 93.8 | |||
end of chemotherapy / 6 months after baseline | 26 | 2.7 | 2.0; 3.5 | 90.9 |
6 months after chemotherapy / 12 months after baseline | 8 | 2.4 | 1.3; 3.4 | |
Type of study | ||||
Chart review | 16 | 3.6 | 2.8, 4.4 | 94.8 |
Prospective | 18 | 1.6 | 1.1, 2.2 | 69.5 |
Publication year | ||||
Before and including 2000 | 13 | 3.8 | 2.9, 4.7 | 93.3 |
After 2000 | 21 | 1.9 | 1.3, 2.5 | 81.6 |
Sample Size | ||||
≤ 100 | 23 | 3.0 | 2.2, 3.9 | 92.7 |
> 100 | 11 | 2.1 | 1.3, 2.8 | 90.1 |
Country | ||||
United States | 10 | 2.8 | 1.6; 4.1 | 93.4 |
Canada | 12 | 3.1 | 2.1; 4.1 | 91.8 |
Western Europe | 9 | 2.0 | 1.1; 2.8 | 86.2 |
Australia | 1 | 2.4 | 1.1;3.6 | |
Turkey | 1 | 1.7 | −0.1; 3.5 | |
Korea | 1 | 3.6 | −3.6; 10.9 | |
Study quality | ||||
Low quality | 11 | 2.9 | 1.6; 4.1 | 96.7 |
High quality | 23 | 2.5 | 1.8; 3.2 | 88.8 |
Meta-regression analysis
Unadjusted | Adjustedd
| |||||||
---|---|---|---|---|---|---|---|---|
RCa
| SEb
| 95% CIc
|
P-value | RC | SE | 95% CI |
P-value | |
Type chemotherapy | ||||||||
No CMF | ref | ref | ||||||
CMF included | 2.2 | 0.6 | 1.1, 3.3 | <0.01 | 1.4 | 0.6 | 0.3, 2.6 | 0.02 |
Menopausal status | ||||||||
Premenopausal | ref | |||||||
Postmenopausal | −1.3 | 1.4 | −4.1, 1.5 | 0.36 | ||||
Perimenopausal | 2.2 | 1.8 | −1.5, 5.8 | 0.23 | ||||
Combination | 0.1 | 0.8 | −1.5, 1.6 | 0.91 | ||||
Follow-up | ||||||||
end of chemotherapy / 6 months after baseline | ref | |||||||
6 months after chemotherapy / 12 months after baseline | −0.1 | 0.1 | −0.3; 0.2 | 0.64 | ||||
Type of studie | ||||||||
Chart review | ref | ref | ||||||
Prospective | −2.0 | 0.6 | −3.1, −0.8 | <0.01 | −0.7 | 0.6 | −1.9, 0.5 | 0.24 |
Publication year | ||||||||
After 2000 | ref | ref | ||||||
Before and including 2000 | 1.9 | 0.6 | 0.8, 3.1 | <0.01 | 1.3 | 0.5 | 0.2, 2.3 | 0.02 |
Sample Size | ||||||||
≤ 100 | ref | |||||||
> 100 | −1.0 | 0.7 | −2.3, 0.4 | 0.15 | ||||
Country | ||||||||
United States | ref | |||||||
Canada | −0.2 | 0.9 | −1.5; 2.0 | 0.79 | ||||
Western Europe | −0.8 | 0.9 | −2.6; 1.0 | 0.39 | ||||
Australia | −0.5 | 1.9 | −4.5; 3.5 | 0.80 | ||||
Turkey | −1.1 | 2.1 | −5.4; 3.1 | 0.58 | ||||
Korea | 0.8 | 4.1 | −7.7; 9.3 | 0.85 | ||||
Quality assessment | ||||||||
Low Quality | ref | |||||||
High Quality | −0.4 | 0.7 | −1.8; 1.0 | 0.58 |