scholarly journals Effectiveness of doxorubicin-based and liposomal doxorubicin chemotherapies for patients with extra-abdominal desmoid-type fibromatosis: a systematic review

2020 ◽  
Vol 50 (11) ◽  
pp. 1274-1281
Author(s):  
Koki Shimizu ◽  
Hiroyuki Kawashima ◽  
Akira Kawai ◽  
Masahiro Yoshida ◽  
Yoshihiro Nishida
Keyword(s):  
Systematic Review ◽  
Adverse Events ◽  
Liposomal Doxorubicin ◽  
Clinical Care ◽  
Response Rates ◽  
The Body ◽  
Evaluation Methodology ◽  
Hand Search ◽  
Guideline Committee ◽  
Extra Abdominal Desmoid

Abstract Objective The treatment modality for desmoid-type fibromatosis has shifted from surgery to conservative treatment. The guideline committee for clinical care of extra-abdominal desmoid-type fibromatosis in Japan conducted a systematic review of treatment with doxorubicin-based chemotherapy for desmoid-type fibromatosis. Methods We searched the pertinent literature. Two reviewers evaluated and screened it independently for eligibility and extracted data. They rated each report according to the grading of recommendations development and evaluation methodology. Based on the ‘body of evidence’, which the reviewers created, the clinical guideline committee decided a recommendation for the clinical question, ‘Is doxorubicin-based chemotherapy effective for patients with extra-abdominal desmoid-type fibromatosis?’ Results Fifty-three articles were extracted by the literature search, and one from hand search. After the first and second screenings, five articles were subjected to the final evaluation. There were no randomized controlled trials. According to response evaluation criteria in solid tumors criteria, the response rates of doxorubicin-based regimens and liposomal doxorubicin were 44% (28.6–54) and 33.3% (0–75) on average, respectively. In two reports, the response rates of doxorubicin-based regimens were higher than those of non-doxorubicin-based ones; 54% vs 12%, 40% vs 11%, respectively. The rates of G3 or G4 complications according to common terminology criteria for adverse events were 28% and 13% with doxorubicin-based and liposomal doxorubicin chemotherapy, respectively, including neutropenia or cardiac dysfunction. None of the reports addressed the issue of QOL. Conclusion Although the evidence level was low in the evaluated studies, doxorubicin-based and liposomal doxorubicin chemotherapy was observed to be effective. However, doxorubicin-based chemotherapy is associated with non-ignorable adverse events, and is not covered by insurance in Japan. We weakly recommend doxorubicin-based chemotherapy for patients with extra-abdominal desmoid-type fibromatosis in cases resistant to other treatments.

Safety and Efficacy of Pegylated Liposomal Doxorubicin In Combination with Dexamethasone and Bortezomib (VMD) or Lenalidomide (RMD) In Multiple Myeloma Refractory/Relapsed Patients

Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 5033-5033
Author(s):  
Gabriele Buda ◽  
Enrico Orciuolo ◽  
Sara Galimberti ◽  
Matteo Pelosini ◽  
Mario Petrini
Keyword(s):  
Multiple Myeloma ◽  
Side Effects ◽  
Liposomal Doxorubicin ◽  
Pegylated Liposomal Doxorubicin ◽  
Response Rates ◽  
The Body ◽  
High Dose ◽  
Combination Regimen ◽  
Prior Therapy ◽  
Number Of Patients

Abstract Abstract 5033 The pharmacology of pegylated liposomal doxorubicin (PLD) gives rise to a compound with major advantages that could potentially improve response and decrease toxicity. PLD comprises doxorubicin incorporated into polyethylene-glycol-coated liposomes, resulting in a longer circulation time in the body compared with the conventional formulation and a unique toxicity profile. The lower toxicity, especially less cardiotoxicity, is also related to the encapsulation of doxorubicin into microscopic liposomes, which preferentially penetrate and accumulate in tumour vasculature. Because increased angiogenic activity occurs in the bone marrow of patients with multiple myeloma, this pegylated formulation can enhance the delivery of doxorubicin to the tumour site. In addition, because myeloma cells divide slowly, the increased exposure of these cells to doxorubicin has the potential of overcoming resistance and increasing tumour cell killing capacity, theoretically resulting in improved response rates. Between December 2008 and May 2010, we treated a total of 39 MM resistant/refractory patients with two different scheme including PLD. Twenty-five patients were resistant/relapsed after at least one prior therapy including conventional doxorubicin. The scheme therapy was based on VMD: bortezomib (Velcade®: 1.3 mg/m2) as intravenous bolus twice a week for 2 weeks (on days 1, 4, 8 and 11 of each cycle) in a 28-day cycle for a total of 4 cycles; oral dexamethasone (40 mg) on the day of each bortezomib dose and the day after, and PLD (Myocet® 30 mg/m2) on day 4 of each cycle, 1 h after bortezomib infusion. Baseline characteristics are shown in table 1. All 25 patients were evaluable for response. Response rates following VMD showed: 2 patients in nCR (10%), 4 in VGPR (20%), 14 in PR (70%) resulting in an overall response rate (ORR) of 80% (20 patients). Global toxicities were lower and included neutropenia (12.5%), fatigue (25%), thrombocytopenia (25%) and neuropathy (37.5%). In the other group, fourteen patients were treated with RMD a combination regimen of lenalidomide (Revlimid®), PLD (Myocet®) and dexamethasone and 11 patients were eligible for evaluation. All the patients had multiple myeloma resistant or progressed after 1 to 5 previous anti-myeloma regimens including at least one doxorubicin containing scheme. RMD was administered for six 28-day cycle. Lenalidomide 25mg d1-21, Liposomal doxorubicin 30 mg/m2 d4, Dex 40 mg d1-4 and d17-20. Eight of eleven patients (73%) achieved an objective response to the therapy. Respectively, 2 patients (25%) obtained a VGPR and additional 6 patients (75%) a PR. The most common side effects was haematological toxicity with grade neutropenia (32%), thrombocytopenia (32%) and anaemia (18%). Under thrombosis prophylaxis with aspirin 100 mg per day we observed thrombembolic complications in only in one patients. Other non haematological side effects were pain (9%), diarrhoea (9%). Neither neurotoxicity nor constitutional symptoms of grade 3/4 were found. In both of groups no cardiovascular events were reported. Additionally 12 patients of RVM group and 4 patients of RMD group underwent to high dose chemotherapy and successfully collected an adequate number of peripherals stem cells at the first attempt. The introduction of pegylated liposomal doxorubicin, in bortezomib or lenalidomide based regimens, can play a key role in overcoming anthracycline resistance and improving the quality of response without limiting toxicity, especially in patients who have already received at least one prior therapy. We believe that there is a rational basis for the use of PLD as a second-, third-, or fourth-line therapy in patients with advanced MM. Table I. Characteristics of MM Patients undergoing VMD or RMD therapy Characteristics Cases Age at diagnosis (median and range) 65 (44–76) Number of patients     VMD 25 (14M, 11F)     RMD 14 (10M, 4F) Stage at diagnosis     Durie-Salmon (II/III) 10/29 Prognostic Markers     b2-microglobulin (m/L.) 2.2 (1.1–35)a     Creatinin (mg/dl.) 0.9 (0.5–4.4)a     Albumin (g/dl)) 4.0 (2.1–4.9)a     Hemoglobin (mg/dl) 11.3 (5.7–16.4)a a Median (Range) Disclosures: No relevant conflicts of interest to declare.

scholarly journals Efficacy of low-dose chemotherapy with methotrexate and vinblastine for patients with extra-abdominal desmoid-type fibromatosis: a systematic review

2019 ◽  
Vol 50 (4) ◽  
pp. 419-424 ◽  
Author(s):  
Koki Shimizu ◽  
Shunsuke Hamada ◽  
Tomohisa Sakai ◽  
Hiroshi Koike ◽  
Masahiro Yoshida ◽  
...  
Keyword(s):  
Systematic Review ◽  
Low Dose ◽  
Evaluation Criteria ◽  
Case Series ◽  
Evaluation Methodology ◽  
Adverse Event Rate ◽  
Prospective Case Series ◽  
Extra Abdominal Desmoid ◽  
Low Dose Chemotherapy

Abstract Objective The treatment modality for desmoid-type fibromatosis has shifted from surgery to conservative treatment. This systematic review aims to evaluate the efficacy of low-dose chemotherapy with methotrexate and vinblastine for patients with extra-abdominal desmoid-type fibromatosis. Methods We searched the pertinent literature from January 1990 to August 2017. Two reviewers evaluated and screened the literature independently for eligibility and extracted data. We evaluated the quality of body of evidence and made a recommendation according to the Grading of Recommendations Development and Evaluation methodology. Results The search yielded 40 studies, 9 of which were included after the first and second screenings. There were three prospective case series but no randomized controlled trials among the nine studies. There was no case–control report (vs. no treatment). According to Response Evaluation Criteria in Solid Tumors criteria, the mean response rate (complete remission or partial response) was 36% (11–57%). Including stable disease, namely, clinical benefit was consistently as high as 85% (69–100%). Mean adverse event rate of G3 or G4 according to CTCAE was 31%. One study reported improvement of pain (87.5%) because of this chemotherapy. Conclusion The efficacy of this chemotherapy was convincing. However, the overall evidence was weak, and this chemotherapy is not covered by insurance in Japan; we only weakly recommend low-dose chemotherapy with methotrexate and vinblastine in patients with extra-abdominal desmoid-type fibromatosis.

Adverse Events after Rigid and Flexible Endoscopic Repair of Zenker’s Diverticula: A Systematic Review and Meta-analysis

2019 ◽  
Vol 161 (3) ◽  
pp. 388-400 ◽  
Author(s):  
Brianna Crawley ◽  
Salem Dehom ◽  
Shanalee Tamares ◽  
Abdullah Marghalani ◽  
Julina Ongkasuwan ◽  
...  
Keyword(s):  
Systematic Review ◽  
Adverse Events ◽  
Meta Analysis ◽  
Case Series ◽  
Cochrane Central Register ◽  
Retrospective Case ◽  
Hand Search ◽  
Endoscopic Techniques ◽  
Vocal Fold Palsy ◽  
Meta Analyses

Objective To determine adverse events after endoscopic flexible vs endoscopic rigid cricopharyngeal myotomy for treatment of Zenker’s diverticulum (ZD). Data Sources Systematic review of MEDLINE, Web of Science, CINAHL, Clinicaltrials.gov, and Cochrane Central Register of Controlled Trials for all years according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Additional studies were identified from review citations and a by hand search of manuscripts referencing ZD. Review Methods A structured literature search was conducted to identify studies for this systematic review. Methodological Index for Non-randomized Studies (MINORS) criteria were applied to assess study quality. For inclusion, each study had to provide data for at least 10 adult patients who had undergone endoscopic ZD repair reporting clear association with the postprocedure course in each case. Data extracted included all reported adverse events, recurrences, follow-up, and operative times. Results In total, 115 studies were included. All but 8 were retrospective case series. Sixty-one reported series of patients after rigid endoscopic stapler repair, 31 after rigid laser repair, and 13 with other rigid endoscopic instruments. Twenty-nine flexible endoscopic studies were included. Mortality, infection, and perforation were not significantly more likely in either the rigid or the flexible group, but bleeding and recurrence were more likely after flexible endoscopic techniques (20% vs <10% and 4% vs 0%, respectively). Dental injury and vocal fold palsy were reported rarely in the rigid endoscopic groups. Conclusions Adverse events are rare after endoscopic Zenker’s repair. The flexible approach minimizes exposure limitations and can be completed in some patients without general anesthesia. Transoral rigid approaches result in fewer revision surgeries compared with flexible diverticulotomy.

scholarly journals Effect of Photodynamic Therapy on Halitosis: A Systematic Review of Randomized Controlled Trials

Sensors ◽  
2022 ◽  
Vol 22 (2) ◽  
pp. 469
Author(s):  
Pamella de Barros Motta ◽  
Lara Jansiski Motta ◽  
Thalita Molinos Campos ◽  
Marcela Leticia Leal Gonçalves ◽  
Elaine Marcílio Santos ◽  
...  
Keyword(s):  
Systematic Review ◽  
Photodynamic Therapy ◽  
Adverse Events ◽  
Randomized Clinical Trials ◽  
Included Study ◽  
Outcome Data ◽  
Risk Of Bias ◽  
The Body ◽  
Microbiological Analysis ◽  
Manual Search

Background: This systematic review aimed to assess the effectiveness and safety of aPDT for the treatment of halitosis. Methods: Search strategies were conducted in October 2021 without language or data restrictions, on the following databases: MEDLINE, EMBASE, CENTRAL, LILACS and BBO, as well as a manual search. Randomized clinical trials (RCTs) with parallel design were considered for inclusion, assessing individuals (adolescents and adults) with a clinical diagnosis of halitosis treated with photodynamic therapy (aPDT). Primary outcomes assessed were halitosis measurements, adverse events and quality of life. The risk of bias for each included study was evaluated with the Cochrane Risk of Bias tool and the certainty of the body of the evidence was assessed with the GRADe approach. Results: Six RCTs (total of 225 participants) were included and due to clinical diversities it was not possible to group the outcome data in meta-analyses. Based on very low-certainty evidence (GRADE) the results showed that, when compared to tongue scraper, aPDT seems to promote a little to no difference in reducing halitosis and in the microbiological analysis. No adverse events were reported. Considering aPDT combined with tongue scraper, better outcome results were observed when compared to tongue scraper alone. Conclusions: Based on very low-certainty evidence, the findings of this review are uncertain about the effects of aPDT for halitosis control. Further RCTs with higher number of participants and long term assessments need to be conducted to support the use of this intervention. The protocol was registered in the PROSPERO database (number: CRD42020215319) on 19 November 2020—retrospectively registered.

INTERVENTION OF THIRSTY IN CONGESTIVE HEART FAILURE (CHF) PATIENTS TO INCREASED ADHERENCE OF FLUID RESTRICTION: A SYSTEMATIC REVIEW

2017 ◽  
Vol 3 (1) ◽  
pp. 7
Author(s):  
DIAN HUDIYAWATI
Keyword(s):  
Heart Failure ◽  
Systematic Review ◽  
Congestive Heart Failure ◽  
Intervention Studies ◽  
Cold Water ◽  
Fluid Restriction ◽  
Common Symptom ◽  
Oral Swab ◽  
Hand Search ◽  
Effective Interventions

Introduction. Thirst is a common symptom of chronic heart failure (CHF) patients. Difficulties to adherence with fluid restrictions are among the effects of thirst in HF patients and therefore have an impact on worsening condition, but intervention studies aimed specifically at reducing thirst in CHF are lacking.Purpose. Purpose of this manuscript is to assess the effective intervention to reduce thirst intensity in CHF patients.Methods. Medline, Pubmed, EBSCO and hand search were searched using the key words thirst, intervention, heart failure, CHF, fluis restriction, therapy.Result.� Eighteen articles were found, six studies were inluded. Any kind of interventions in each articles, include: drink cold water 5oC, chewing gum, saliva substitute, sucking ice cubes and three bundle of interventions (oral swab, water sprays and menthol moisturizer).Conclusions. The most effective interventions to alleviate thirst was sucking ice cubes. But, no intervention studies were found in congestive heart failure patients. So investigations in people with heart failure is needed.�Keywords: thirst, intervention, heart failure, systematic review

Systematic Review and Meta-analysis of Flibanserin's Effects and Adverse Events in Women with Hypoactive Sexual Desire Disorder

2017 ◽  
Vol 18 (1) ◽  
pp. 78-85 ◽  
Author(s):  
Seyed Saadat ◽  
Yunes Panahi ◽  
Milad Hosseinialhashemi ◽  
Ali Kabir ◽  
Khaled Rahmani ◽  
...  
Keyword(s):  
Systematic Review ◽  
Adverse Events ◽  
Sexual Desire ◽  
Meta Analysis ◽  
Hypoactive Sexual Desire Disorder ◽  
Desire Disorder
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