scholarly journals Effects of Traditional Chinese Medicine on Chemotherapy-Induced Myelosuppression and Febrile Neutropenia in Breast Cancer Patients

2015 ◽  
Vol 2015 ◽  
pp. 1-11 ◽  
Author(s):  
Huan Tian ◽  
Wei Qin ◽  
Wenjing Wu ◽  
Pi Guo ◽  
Yong Lu ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Multivariate Analysis ◽  
Chinese Medicine ◽  
Treatment Group ◽  
Traditional Chinese Medicine ◽  
Febrile Neutropenia ◽  
Cancer Patients ◽  
Breast Cancer Patients ◽  
Group 2 ◽  
Group 1

Title. Chemotherapy-induced myelosuppression lowers the quality of life in breast cancer patients and causes many complications. Traditional Chinese Medicine (TCM) is a widely used complementary and alternative medicine therapies.Objective. To study whether TCM can reduce the incidence of chemotherapy-induced leukopenia, neutropenia, and febrile neutropenia (FN) in breast cancer patients.Methods. The data were analyzed retrospectively between patients who received TCM treatment (group 1,n=453) and patients who did not receive TCM treatment (group 2,n=359). Significant risk factors associated with the occurrence of chemotherapy-induced leukopenia, neutropenia, and FN were identified using multivariate analysis. Propensity score-matched patients were analyzed to adjust for any baseline differences.Results. Group 1 patients had a significantly lower rate of chemotherapy-induced severe leukopenia, neutropenia, and FN, compared with group 2 (43% versus 71%,P<0.0001, 72% versus 78%,P=0.005, 6% versus 24%,P<0.0001, resp.). Multivariate analysis revealed that chemotherapy regimens containing anthracyclines combined with paclitaxel or docetaxel were the most significant predictor. Subgroup analysis indicated that TCM treatment showed benefit in relieving chemotherapy-induced leukopenia and FN in most chemotherapy regimens.Conclusions. TCM treatment could lower the risk of severe chemotherapy-induced leukopenia, neutropenia, and FN in breast cancer patients.

scholarly journals Effects of Integrated Chinese Traditional Medicine and Conventional Western Medicine on the Quality of Life of Breast Cancer Patients: A Systematic Review and Meta-Analysis

2022 ◽  
Vol 2022 ◽  
pp. 1-19
Author(s):  
Xue Bai ◽  
Na Ta ◽  
Guo-Hua Gong ◽  
Bin Zhang ◽  
Cheng-Xi Wei
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Chinese Medicine ◽  
Traditional Chinese Medicine ◽  
Cancer Patients ◽  
Western Medicine ◽  
Adverse Reactions ◽  
Rating Scales ◽  
Breast Cancer Patients

Background. Traditional Chinese medicine has been widely used, in conjunction with conventional Western medicine, in clinical practice around the world to treat breast cancer. The study systematically reviewed and summarized the quality of life of breast cancer patients treated with integrated treatment method vs. conventional Western medicine. Methods. Eight databases including PubMed, EMBASE, Web of Science, the Cochrane Library, Chinese National Knowledge Infrastructure, China Biology Medicine Disc, Chinese Scientific Journal Database, and Wanfang Data knowledge service platform were searched in this study. The retrieval period was set from January 1, 2005, to December 31, 2020. Results. Twenty-two high-quality publications were included in this study. The total sample size was 1689 patients including 844 in the intervention group receiving traditional Chinese medicine combined with conventional Western medicine and 845 patients in the control group receiving conventional Western medicine only. Compared with the single-used conventional Western medicine treatment, an integrated approach to treat breast cancer can increase quality of life measured by rating scales (SMD = 1.29, 95% CI (1.07, 1.52) and P = 0.01 ) and ranking scales (RR = 1.53, 95% CI (1.39 1.68) and P = 0.02 ) and also decrease adverse reactions measured by rating scales (Z = 10.89, P < 0.05 ; Group 1: I2 = 9.0%, P = 0.258 , SMD = 1.03; and Group 2: I2 = 31.6%, P = 0.199 , SMD = 1.56). For further analysis, chemotherapy with epirubicin exhibited higher quality of life than the chemotherapy without epirubicin among breast cancer patients [Z = 19.80, P < 0.05 ; Group 1: I2 = 62.4%, P = 0.070 , SMD = 1.61; and Group 2: I2 = 9.0%, P = 0.359 , SMD = 1.04]. Despite the heterogeneity, which was due to a portion of relative low-quality literature or other factors, the results were satisfactory. In terms of secondary results, the patients with lower tumor markers (CEA and CA153) had better efficiency in quality of life with a statistically significant difference (SMD = 1.39, 95% CI: 1.10,1.67) for rating scales. In addition, secondary results related to high incidence of gastrointestinal adverse reactions (RR = 1.33, 95% CI (1.20, 1.48)) and the traditional Chinese medicine syndrome (RR = 1.50, 95% CI (1.28, 1.80))showed lower quality of life in the intervention group than the control group for ranking scales. Conclusion. Traditional Chinese medicine, when used in conjunction with the conventional Western medicine, could be an effective way in improving the quality of life and alleviating incidence of associated adverse symptoms such as gastrointestinal adverse reactions, value of tumor markers, and the incidence of traditional Chinese medicine syndrome. Further investigation of larger and methodologically sound trials with longer follow-up periods and appropriate comparison groups is needed.

scholarly journals Expression level of serum circulating miRNA-21, miRNA-10b and miRNA-200c in breast cancer patients with sentinel lymph node metastasis*

2019 ◽  
Vol 73 ◽  
pp. 325-332
Author(s):  
Sebastian Niedźwiecki ◽  
Janusz Piekarski ◽  
Bożena Szymańska ◽  
Zofia Pawłowska ◽  
Arkadiusz Jeziorski
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Lymph Node Metastasis ◽  
Cancer Patients ◽  
Sentinel Lymph Node Metastasis ◽  
Breast Cancer Patients ◽  
Node Metastasis ◽  
Group 2 ◽  
Group 1

MicroRNAs (miRNAs) act a role in regulation numerous processes crucial for oncogenesis. The aim of the study was to compare the blood serum concentrations of selected microRNAs (miRNA-21, miRNA-10b and miRNA-200c) between breast cancer patients without sentinel lymph node metastasis (Group 1) and those with metastasis (Group 2). The serum levels of miRNA-21, miRNA-10b and miRNA-200c were measured with using TaqMan PCR assays performed on a 7900HT Fast Real-Time PCR System in two groups of breast cancer patients: Group 1 – without sentinel lymph node metastasis (32 patients) and Group 2 – with sentinel lymph node metastasis (14 patients). The mean level of miRNA-200c was noticeably lower in Group 2 than in Group 1. The mean fold change of miRNA-200c level in the metastatic group (Group 2) was approximately 1.3 times lower than that in non-metastatic group (Group 1). However, this result just approached the arbitrary threshold for significance (p = 0.05). Breast cancer patients with sentinel lymph node metastasis demonstrate diminished levels of circulating miR-200c compared to non-metastatic patients.

Primary outcome results of NSABP B-32, a randomized phase III clinical trial to compare sentinel node resection (SNR) to conventional axillary dissection (AD) in clinically node-negative breast cancer patients.

2010 ◽  
Vol 28 (18_suppl) ◽  
pp. LBA505-LBA505 ◽  
Author(s):  
D. N. Krag ◽  
S. J. Anderson ◽  
T. B. Julian ◽  
A. Brown ◽  
S. P. Harlow ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Disease Free Survival ◽  
Phase Iii ◽  
Breast Cancer Patients ◽  
Regional Control ◽  
Kaplan Meier ◽  
Regional Node ◽  
Group 2 ◽  
Group 1

LBA505 Background: NSABP B-32 is the largest prospective randomized phase III trial designed to determine in SN negative patients that SNR alone results in the same survival and regional control as SNR + AD while reducing morbidity. It was designed to detect a survival difference of 2% between the 2 groups at 5 years. Methods: 5,611 women with operable, clinically N0, invasive breast cancer were randomized to SNR + AD (Group 1) or to SNR alone with AD only if SNs were positive (Group 2). 3,989 (71.1%) of the 5,611 patients were SN negative and followed for events. 99.9% of these SN negative patients had follow-up information: 1,975 in Group 1 and 2,011 in Group 2. Median time on study was 95.3 months. Patients were well balanced across clinical strata. Log-rank tests for unadjusted analyses and Cox proportional hazard models adjusting for study stratification variables were used to compare overall survival (OS) and disease-free survival (DFS) between the two groups. Two-sided p-values were used. HR values > 1 indicate a more favorable outcome in Group 1 (SNR + AD). Results: Comparisons of OS (Group 1 vs. Group 2) yielded an unadjusted HR of 1.20 (p = 0.12) and an adjusted HR of 1.19 (p=0.13). Five-year Kaplan-Meier estimates for OS are 96.4% in Group 1 and 95.0% in Group 2 and the 8-year estimates are 91.8% and 90.3%, respectively. Comparisons of DFS (Group 1 vs. Group 2) yielded an unadjusted HR of 1.05 (p=0.54) and an adjusted HR of1.07 (p=0.57). No substantial differences could be seen across sites for first treatment failure. Five-year Kaplan-Meier estimates for DFS are 89.0% in Group 1, and 88.6% in Group 2 and the 8-year estimates are 82.4% and 81.5%, respectively. Local and Regional Recurrences: There were 54 local recurrences in Group 1 and 49 in Group 2 (p=0.55). There were 8 regional node recurrences as first events in Group 1 and 14 in Group 2 (p=0.22). Conclusions: No significant differences were observed in OS, DFS, or regional control between the trial groups. Within the limits of this trial, SNR without AD is validated as a safe and effective method for regional node treatment of SN negative breast cancer patients. [Table: see text]

scholarly journals Metformin in neoadjuvant systemic therapy of breast cancer patients with metabolic syndrome

2018 ◽  
Vol 24 (1) ◽  
pp. 1-5
Author(s):  
Roman Liubota ◽  
Valeriy Cheshuk ◽  
Olexyy Zotov ◽  
Roman Vereshchako ◽  
Mykola Anikusko ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Metabolic Syndrome ◽  
Cancer Patients ◽  
Systemic Therapy ◽  
Response Rate ◽  
Breast Cancer Patients ◽  
Metformin Group ◽  
Neoadjuvant Systemic Therapy ◽  
Group 2 ◽  
Group 1

Background: The aim of this prospective randomized trial was to investigate the influence of metformin on the effectiveness of neoadjuvant systemic therapy in breast cancer patients with metabolic syndrome. Patients and methods: The study included 72 patients (from 31 to 77 years of age) who received neoadjuvant systemic treatment for stage II-III breast cancer at the National Medical University named after O.O Bogomolets, Municipal City Clinical Oncological Center, Department of Oncology, Kyiv during 2010 - 2014. Metabolic syndrome was diagnosed in all patients according to the International Diabetes Federation criteria. They were divided in two groups: group 1 that included 36 patients with metabolic syndrome and breast cancer who did not intake metformin during neoadjuvant systemic therapy, and group 2 that included 36 patients with metabolic syndrome and breast cancer who received metformin with neoadjuvant systemic therapy. Results: Complete clinical response was identified in 2 (6%) patients from group 1 and 10 (27.5%) patients from group 2. Overall clinical response rate (cCR + cPR) was achieved in 28 (77.5%) patients treated with metformin compared to 9 (25%) patients from group 1. A stable disease was observed in 19 (53%) patients who were not taking metformin. The rate of pathological complete response was 26.5% (9 patients) in the metformin group and 6% (2 patients) in the non-metformin group. Conclusions: Combined neoadjuvant systemic anticancer therapy of breast cancer patient with metabolic syndrome with metformin has a higher clinical and pathological overall response rate than treatment without metformin.

scholarly journals Myocardial work index: a novel tool for detection of early cardiotoxicity in breast cancer patient

2021 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
A Moya ◽  
W Heggermont ◽  
S Verstreken ◽  
M Goethals ◽  
R Dierckx ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Cardiac Dysfunction ◽  
Predictive Value ◽  
Relative Reduction ◽  
Breast Cancer Patients ◽  
Work Index ◽  
Group 2 ◽  
Group 1

Abstract Funding Acknowledgements Type of funding sources: Foundation. Main funding source(s): Cardiovascular Research Center Aalst, (Aalst, Belgium) Introduction Breast cancer patients receiving anthracyclines are particularly prone to develop cancer therapeutics-related cardiac dysfunction (CTRCD). Early detection of cardiotoxicity onset is required for optimal timing of cardio protection treatment. The latest guidelines consider a relative reduction of 15% in global longitudinal strain (GLS) from baseline as risk for cardiotoxicity. Nevertheless, the more recent Myocardial Work Index (MWI) offers a load-independent tool for detection of subclinical heart failure (HF). Data in cancer patients are still scarce.  Purpose This study analyses the predictive value of MWI for cardiotoxicity diagnosis after 6 months chemotherapy. Methods The study population consists of breast cancer patients referred for chemotherapy with anthracyclines and taxanes. Patients with a history of HF previous to chemotherapy or depressed LV function at baseline were excluded. Echocardiography was performed before onset of the chemotherapy (baseline) and after 6 months follow-up. LVEF, GLS and MWI were assessed offline using EchoPAC software. The values at baseline and 6 months follow-up were pairwise compared to detect subclinical cardiac dysfunction. Mean LVEF, GLS and MWI at baseline were taken as cut-off value to compare the predictive value of each parameter. Moreover, patients were categorized in one group with GLS reduction &gt;15% (Group 1) and one group with GLS reduction &lt;15% (Group 2).   Results From April 2016 to January 2020, 24 women with breast cancer were included (age 54 ± 11 years, LVEF 58 ± 4%, GLS -21 ± 2%, MWI 2181 ± 325 mmHg). All patients underwent the same standard chemotherapy protocol (4xEC, 12xTaxol). No difference in baseline characteristics between group 1 (n = 9) and group 2 (n = 15) was observed. At 6 months follow up a significant decrease in LVEF (53 ± 8%, p = 0.003), GLS (-19 ± 3%, p = 0.002) and MWI (1933 ± 410 mmHg, p = 0.005) was shown without any change in blood systolic pressure. However, while mean LVEF and GLS at baseline did not predict any significant change, patients with MWI under the mean value at baseline (n = 13) presented significant lower LVEF (49 ± 8%, p = 0.006), GLS (-18 ± 4%, p = 0.045), MWI (1753 ± 341 mmHg, p = 0.018) after 6 months. Additionally, both groups had similar MWI at baseline (2199 ± 390 mmHg vs 2170 ± 294 mmHg, p = 0.85), whereas those patients with GLS reduction &gt;15% showed significant lower MWI after 6 months (1626 ± 344 mmHg vs 2116 ± 334 mmHg, p = 0.003, Figure 1). Conclusions At 6 months follow up, a decline of the LV systolic function as side effect of chemotherapy can be seen. In comparison to LVEF and GLS, MWI shows the best predictive value for development of early cardiotoxicity. Further studies are warranted to better understand the role of MWI in predicting CTRCD and its clinical relevance. Abstract Figure. Change in MWI

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