BACKGROUND Anthracyclines and taxanes are more active group of chemotherapy regimen.Randomized controlled trials(RCTs) reported variable evidences regarding efficacy of taxanes over anthracyclines for tumor response a...BACKGROUND Anthracyclines and taxanes are more active group of chemotherapy regimen.Randomized controlled trials(RCTs) reported variable evidences regarding efficacy of taxanes over anthracyclines for tumor response and survival outcomes. The present study compares the relative efficacy of taxanes over anthracyclines using pathological complete response(pCR), clinical responses,breast-conserving surgeries and survival outcomes in female breast cancer patients by systematic review and meta-analysis of available RCTs.AIM To assess the effectiveness of taxanes over anthracyclines in neoadjuvant setting in terms of tumor response and survival outcomes.METHODS All RCTs assessing efficacy of taxanes over anthracyclines in neoadjuvant setting for management of breast cancer searched through PubMed and Cochrane register of controlled trials on 28 April 2017 and published in English language were considered. Following PRISMA guideline, retrieved records were screened and data were extracted by two independent reviewers. Meta-analysis was performed using fixed effect or random effect method depending on heterogeneity assessed using I^2 statistic. Subgroup meta-analyses on the basis of taxane alone or taxane along with anthracycline in comparison to anthracycline alone were also performed for each considered outcomes.RESULTS A total of 16 RCTs involving 6752 breast cancer patients were found eligible.Taxanes based chemotherapy significantly improved pCR(n = 7, RR = 1.48,95%CI: 1.04-2.12), disease free survival [n = 6, RR = 0.89(0.80-0.99)] and locoregional recurrence free survival [n = 4, RR = 0.74(0.59-0.94)]. Interestingly in subgroup analysis, addition of taxane to anthracyclines showed better effectiveness regarding these survivals over anthracyclines than taxane alone over anthracycline.CONCLUSION Addition of taxanes to anthracyclines based chemotherapy significantly improves pCR, disease free survival and loco-regional recurrence free survival but with no significant impact on breast conservation rates.展开更多
In India, the most common cancer among men is cancer of lip-oral and its incidence is further increasing. Nodal metastasis is an important prognostic factor in oral cancer. Previous studies on factors associated with ...In India, the most common cancer among men is cancer of lip-oral and its incidence is further increasing. Nodal metastasis is an important prognostic factor in oral cancer. Previous studies on factors associated with nodal involvement are mainly focused on clinical exploration, and there is very little work in statistical modeling for nodal involvement. Also, the available studies have limited covariates and their varying forms. Further, studies available from India have mainly focused either on occult nodal metastasis only or a specific site of oral or stages. Hence, in order to identify epidemiological determinants of nodal metastasis, objective of this study was to develop a regression model to find out factors associated with nodal involvement and assess its validity. 945 histopathologically proven oral squamous cell carcinoma (OSCC) patients who went under surgery including neck dissection during 1995-2013 at the Department of Surgical Oncology, Dr. BRA-IRCH, AIIMS, New Delhi, India, were included for model building. Another data of 204 patients available during 2014-2015 was used for the temporal validation of the developed model. To assess the factors associated with nodal involvement, stepwise multivariable logistic regression procedure was used and results are presented as odds ratio and corresponding 95% confidence interval (CI). Pain at the time of presentation [1.34 (1.02 to 1.77)], sub mucous fibrosis (SMF) [0.45 (0.21 to 0.95)], palpable neck node [2.38 (1.69 to 3.35)], tongue [1.63 (1.07 to 2.46)] as compared to buccal mucosa and degree of differentiation [1.41 (1.05 to 1.89)] were found to be significantly associated with nodal involvement. Further, diagnostic performance of the developed model was found to be satisfactory on temporal validation. These data suggest that, Pain at time of presentation, presence of clinical neck node, SMF, degree of differentiation and oral site are the most probable factors associated with nodal involvement in OSCC.展开更多
文摘BACKGROUND Anthracyclines and taxanes are more active group of chemotherapy regimen.Randomized controlled trials(RCTs) reported variable evidences regarding efficacy of taxanes over anthracyclines for tumor response and survival outcomes. The present study compares the relative efficacy of taxanes over anthracyclines using pathological complete response(pCR), clinical responses,breast-conserving surgeries and survival outcomes in female breast cancer patients by systematic review and meta-analysis of available RCTs.AIM To assess the effectiveness of taxanes over anthracyclines in neoadjuvant setting in terms of tumor response and survival outcomes.METHODS All RCTs assessing efficacy of taxanes over anthracyclines in neoadjuvant setting for management of breast cancer searched through PubMed and Cochrane register of controlled trials on 28 April 2017 and published in English language were considered. Following PRISMA guideline, retrieved records were screened and data were extracted by two independent reviewers. Meta-analysis was performed using fixed effect or random effect method depending on heterogeneity assessed using I^2 statistic. Subgroup meta-analyses on the basis of taxane alone or taxane along with anthracycline in comparison to anthracycline alone were also performed for each considered outcomes.RESULTS A total of 16 RCTs involving 6752 breast cancer patients were found eligible.Taxanes based chemotherapy significantly improved pCR(n = 7, RR = 1.48,95%CI: 1.04-2.12), disease free survival [n = 6, RR = 0.89(0.80-0.99)] and locoregional recurrence free survival [n = 4, RR = 0.74(0.59-0.94)]. Interestingly in subgroup analysis, addition of taxane to anthracyclines showed better effectiveness regarding these survivals over anthracyclines than taxane alone over anthracycline.CONCLUSION Addition of taxanes to anthracyclines based chemotherapy significantly improves pCR, disease free survival and loco-regional recurrence free survival but with no significant impact on breast conservation rates.
文摘In India, the most common cancer among men is cancer of lip-oral and its incidence is further increasing. Nodal metastasis is an important prognostic factor in oral cancer. Previous studies on factors associated with nodal involvement are mainly focused on clinical exploration, and there is very little work in statistical modeling for nodal involvement. Also, the available studies have limited covariates and their varying forms. Further, studies available from India have mainly focused either on occult nodal metastasis only or a specific site of oral or stages. Hence, in order to identify epidemiological determinants of nodal metastasis, objective of this study was to develop a regression model to find out factors associated with nodal involvement and assess its validity. 945 histopathologically proven oral squamous cell carcinoma (OSCC) patients who went under surgery including neck dissection during 1995-2013 at the Department of Surgical Oncology, Dr. BRA-IRCH, AIIMS, New Delhi, India, were included for model building. Another data of 204 patients available during 2014-2015 was used for the temporal validation of the developed model. To assess the factors associated with nodal involvement, stepwise multivariable logistic regression procedure was used and results are presented as odds ratio and corresponding 95% confidence interval (CI). Pain at the time of presentation [1.34 (1.02 to 1.77)], sub mucous fibrosis (SMF) [0.45 (0.21 to 0.95)], palpable neck node [2.38 (1.69 to 3.35)], tongue [1.63 (1.07 to 2.46)] as compared to buccal mucosa and degree of differentiation [1.41 (1.05 to 1.89)] were found to be significantly associated with nodal involvement. Further, diagnostic performance of the developed model was found to be satisfactory on temporal validation. These data suggest that, Pain at time of presentation, presence of clinical neck node, SMF, degree of differentiation and oral site are the most probable factors associated with nodal involvement in OSCC.
