Evidence-based medicine: its effect on treatment recommendations as illustrated by the changing role of postmastectomy irradiation to treat breast cancer

Levitt, Seymour H.; Aeppli, Dorothee M.; Nierengarten, Mary Beth

doi:10.1016/s0360-3016(02)04076-2

Cited by 10 publications

(6 citation statements)

References 42 publications

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“…On the other hand, radioresistance of tumor cells is a common phenomenon and intrinsic radioresistance of tumor cells has been correlated to a poorer prognosis after radiotherapy (Girinsky et al, 1992, West et al, 1993. Indeed, several breast cancer cases present failure after radiation therapy in spite of the use of standard protocols (Jobsen et al, 2001, Levitt et al, 2003, Andrade et al, 2004. Further studies are necessary to understand the mechanisms of radioresistance in the human breast carcinoma cell line MDAMB-231 to contribute to breast cancer radiation therapy treatment.…”

Section: Discussionmentioning

confidence: 99%

In vitro response of the human breast cancer cell line MDAMB-231 and human peripheral blood mononuclear cells exposed to 60Co at single fraction

Andrade¹,

Campos²,

Leite³

et al. 2005

Braz. arch. biol. technol.

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Section: Discussionmentioning

confidence: 99%

In vitro response of the human breast cancer cell line MDAMB-231 and human peripheral blood mononuclear cells exposed to 60Co at single fraction

Andrade¹,

Campos²,

Leite³

et al. 2005

Braz. arch. biol. technol.

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“…These records show all healthcare benefits with a moderate cost-sharing, and also reveal regular monitoring of diagnostic accuracy and treatment. As we know, randomized controlled trials or meta-analysis review studies are the gold standard in clinical research and also provide the strongest evidence for resolving clinical problems [15]. Population-based observation studies with large case numbers are also useful.…”

Section: Discussionmentioning

confidence: 99%

Hyperlipidemia and statins use for the risk of new-onset anxiety/depression in patients with head and neck cancer: A population-based study

et al. 2017

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ObjectiveAnxiety/depression is common among patients with head and neck cancer (HNC), and can negatively affect treatment compliance and outcome. The aim of this study was to assess the association between hyperlipidemia and the risk of new-onset anxiety/depression after the diagnosis of HNC and the influence of administering statins.MethodsA matched longitudinal cohort study of 1632 subjects (408 HNC patients with preexisting hyperlipidemia and 1224 age- and sex-matched HNC patients without hyperlipidemia) was included and analyzed by using data from Taiwan’s National Health Insurance Research Database from January 1996 to December 2012. The incidence and hazard ratios (HRs) for the development of new-onset anxiety/depression were examined between the two groups. Cox proportional hazard regression was applied to estimate the relative risks of anxiety/depressive disorders adjusted for potential confounding factors. To estimate the risks of anxiety/depression in different sub-groups, a stratified analysis was also used.ResultsHNC patients with preexisting hyperlipidemia had a higher risk for comorbidities such as hypertension, diabetes mellitus, and cardiovascular disease (P <0.001). The incidence rate of anxiety/depression in the HNC patients with preexisting hyperlipidemia was also significantly higher than that among patients without hyperlipidemia (10.78% vs 7.27%, respectively; P = 0.03). A Cox regression model revealed that preexisting hyperlipidemia was an independent risk factor for anxiety/depression (aHR, 1.96; 95% CI, 1.30–2.94). Statins use was protective against anxiety/depression among HNC patients with hyperlipidemia (aHR, 0.85; 95% CI, 0.46–1.57), especially for individuals older than 65 years and for females.ConclusionsPreexisting hyperlipidemia was associated with increased risk of new-onset anxiety/depression in the HNC patients. Statins use for HNC patients with hyperlipidemia could decrease the risk of anxiety/depression, especially for those older than 65 years and for female patients.

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“…645). 39 We have assessed the quality of the current evidence, and it has been found wanting. It is now time to improve it.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the quality of radiotherapy randomized trials for painful bone metastases

Shakespeare

Thiagarajan

Gebski

2005

Cancer

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BACKGROUNDThe quality of randomized radiotherapy studies investigating the palliation of painful bone metastases has been questioned, with some authors recognizing the potential impact of bias on result interpretation. However, there has been no published comprehensive evaluation of quality assessment. The goals of the current study were to evaluate the quality of randomized studies using a validated checklist and to discuss implications and future directions.METHODSThe authors performed a search for studies that could be reliably assessed using the validated quality assessment instrument. Independent assessors scored study quality using the instrument.RESULTSThe median quality score of the 17 identified randomized studies was 1 of 5 (range, 0–3). The majority (71%) of points were awarded for the authors describing the study as “randomized.” The method of randomization and description of withdrawals and dropouts were scored poorly for most studies. None of the studies were awarded points for allocation concealment (blinding). The overall quality was deemed poor (a score of 0–2) for 16 of 17 (94%) studies.CONCLUSIONSThe quality of published randomized evidence comparing efficacy of fractionation schedules for the palliation of bone metastases was suboptimal. As a result of the potential biases present, subjective end points (e.g., retreatment rates) cannot be reliably evaluated. Greater efforts are required by radiation oncology trial groups to improve quality, with a particular focus on developing methods of allocation concealment and comprehensively reporting results. Cancer 2005. © 2005 American Cancer Society.

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Evidence-based medicine: its effect on treatment recommendations as illustrated by the changing role of postmastectomy irradiation to treat breast cancer

Cited by 10 publications

References 42 publications

In vitro response of the human breast cancer cell line MDAMB-231 and human peripheral blood mononuclear cells exposed to 60Co at single fraction

In vitro response of the human breast cancer cell line MDAMB-231 and human peripheral blood mononuclear cells exposed to 60Co at single fraction

Hyperlipidemia and statins use for the risk of new-onset anxiety/depression in patients with head and neck cancer: A population-based study

Evaluation of the quality of radiotherapy randomized trials for painful bone metastases

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