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Science Forum Index » Medicine - Cancer Forum » metanalysis HDC vs HDC/ABMT
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| J |
 Posted: Thu Nov 16, 2006 4:47 pm |
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http://www.academyhealth.org/2004/ppt/farquhar2.ppt
It's a powerpoint file. Not too large to open for most computers.
J
Looks like a retrospective metanalysis
HDC in women with high risk BC: treatment related mortality.
Increased by standard chemotherapy
To determine the effectiveness and safety of HDC/ABMT in women with
metastatic and high risk breast
cancer
American Society of Clinical Oncologists 1999
Results of 5 RCTs presented
Overall summary:
4/5 concluded “that treatment with HDC/ABMT is no better than conventional
chemotherapy”
Jan 2000 - the only trial (South African) to show a benefit was declared
fraudulent by the US auditors (Bezwoda 1999)
Systematic review
All trials meet the inclusion criteria
Assess the quality of the trials
Trial results extracted for overall survival, event free survival and
treatment related mortality
Data was pooled using metanalysis
Excluded studies
Bezwoda 1995, 1999 – declared fraudulent in 2000
Bergh 2000 – overall dose in conventional group higher than HDC/ABMT group
Peters 1996 - – control group crossed over to HDC/ABMT
Madan 2000 – control group crossed over to HDC/ABMT
ACCOG : 84 women on HDC/ABMT and 82 standard dose. no difference b/w
groups at 6 or 12 months
CALBG: 106 HDC/ABMT and 104 standard dose. HDC worse at 3 months, but no
difference at 12 months
Dutch IG trial: HDC/ABMT lower scores at 3 months but no difference at 6
months.
Also looked at cognitive functioning in Dutch IG: significantly impaired
in HDC/ABMT
Conclusions: women with metastatic breast cancer
Treatment related mortality was significantly increased
At one year of follow up there is a increase in event free survival in
women with HCD/ABMT
At three and five years of follow up there is no impact on either event
free survival or overall survival
Conclusions: women with high risk breast cancer
Treatment related mortality was significantly increased
At three years of follow up there is a reduction in event free survival
but no impact on overall survival
At five years of follow up there is no impact seen on either event free
survival or overall survival |
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