Abstract:
BACKGROUND:Pain is the most frequent symptom experienced by cancer patients, its intensity dependent on the site of the tumour. Tumours that compromise bone or nervous structures due to the bone destruction process are the most painful. There are several treatments to deal with pain (and other symptoms) caused by bone metastases. The hormone, calcitonin, has the potential to relieve pain, and also retain bone density, thus reducing the risk of fractures. This review is an update of a previously published review in The Cochrane Library (Issue 3, 2003) on this topic. OBJECTIVES:To assess the effectiveness of calcitonin in controlling metastatic bone pain and reducing bone complications (hypercalcemia, fractures and nerve compression) in patients with bone metastases. SEARCH STRATEGY:Electronic searches were performed in MEDLINE (1966 to 2005), EMBASE (1974 to 2005), the Cochrane Central Register of Controlled Trials (Issue 2, 2005), specialised registers of the Cochrane Cancer Network and of the Cochrane Pain, Palliative and Supportive Care Group. Registers of clinical trials in progress were also searched. SELECTION CRITERIA:Studies were included if they were randomised, double-blind clinical trials of patients with metastatic bone pain, treated with calcitonin, where the major outcome measure was pain, assessed at four weeks or longer. DATA COLLECTION AND ANALYSIS:Study selection and data extraction were performed by two independent review authors. Only two studies (90 patients) were eligible for inclusion in the review and therefore meta-analysis of the data was not possible. Intention-to-treat analysis was performed by imputing all missing values as adverse outcomes. MAIN RESULTS:Of the two small studies included in the review, one study showed a non-significant effect of calcitonin in the number of patients with total pain reduction (RR 2.50; CI 95%, 0.55 to 11.41). The second study provided no evidence that calcitonin reduced analgesia consumption (RR 1.05; CI 95%, 0.90 to 1.21) in patients with painful bone metastases. There was no evidence that calcitonin was effective in controlling complications due to bone metastases; for improving quality of life; or patients' survival. Although not statistically significant, a greater number of adverse effects were observed in the groups given calcitonin in the two included studies (RR 3.35, CI 95%, 0.72 to 15.66). AUTHORS' CONCLUSIONS:The limited evidence currently available does not support the use of calcitonin to control pain from bone metastases. Since the last version of this review, none of the new relevant studies have provided additional information on this treatment, in contrast to other therapeutic approaches that should be considered.
journal_name
Cochrane Database Syst Revjournal_title
The Cochrane database of systematic reviewsauthors
Martinez-Zapata MJ,Roqué M,Alonso-Coello P,Català Edoi
10.1002/14651858.CD003223.pub2subject
Has Abstractpub_date
2006-07-19 00:00:00pages
CD003223issue
3issn
1469-493Xpub_type
杂志文章,meta分析,评审abstract:BACKGROUND:The optimal timing of birth for women with an otherwise uncomplicated twin pregnancy at term is uncertain, with clinical support for both elective delivery at 37 weeks, as well as expectant management (awaiting the spontaneous onset of labour). OBJECTIVES:To assess a policy of elective delivery from 37 week...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,评审
doi:10.1002/14651858.CD003582
更新日期:2003-01-01 00:00:00
abstract:BACKGROUND:Multifocal motor neuropathy (MMN) is characterised by progressive, predominantly distal, asymmetrical limb weakness and usually multiple partial motor nerve conduction blocks. Intravenous immunoglobulin (IVIg) is beneficial but the role of immunosuppressive agents is uncertain. This is an update of a review ...
journal_title:The Cochrane database of systematic reviews
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doi:10.1002/14651858.CD003217.pub5
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abstract:BACKGROUND:Bronchiectasis is a chronic respiratory disease characterised by abnormal and irreversible dilatation and distortion of the smaller airways. Bacterial colonisation of the damaged airways leads to chronic cough and sputum production, often with breathlessness and further structural damage to the airways. Long...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD012406.pub2
更新日期:2018-03-15 00:00:00
abstract:BACKGROUND:Chlorpromazine, formulated in the 1950s, remains a benchmark treatment for people with schizophrenia. OBJECTIVES:To evaluate the effects of chlorpromazine for schizophrenia in comparison with placebo. SEARCH STRATEGY:We updated previous searches of the Cochrane Schizophrenia Group Register (October 1999), ...
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doi:10.1002/14651858.CD000284.pub2
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doi:10.1002/14651858.CD001746.pub4
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doi:10.1002/14651858.CD000081
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pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD005285
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doi:10.1002/14651858.CD005978.pub3
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journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD007230.pub2
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pub_type: 杂志文章
doi:10.1002/14651858.CD009760.pub4
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journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD001886.pub2
更新日期:2007-10-17 00:00:00
abstract:BACKGROUND:Bell's palsy is an idiopathic, acute unilateral facial weakness that evolves rapidly and is maximal within two days. Moderate ear discomfort, sensitivity to sound and reduced tearing may occur. OBJECTIVES:To assess the effects of hyperbaric oxygen therapy on recovery of facial function in adults with modera...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,评审
doi:10.1002/14651858.CD007288.pub2
更新日期:2012-02-15 00:00:00
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doi:10.1002/14651858.CD003520.pub2
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journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章
doi:10.1002/14651858.CD013113.pub2
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abstract:BACKGROUND:Many smokers give up smoking on their own, but materials that provide a structured programme for smokers to follow may increase the number who quit successfully. OBJECTIVES:The aims of this review were to determine the effectiveness of different forms of print-based self-help materials that provide a struct...
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journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD001340.pub2
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journal_title:The Cochrane database of systematic reviews
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doi:10.1002/14651858.CD002977
更新日期:2002-01-01 00:00:00
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pub_type: 杂志文章,meta分析,评审
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更新日期:2006-10-18 00:00:00