Abstract：
BACKGROUND:We performed a systematic review and meta-analysis of randomised trials of neo-adjuvant hormone therapy (NHT) in localised and locally advanced prostate cancer to assess the effectiveness of this therapy. METHODS:We searched MEDLINE, The Cochrane Library, Science Citation Index, LILACS and SIGLE for randomised trials comparing NHT plus primary therapy (radiotherapy or prostatectomy) with primary therapy alone. Data included information on study design, participants, interventions, and outcomes. Comparable data were extracted from eligible studies and pooled for meta-analysis with intention to treat principle. FINDINGS:NHT prior to prostatectomy did not improve overall or disease-free survival, but did significantly reduce positive margin rates (RR 0.49, 95% CI 0.42-0.56, p<0.00001), organ confinement (RR 1.63, 95% CI 1.37-1.95, p<0.0001) and lymph node invasion (RR 0.49, 95% CI 0.42-0.56, p<0.02). In one study NHT before radiotherapy significantly improved overall survival for men with Gleason 2-6 (p=0.015). In addition, there was a significant improvement in both clinical disease-free survival (RR 1.46, 95% CI 1.24-1.71, p<0.00001) and biochemical disease-free survival (RR 1.59, 95% CI 1.00-2.55, p=0.05). Toxicities included hot flushes, gastrointestinal, hepatic and miscellaneous adverse events. CONCLUSIONS:NHT is associated with significant clinical benefit when given with radiotherapy and improves pathological outcome prior to prostatectomy but is of minimal value prior to radical prostatectomy. The decision to use hormone therapy should be discussed between the patient, the clinician and policy maker based on the benefits, toxicity and cost.
journal_name
Cancer Treat Revjournal_title
Cancer treatment reviewsauthors
Shelley MD,Kumar S,Wilt T,Staffurth J,Coles B,Mason MDdoi
10.1016/j.ctrv.2008.08.002subject
Has Abstractpub_date
2009-02-01 00:00:00pages
9-17issue
1eissn
0305-7372issn
1532-1967pii
S0305-7372(08)00269-7journal_volume
35pub_type
杂志文章,meta分析,评审abstract：:The Notch signalling pathway plays a fundamental role in tissue development due to its involvement in cell fate determination and postnatal tissue differentiation. Its capacity to regulate cell growth and development has been linked to the occurrence of several cancers including that of the prostate. The transmembrane...
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pub_type： 杂志文章,meta分析,评审
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abstract：BACKGROUND:Gastric cancer remains a major health problem worldwide. Treatment of advanced gastric cancer is controversial and there is no standard regimen for first- or second-line chemotherapy (CT). This review aims to give an overview of the hot topics concerning treatment, prognostic factors and new strategies in ad...
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journal_title：Cancer treatment reviews
pub_type： 杂志文章,评审
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journal_title：Cancer treatment reviews
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journal_title：Cancer treatment reviews
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journal_title：Cancer treatment reviews
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journal_title：Cancer treatment reviews
pub_type： 杂志文章,评审
doi：10.1016/j.ctrv.2006.05.003
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journal_title：Cancer treatment reviews
pub_type： 杂志文章
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journal_title：Cancer treatment reviews
pub_type： 杂志文章,评审
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journal_title：Cancer treatment reviews
pub_type： 杂志文章,meta分析,评审
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journal_title：Cancer treatment reviews
pub_type： 杂志文章,评审
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pub_type： 杂志文章,评审
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journal_title：Cancer treatment reviews
pub_type： 杂志文章,meta分析,评审
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journal_title：Cancer treatment reviews
pub_type： 杂志文章,评审
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journal_title：Cancer treatment reviews
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