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dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP-
dc.contributor.authorMCGEE, S. F.-
dc.contributor.authorMAZZARELLO, S.-
dc.contributor.authorCAUDRELIER, J. M.-
dc.contributor.authorLIMA, M. A. G.-
dc.contributor.authorHUTTON, B.-
dc.contributor.authorSIENKIEWICZ, M.-
dc.contributor.authorSTOBER, C.-
dc.contributor.authorFERNANDES, R.-
dc.contributor.authorIBRAHIM, M. F. K.-
dc.contributor.authorVANDERMEER, L.-
dc.contributor.authorHILTON, J.-
dc.contributor.authorSHORR, R.-
dc.contributor.authorFERGUSSON, D.-
dc.contributor.authorCLEMONS, M.-
dc.identifier.citationCANCER TREATMENT REVIEWS, v.69, p.132-142, 2018-
dc.description.abstractImportance: Clinical equipoise exists around the optimal time to start adjuvant endocrine therapy in patients who will receive post-operative radiotherapy for breast cancer. Concerns continue to exist regarding potential reduced efficacy, or increased toxicity, when radiation, and endocrine therapy are administered concurrently. Objective: To perform a systematic review of studies comparing outcomes between sequential and concurrent adjuvant radiation and endocrine therapy in early-stage breast cancer. All modalities of radiation therapy were considered, and endocrine therapy could be either tamoxifen or an aromatase inhibitor. Outcomes of interest included; local, regional or distant recurrence, overall survival and treatment-related toxicities. Evidence reviewed: PubMed, Ovid Medline, EMBASE, and the Cochrane Central Register of Controlled Trials were searched from 1946 to December 2017. Two reviewers independently assessed each citation using the criteria outlined above. Study quality was assessed using the Cochrane Collaboration's tool for prospective studies, and the Newcastle-Ottawa scale for retrospective studies. Findings: Of 2137 unique citations identified, 13 met eligibility criteria. Eleven were unique studies (7569 patients), while 2 of the studies were updated analyses of previous studies. Studies evaluated the timing of adjuvant radiation, and tamoxifen (5 studies, 1550 patients), or aromatase inhibitors (6 studies, 6019 patients). We identified 1 complete randomized clinical trial (150 patients), and 5 retrospective studies (1580 patients), in addition to conference abstracts (5 studies, 5839 patients). Overall, none of the studies showed a significant difference in efficacy, or toxicity, with concurrent versus sequential treatment. However, given the significant heterogeneity of the study populations, it was not possible to conduct a meta-analysis. Conclusions and relevance: In the absence of high quality data, adequately powered randomized trials are required to answer this important clinical question.-
dc.publisherELSEVIER SCI LTD-
dc.relation.ispartofCancer Treatment Reviews-
dc.subjectBreast cancer-
dc.subjectAdjuvant therapy-
dc.subjectEndocrine therapy-
dc.subject.otherpostmenopausal women-
dc.subject.otheraromatase inhibitors-
dc.subject.otherconservation therapy-
dc.titleOptimal sequence of adjuvant endocrine and radiation therapy in early-stage breast cancer - A systematic review-
dc.rights.holderCopyright ELSEVIER SCI LTD-
dc.type.versionpublishedVersion-, S. F.:Univ Ottawa, Dept Med, Ottawa, ON, Canada; Univ Ottawa, Div Med Oncol, Ottawa, ON, Canada-, S.:Ottawa Hosp Res Inst, Ottawa, ON, Canada-, J. M.:Ottawa Hosp Canc Ctr, Dept Radiat Med, Ottawa, ON, Canada-, B.:Ottawa Hosp Res Inst, Clin Epidemiol Dept, Ottawa, ON, Canada-, M.:Ottawa Hosp Res Inst, Ottawa, ON, Canada-, C.:Ottawa Hosp Res Inst, Ottawa, ON, Canada-, R.:Western Univ, Schulich Sch Med & Dent, Dept Oncol, Div Med Oncol, London, ON, Canada-, M. F. K.:Univ Ottawa, Dept Med, Ottawa, ON, Canada; Univ Ottawa, Div Med Oncol, Ottawa, ON, Canada-, L.:Ottawa Hosp Res Inst, Ottawa, ON, Canada-, J.:Univ Ottawa, Dept Med, Ottawa, ON, Canada; Univ Ottawa, Div Med Oncol, Ottawa, ON, Canada; Ottawa Hosp Res Inst, Ottawa, ON, Canada-, R.:Ottawa Hosp, Ottawa, ON, Canada-, D.:Ottawa Hosp Res Inst, Clin Epidemiol Dept, Ottawa, ON, Canada-, M.:Univ Ottawa, Dept Med, Ottawa, ON, Canada; Univ Ottawa, Div Med Oncol, Ottawa, ON, Canada; Ottawa Hosp Res Inst, Ottawa, ON, Canada-
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Artigos e Materiais de Revistas Científicas - HC/ICESP
Instituto do Câncer do Estado de São Paulo - HC/ICESP

Artigos e Materiais de Revistas Científicas - ODS/03
ODS/03 - Saúde e bem-estar

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