Abstract
Materials and Methods We conducted a systematic literature search in PubMed, Cochrane Central Register of Controlled Trials, Embase, Chinese Biomedicine Database (CBM), China National Knowledge Infrastructure (CNKI), Wan Fang, and VIP up to May 2018. Randomized controlled trials (RCTs) reporting nonhormonal hot flash treatments for breast cancer survivors were included. Primary outcome measurements were hot flash frequency and hot flash score of posttreatment. The methodological quality of each study was assessed with Cochrane's risk of bias tool. Results 16 RCTs involving 2,349 participants were included. The nonhormonal therapies used in the included studies were classified as follows: lifestyle changes, mind-body techniques, dietary/supplements, SSRIs/SNRIs, other medications, and other therapies. Pairwise meta-analysis showed that the general effect of nonhormonal management was statistically more effective than no treatment/placebo/sham in reducing hot flash frequency (SMD = −0.60, 95% CI [−1.13, −0.06]; P=0.03)) and hot flash score (SMD = −0.38, 95% CI [−0.68, −0.08]). For hot flash frequency, results from the NMA showed that there was no statistically significant difference between any two of the nonhormonal treatments. Another NMA result indicated that acupuncture (other therapies) was 16.05 points more effective in reducing hot flash scores than no treatment/waitlist (SMD = −16.05, 95% CI [−30.2, −1.99]). These results were statistically significant. Acupuncture was also ranked the optimal nonhormonal therapy for both hot flash frequency and hot flash score. The safety analysis showed that there were few related adverse events during acupuncture and that drug related adverse reactions could have also occurred in studies using drug interventions Conclusions This network meta-analysis comparing nonhormonal treatments suggested that acupuncture might be more effective in improving hot flashes for breast cancer survivors. A pronounced placebo response was found during hot flash treatments. The evidence of safety for nonhormonal therapies was also insufficient. Therefore, at present, we cannot make confirmative recommendations of nonhormonal hot flash management for breast cancer survivors. This study is registered with PROSPERO (CRD42018082008).
Highlights
Hot flashes are common among breast cancer survivors [1]. is population has more severe and persistent hot flashes due to premature menopause resulting from chemotherapy and the use of endocrine therapies such as tamoxifen and aromatase inhibitors [2, 3]
We looked for the following inclusion criteria: (1) participants: women who had been diagnosed with breast cancer and who were experiencing hot flashes, without restrictions on age or cancer stage; (2) intervention: nonhormonal therapies
Study Characteristics. e 16 randomized clinical trial (RCT) involving 2,349 participants included in the analyses were published between 2002 and 2016
Summary
Hot flashes are common among breast cancer survivors [1]. is population has more severe and persistent hot flashes due to premature menopause resulting from chemotherapy and the use of endocrine therapies such as tamoxifen and aromatase inhibitors [2, 3]. Hot flashes are common among breast cancer survivors [1]. Is population has more severe and persistent hot flashes due to premature menopause resulting from chemotherapy and the use of endocrine therapies such as tamoxifen and aromatase inhibitors [2, 3]. It has been demonstrated that 72% of tamoxifen recipients and 78% of chemotherapy recipients experience hot flashes [4]. Breast cancer survivors who experience hot flashes tend to experience more fatigue, worse sleep quality, and lower quality of life [5,6,7]. Because of concerns that estrogen exposure increases cancer recurrence rates, menopausal hormonal therapy (HT) is not the recommended first-line hot flash treatment for breast cancer survivors [8]. Several systematic reviews have summarized studies and data comparing these interventions, both for placebos and for controls [17,18,19,20], and have provided favorable recommendations of particular interventions
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
