Van der Weijden-Van Doornik E M, Slot Dagmar E, Burtin Chris, van der Weijden G A
Fysiotherapeuten Maatschap Woerden, Woerden, the Netherlands.
Department Periodontology, Academic Centre for Dentistry Amsterdam, University of Amsterdam and Vrije Universiteit Amsterdam.
Phys Ther. 2017 Sep 1;97(9):904-914. doi: 10.1093/ptj/pzx069.
Adjuvant endocrine therapy in breast cancer has increased survival rates; however, it is not without musculoskeletal side effects.
The purpose of this review was to systematically and critically appraise the available scientific evidence concerning the effect of adjuvant endocrine treatment on grip strength in women being treated for breast cancer.
The National Library of Medicine (MEDLINE-PubMed), Cochrane Central Register of Controlled Trials (CENTRAL), Excerpta Medical Database by Elsevier (EMBASE), Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Physiotherapy Evidence Database (PEDro) were searched from inception to February 2017 for appropriate papers that could answer the focused question. The searches were independently screened by 2 reviewers. The data from 7 papers that met the eligibility criteria were processed for further analysis.
The collective data and the statistical analysis of all included studies were summarized and presented in a descriptive manner. If not provided, based on data from the individual included studies, a mean percent change in grip strength was calculated. The included studies evaluating aromatase inhibitors had inconclusive outcomes, and studies with a follow-up of 6 or 12 months showed a percent reduction in grip strength varying from 0.1% to 9.7%. None of the included studies showed a significant decrease in grip strength in tamoxifen users, with a percent reduction in grip strength varying from 1.4% to 2.2%.
The 7 studies included cohort studies lacking a control group.
There is inconclusive evidence for a small decrease in grip strength in women treated for breast cancer who are also receiving aromatase inhibitors. In those that use tamoxifen, grip strength did not change significantly.
乳腺癌辅助内分泌治疗提高了生存率;然而,它并非没有肌肉骨骼方面的副作用。
本综述的目的是系统地、批判性地评估关于辅助内分泌治疗对乳腺癌女性握力影响的现有科学证据。
检索了美国国立医学图书馆(MEDLINE - PubMed)、考克兰对照试验中心注册库(CENTRAL)、爱思唯尔医学文摘数据库(EMBASE)、护理学与健康相关文献累积索引(CINAHL)以及物理治疗证据数据库(PEDro),从建库至2017年2月,以查找能够回答重点问题的合适论文。由2名评审员独立筛选检索结果。对符合纳入标准的7篇论文的数据进行进一步分析。
对所有纳入研究的汇总数据和统计分析进行总结,并以描述性方式呈现。若未提供相关数据,则根据各纳入研究的数据计算握力的平均百分比变化。评估芳香化酶抑制剂的纳入研究结果尚无定论,随访6个月或12个月的研究显示握力下降百分比在0.1%至9.7%之间。纳入研究中,服用他莫昔芬的患者均未显示握力有显著下降,握力下降百分比在1.4%至2.2%之间。
这7项研究均为队列研究,缺乏对照组。
对于接受芳香化酶抑制剂治疗的乳腺癌女性握力略有下降这一情况,证据尚无定论。而使用他莫昔芬的患者,握力无显著变化。