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《Journal of the Fourth Military Medical University》 2009-11
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Toremifene and tamoxifen for patients with advanced breast cancer:A meta-analysis of randomized controlled trials

MA Wen1,2,WANG Xiao-Hu1,YANG Ke-Hu2,TIAN Jin-Hui2,LIU Rui-Feng1,21Department of Radiotherapy,Cancer Hospital of Gansu Province,Lanzhou 730050,China,2Evidence-Based Medicine Center,Lanzhou University,Lanzhou 730000,China  
AIM:To evaluate the clinical effectiveness and safety of toremifene(TOR) versus tamoxifen(TAM) for patients with advanced breast cancer.METHODS:This study retrieved relevant randomized controlled trials in PubMed,EMBASE,Cochrane Library,Chinese Biomedical Literature Database,Chinese Scientific Journal Full-text Database,and Chinese Journal Full-text Database up to June 2008.According to the handbook 4.2.6 of Cochrane collaborate,two reviewers assessed the quality of included trials and extracted data independently.The RevMan 4.2.10 software was used for Meta-analysis,relative risk(RR) was used as statistical index for numeration data and weighted mean difference(WMD) was used for measurement data.RESULTS:Ten studies were included(3680 patients).Meta-analysis showed no statistical difference between the 2 groups in 1 and 3-year overall survival rate,but statistical difference was observed in 5-year overall survival rate.The pooled RR and 95% CI were respectively 1.00(0.97,1.03),1.04(0.98,1.09) and 1.06(1.01,1.12).No statistical difference was found between the 2 groups in 1 and 3-year disease-free survival rate but statistical difference was observed in 5-year disease-free survival rate.The pooled RR and 95% CI were respectively 1.00(0.98,1.02),1.05(1.00,1.10),and 1.08(1.02,1.15).No statistical difference was found between the 2 groups in complete response,partial response and objective response.The pooled RR and 95% CI were respectively 1.41(0.90,2.22),0.91(0.71,1.17) and 0.97(0.82,1.14).Adverse reactions in TOR group were lower than those in TAM group,and the quality of life was similar in the 2 groups.CONCLUSION:The results suggest that TOR has better effectiveness and safety than TAM in improving the long-term survival rate for patients with advanced breast cancer.
【CateGory Index】: R737.9
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