Is radiation-induced ovarian ablation in breast cancer an obsolete procedure? Results of a meta-analysis

Mushabbab Al Asiri,1,* Mutahir A Tunio,1,* Reham Abdulmoniem,2,*1Radiation Oncology, Comprehensive Cancer Center, King Fahad Medical City, Riyadh, Saudi Arabia; 2Radiation Oncology, National Cancer Institute, Cairo, Egypt *These authors contributed equally to this work Background: A meta-analysis w...

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Autores principales:	Al Asiri M, Tunio MA, Abdulmoniem R
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2016
Materias:	Radiation induced ovarian ablation pre/perimenopausal breast cancer meta-analysis Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/cb8563ec372946d08cbb8d2a71bf7c87
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spelling	oai:doaj.org-article:cb8563ec372946d08cbb8d2a71bf7c872021-12-02T00:52:02ZIs radiation-induced ovarian ablation in breast cancer an obsolete procedure? Results of a meta-analysis1179-1314https://doaj.org/article/cb8563ec372946d08cbb8d2a71bf7c872016-05-01T00:00:00Zhttps://www.dovepress.com/is-radiation-induced-ovarian-ablation-in-breast-cancer-an-obsolete-pro-peer-reviewed-article-BCTThttps://doaj.org/toc/1179-1314Mushabbab Al Asiri,1,* Mutahir A Tunio,1,* Reham Abdulmoniem,2,1Radiation Oncology, Comprehensive Cancer Center, King Fahad Medical City, Riyadh, Saudi Arabia; 2Radiation Oncology, National Cancer Institute, Cairo, Egypt These authors contributed equally to this work Background: A meta-analysis was conducted to assess the impact of radiation-induced ovarian ablation (RT-OA) on amenorrhea cessation rates, progression-free survival, and overall survival in pre/perimenopausal women with breast cancer. Materials and methods: The Medline, CANCERLIT, and Cochrane Library databases and search engines were searched to identify randomized controlled studies comparing RT-OA with control for early or metastatic breast cancer. Further, radiotherapy doses, techniques, and associated side effects were evaluated. Results: Six controlled trials with a total patient population of 3,317 were identified. Pooled results from these trials showed significant amenorrhea rates (P<0.00001) and increase in progression-free survival in patients treated with RT-OA (P<0.00001). However, there was no difference in overall survival (P=0.37). The majority of patients were treated with larger field sizes with parallel-opposed anteroposterior and posteroanterior pelvic fields. RT-OA was generally well tolerated. Radiotherapy doses of 1,500 cGy in five fractions, 1,500 cGy in four fractions, 1,600 cGy in four fractions, and 2,000 cGy in ten fractions were associated with excellent amenorrhea rates. The resultant funnel plot showed no publication bias (Egger test P=0.16). Conclusion: RT-OA is cost-effective and can safely be used in pre/perimenopausal women with metastatic breast cancer, or if luteinizing hormone-releasing hormone analogs are contraindicated, or in patients in whom fertility preservation is not an issue. Radiation dose of 1,500 cGy in five fractions, 1,500 cGy in four fractions, 1,600 cGy in four fractions, and 2,000 cGy in ten fractions showed more efficacies. However, further studies incorporating three-dimensional conformal radiotherapy and intensity-modulated radiotherapy are warranted. Keywords: radiation-induced ovarian ablation, pre/perimenopausal, breast cancer, meta-analysisAl Asiri MTunio MAAbdulmoniem RDove Medical PressarticleRadiation induced ovarian ablationpre/perimenopausalbreast cancermeta-analysisNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENBreast Cancer: Targets and Therapy, Vol 2016, Iss Issue 1, Pp 109-116 (2016)
institution	DOAJ
collection	DOAJ
language	EN
topic	Radiation induced ovarian ablation pre/perimenopausal breast cancer meta-analysis Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	Radiation induced ovarian ablation pre/perimenopausal breast cancer meta-analysis Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Al Asiri M Tunio MA Abdulmoniem R Is radiation-induced ovarian ablation in breast cancer an obsolete procedure? Results of a meta-analysis
description	Mushabbab Al Asiri,1,* Mutahir A Tunio,1,* Reham Abdulmoniem,2,1Radiation Oncology, Comprehensive Cancer Center, King Fahad Medical City, Riyadh, Saudi Arabia; 2Radiation Oncology, National Cancer Institute, Cairo, Egypt These authors contributed equally to this work Background: A meta-analysis was conducted to assess the impact of radiation-induced ovarian ablation (RT-OA) on amenorrhea cessation rates, progression-free survival, and overall survival in pre/perimenopausal women with breast cancer. Materials and methods: The Medline, CANCERLIT, and Cochrane Library databases and search engines were searched to identify randomized controlled studies comparing RT-OA with control for early or metastatic breast cancer. Further, radiotherapy doses, techniques, and associated side effects were evaluated. Results: Six controlled trials with a total patient population of 3,317 were identified. Pooled results from these trials showed significant amenorrhea rates (P<0.00001) and increase in progression-free survival in patients treated with RT-OA (P<0.00001). However, there was no difference in overall survival (P=0.37). The majority of patients were treated with larger field sizes with parallel-opposed anteroposterior and posteroanterior pelvic fields. RT-OA was generally well tolerated. Radiotherapy doses of 1,500 cGy in five fractions, 1,500 cGy in four fractions, 1,600 cGy in four fractions, and 2,000 cGy in ten fractions were associated with excellent amenorrhea rates. The resultant funnel plot showed no publication bias (Egger test P=0.16). Conclusion: RT-OA is cost-effective and can safely be used in pre/perimenopausal women with metastatic breast cancer, or if luteinizing hormone-releasing hormone analogs are contraindicated, or in patients in whom fertility preservation is not an issue. Radiation dose of 1,500 cGy in five fractions, 1,500 cGy in four fractions, 1,600 cGy in four fractions, and 2,000 cGy in ten fractions showed more efficacies. However, further studies incorporating three-dimensional conformal radiotherapy and intensity-modulated radiotherapy are warranted. Keywords: radiation-induced ovarian ablation, pre/perimenopausal, breast cancer, meta-analysis
format	article
author	Al Asiri M Tunio MA Abdulmoniem R
author_facet	Al Asiri M Tunio MA Abdulmoniem R
author_sort	Al Asiri M
title	Is radiation-induced ovarian ablation in breast cancer an obsolete procedure? Results of a meta-analysis
title_short	Is radiation-induced ovarian ablation in breast cancer an obsolete procedure? Results of a meta-analysis
title_full	Is radiation-induced ovarian ablation in breast cancer an obsolete procedure? Results of a meta-analysis
title_fullStr	Is radiation-induced ovarian ablation in breast cancer an obsolete procedure? Results of a meta-analysis
title_full_unstemmed	Is radiation-induced ovarian ablation in breast cancer an obsolete procedure? Results of a meta-analysis
title_sort	is radiation-induced ovarian ablation in breast cancer an obsolete procedure? results of a meta-analysis
publisher	Dove Medical Press
publishDate	2016
url	https://doaj.org/article/cb8563ec372946d08cbb8d2a71bf7c87
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Is radiation-induced ovarian ablation in breast cancer an obsolete procedure? Results of a meta-analysis

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