辅助内分泌治疗(AET)的副作用在乳腺癌幸存者中很常见,并且会影响对治疗的坚持。我们综合了自我管理这些副作用的策略的证据。
我们搜索了有关AET副作用的自我管理策略的系统评价和临床指南(关节痛,疲劳,潮热,肠胃不适,恶心,外阴阴道症状,和睡眠障碍)。我们搜索了肿瘤学组织的网站和八个数据库(Inception-2020年11月)。筛选,数据提取和质量评估独立完成,一式两份.
2019CRD4201914001。
我们确定了33篇系统评价和18篇临床指南。21%的评论是高质量的,指南的平均质量评分为44%.大多数策略的证据缺乏或薄弱。来自低质量审查和多个指南的共识是推荐保湿霜,外阴阴道症状的凝胶和润滑剂。体力活动对自我管理大多数症状的证据很弱,尽管两项高质量的评论表明,瑜伽和有氧运动可以减轻疲劳。初级研究通常因研究设计薄弱和动力不足而产生偏见。11篇综述没有报告有关不良事件的信息。
大多数针对经历AET副作用的乳腺癌幸存者的自我管理策略缺乏证据。需要使用高质量的动力良好的设计进行初步研究,重点是可实施的策略。
患者和临床医生应该意识到,尽管这些自我管理策略的伤害风险很低,获益的可能性通常不清楚。女性应该考虑保湿霜,用于自我管理外阴阴道症状的凝胶或润滑剂,和瑜伽或有氧运动缓解疲劳。
Side-effects of adjuvant endocrine therapy (AET) are common in breast cancer survivors, and can affect adherence to treatment. We synthesised the evidence for strategies to self-manage these side-effects.
We searched for systematic reviews and clinical
guidelines on self-management strategies for AET side-effects (arthralgia, fatigue, hot flashes, gastrointestinal discomfort, nausea, vulvovaginal symptoms, and sleep disturbance). We searched oncology organisation\'s websites and eight databases (Inception-November 2020). Screening, data extraction and quality assessment were completed independently in duplicate.
2019CRD4201914001.
We identified 33 systematic reviews and 18 clinical
guidelines. 21% of reviews were high quality, and the average quality score for
guidelines was 44%. Evidence for most strategies was absent or weak. There was
consensus from a low-quality review and multiple
guidelines to recommend moisturisers, gels and lubricants for vulvovaginal symptoms. Evidence was weak for physical activity for self-managing most symptoms, although two high-quality reviews indicated yoga and aerobic exercise could reduce fatigue. Primary research was often biased by weak and underpowered study designs. Eleven reviews did not report information on adverse events.
Most self-management strategies for breast cancer survivors experiencing side-effects from AET lack evidence. Primary research is needed using high-quality well-powered designs focusing on implementable strategies.
Patients and clinicians should be aware that although the risk of harm is low for these self-management strategies, the likelihood of benefit is often unclear. Women should consider moisturisers, gels or lubricants for self-managing vulvovaginal symptoms, and yoga or aerobic exercise for alleviating fatigue.