Skip to main content

Advertisement

SpringerLink
Log in

The efficacy of nonestrogenic therapy to hot flashes in cancer patients under hormone manipulation therapy: a systematic review and meta-analysis

  • Original Paper
  • Published:
Journal of Cancer Research and Clinical Oncology Aims and scope Submit manuscript

Abstract

Purpose

The incidence of hot flashes under hormone manipulation therapy is so high that this symptom caused by sex hormone blocking agents has been bothering patients and has a negative impact on their quality of life. Venlafaxine and gabapentin are most promising novel nonestrogenic agents to control the symptom. We seek to quatitatively summarize the efficacy of these novel agents.

Patients and methods

We conducted a meta-analysis of randomized controlled studies on the efficacy of venlafaxine/gabapentin to hot flashes in cancer patient under hormone deprivation therapies. A search for Medline, Embase, Cochrane Central Register of Controlled Trials, Ichushi, and Google Scholar yielded 733 citations, which were independently assessed by two authors. We estimated overall effect sizes and its 95 % confidence intervals (CI) for the efficacy of these agents compared with the controls with standardized mean difference.

Results

A total of 5 studies involving 588 cancer patients with hot flashes finally fulfilled the predefined inclusion criteria. Overall effect size of the efficacy of venlafaxine/gabapentin was −0.630 (95 % CI [−0.801, −0.459]).

Conclusion

Venlafaxine/gabapentin significantly improved hot flashes in cancer patients under hormone manipulation therapies.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  • Atkins D, Best D, Briss PA et al (2004) Grading quality of evidence and strength of recommendations. BMJ 328(7454):1490

    Article  PubMed  Google Scholar 

  • Biglia N, Torta R, Roagna R et al (2005) Evaluation of low-dose venlafaxine hydrochloride for the therapy of hot flushes in breast cancer survivors. Maturitas 52(1):78–85

    Article  PubMed  CAS  Google Scholar 

  • Biglia N, Sgandurra P, Peano E et al (2009) Non-hormonal treatment of hot flushes in breast cancer survivors: gabapentin vs. vitamin E. Climacteric 12(4):310–318

    Article  PubMed  CAS  Google Scholar 

  • Boekhout AH, Vincent AD, Dalesio OB et al (2011) Management of hot flashes in patients who have breast cancer with venlafaxine and clonidine: a randomized, double-blind, placebo-controlled trial. J Clin Oncol 29(29):3862–3868

    Article  PubMed  CAS  Google Scholar 

  • Bordeleau L, Pritchard KI, Loprinzi CL et al (2010) Venlafaxine versus gabapentin for the management of hot flashes in breast cancer survivors. J Clin Oncol 28(35):5147–5152

    Article  PubMed  CAS  Google Scholar 

  • Buijs C, Mom CH, Willemse PH et al (2009) Venlafaxine versus clonidine for the treatment of hot flashes in breast cancer patients: a double-blind, randomized cross-over study. Breast Cancer Res Treat 115(3):573–580

    Article  PubMed  CAS  Google Scholar 

  • Carpenter JS, Andrykowski MA, Cordova M et al (1998) Hot flashes in postmenopausal women treated for breast carcinoma: prevalence, severity, correlates, management, and relation to quality of life. Cancer 82(9):1682–1691

    Article  PubMed  CAS  Google Scholar 

  • Carpenter JS, Storniolo AM, Johns S et al (2007) Randomized, double-blind, placebo-controlled crossover trials of venlafaxine for hot flashes after breast cancer. Oncologist 12(1):124–135

    Article  PubMed  CAS  Google Scholar 

  • Charig CR, Rundle JS (1989) Flushing long-term side effect of orchiectomy in treatment of prostatic carcinoma. Urology 33(3):175–178

    Article  PubMed  CAS  Google Scholar 

  • Chlebowski RT, Kuller LH, Prentice RL et al (2009) Breast cancer after use of estrogen plus progestin in postmenopausal women. N Engl J Med 360(6):573–587

    Article  PubMed  CAS  Google Scholar 

  • Couzi RJ, Helzisouer KJ, Fetting JH (1995) Prevalence of menopausal symptoms among women with a history of breast cancer and attitudes toward estrogen replacement therapy. J Clin Oncol 13(11):2737–2744

    PubMed  CAS  Google Scholar 

  • Furukawa TA, Barbui C, Cipriani A et al (2006) Imputing missing standard deviations in meta-analyses can provide accurate results. J Clin Epidemiol 59(1):7–10

    Article  PubMed  Google Scholar 

  • Hershman DL, Shao T, Kushi LH et al (2011) Early discontinuation and non-adherence to adjuvant hormonal therapy are associated with increased mortality in women with breast cancer. Breast Cancer Res Treat 126(2):529–537

    Article  PubMed  CAS  Google Scholar 

  • Higgins JP, Thompson SG, Deeks JJ et al (2003) Measuring inconsistency in meta-analyses. BMJ 327(7414):557–560

    Article  PubMed  Google Scholar 

  • Ioannidis JP, Trikalinos TA (2007) The appropriateness of asymmetry tests for publication bias in meta-analysis: a large study. CMAJ 176(8):1091–1096

    Article  PubMed  Google Scholar 

  • Irani J, Salomon L, Oba R et al (2010) Efficacy of venlafaxine, medroxyprogesterone acetate, and cyproterone acetate for the treatment of vasomotor hot flushes in men taking gonadotropin-releasing hormone analogues for prostate cancer: a double-blind, randomised trial. Lancet Oncol 11(2):147–154

    Article  PubMed  CAS  Google Scholar 

  • Loibi S, Schwedler K, von Minckwitz G et al (2007) Venlafaxine is superior to clonidine as treatment of hot flashes in breast cancer patients–a double-blind, randomized study. Ann Oncol 18(4):689–693

    Google Scholar 

  • Loprinzi CL, Kugler JW, Sloan JA et al (2000) Venlafaxine in management of hot flashes in survivors of breast cancer: a randomised controlled trial. Lancet 356(9247):2059–2063

    Article  PubMed  CAS  Google Scholar 

  • Loprinzi CL, Dueck AC, Khoyratty BS et al (2009) A phase III randomized, double-blind, placebo-controlled trial of gabapentin in the management of hot flashes in men (N00CB). Ann Oncol 20(3):542–549

    Article  PubMed  CAS  Google Scholar 

  • McCowan C, Shearer J, Donnan PT et al (2008) Cohort study examining tamoxifen adherence and its relationship to mortality in women with breast cancer. Br J Cancer 99(11):1763–1768

    Article  PubMed  CAS  Google Scholar 

  • Moher D, Liberati A, Tetzlaff J et al (2009) PRISMA Group.preferred reporting items for systematic reviews and meta-analyses: the prisma statement. PLoS Med 6(7):e1000097

    Article  PubMed  Google Scholar 

  • Pandya KJ, Morrow GR, Roscoe JA et al (2005) Gabapentin for hot flashes in 420 women with breast cancer: a randomised double-blind placebo-controlled trial. Lancet 366(9488):818–824

    Article  PubMed  CAS  Google Scholar 

  • Rada G, Capurro D, Pantoja T et al (2010) Non-hormonal interventions for hot flashes in women with a history of breast cancer. Cochrane Database Syst Rev 8(9):CD004923

    Google Scholar 

  • Rhoden EL, Averbeck MA, Teloken PE (2008) Androgen replacement in men undergoing treatment for prostate cancer. J Sex Med 5(9):2202–2208

    Article  PubMed  Google Scholar 

  • Savard MH, Savard J, Quesnel C et al (2009) The influence of breast cancer treatment on the occurrence of hot flashes. J Pain Symptom Manage 37(4):687–697

    Article  PubMed  Google Scholar 

  • Siegel R, Desantis C, Virgo K et al. (2012) Cancer treatment and survivorship statistics CA Cancer J Clin 2012 Published on June 14 2012 doi: 10.3322/caac.21149

  • Sloan JA, Loprinzi CL, Novotny PJ et al (2001) Methodologic lessons learned from hot flash studies. J Clin Oncol 19(23):4280–4290

    PubMed  CAS  Google Scholar 

  • Walker EM, Rodriguez AI, Kohn B et al (2010) Acupuncture versus venlafaxine for the management of vasomotor symptoms in patients with hormone receptor-positive breast cancer: a randomized controlled trial. J Clin Oncol 28(4):634–640

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgments

The authors thank the supervision by Dr. Julie Goodman and Dr. Chung Hsieh at Harvard School of Public Health.

Conflict of interest

The authors declare no conflict of interest.

Author information

Authors and Affiliations

  1. Division of Hematology/Oncology, Department of Medicine, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA, 02215, USA

    N. Yamaguchi

  2. Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA

    Y. Okajima

  3. Department of Radiology, St. Luke’s International Hospital, Tokyo, Japan

    Y. Okajima

  4. Division of Medical Oncology, Department of Internal Medicine, St. Luke’s International Hospital, Tokyo, Japan

    T. Fujii & A. Natori

  5. Division of General Medicine and Primary Care, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA

    D. Kobayashi

Authors
  1. N. Yamaguchi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Y. Okajima
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. T. Fujii
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. A. Natori
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. D. Kobayashi
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to N. Yamaguchi.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Yamaguchi, N., Okajima, Y., Fujii, T. et al. The efficacy of nonestrogenic therapy to hot flashes in cancer patients under hormone manipulation therapy: a systematic review and meta-analysis. J Cancer Res Clin Oncol 139, 1701–1707 (2013). https://doi.org/10.1007/s00432-013-1491-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00432-013-1491-4

Keywords

Search

Navigation