The Efficacy Of Bisphosphonates In Primary Breast Cancer Adjuvant Therapy: A Systematic Review

Objectives: To assess the efficacy of bisphosphonates in primary breast canceradjuvant therapy. Methods: We search the The Cochrane Central Register of ControlledTtials、MEDLINE、PubMed、EMBACE、OVIDsp、Springlink、SCI、CBM、Wanfang、CNKI，we also hand searched relevant journals and coference proceedings. Data wereextracted by two reviewers independently using an extraction form. The end time ofsearching was Jan24thin2013. RevMan5.1software was used for statistical analysis anddrawing forest map. Results: Ten RCTs including5654subjects and5694controls metour search criteria and were evaluated. Meta-analysis showed that compared with theplacebo controls, there were no significantly defferences in overall survival (P=0.026)、disease free survival (P=0.56)、bone metastasis free survival (P=0.91)、incidence ofvisceral metastasis (P=0.71)、 incidence of venous thrombosis (P=0.059)、 diarrhea(P=0.24)，mucosal inflammation (P=0.95)，myalgia (P=0.05)，arthralgia (P=0.05)，nausea(P=0.34). But there were significantly defferences in incidence of bone metastasis (P=0.01)and hyrexia (P=0.02). There were20patients in the subjects had osteonecrosis of the jaws,no one had got this side effect. Conclusion: Adjuvant bisphosphonates can control theincidence of bone metastasis and cause osteonecrosis of the jaws and hyrexia.