ObjectivesTo systematically review the efficacy and safety of palifermin on oral mucositis (OM) and acute graft versus host disease (aGVHD) for hematological malignancy patients undergoing hematopoietic stem cell transplantation (HSCT).MethodsPubMed, The Cochrane Library, Web of Science, EMbase, Clinicaltrials.gov, CNKI and WanFang Data databases were electronically searched to collect randomized controlled trials (RCTs) of the efficacy of palifermin on OM and aGVHD for hematological malignancy patients undergoing HSCT from inception to September 30th, 2018. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies, then, meta-analysis was performed by using RevMan 5.3 software.ResultsA total of 7 RCTs involving 904 patients were included. The results of meta-analysis showed that: palifermin could reduce the duration of OM grade 2 to 4 (MD=?4.21, 95%CI ?7.83 to ?0.58, P=0.02), OM grade 3 to 4 (MD=?2.54, 95%CI ?4.61 to ?0.46, P=0.02) significantly for hematological malignancy patients undergoing HSCT. However, no significant difference was found in the prevalence of aGVHD grade 2 to 4 (RR=1.29, 95%CI 0.95 to 1.75, P=0.11), aGVHD grade 3 to 4 (RR=0.99, 95%CI 0.55 to 1.77, P=0.97), OM grade 2 to 4 (RR=0.86, 95%CI 0.72 to 1.03, P=0.11) and OM grade 3 to 4 (RR=0.82, 95%CI 0.65 to 1.03, P=0.08) between palifermin group and placebo group. The prevalence of paresthesia (RR=4.24, 95%CI 1.24 to 14.56, P=0.02) and erythema (RR=1.49, 95%CI 1.06 to 2.09, P=0.02) were significantly higher in palifermin group.ConclusionsThe durations of OM grade 2 to 4, 3 to 4 are significantly reduce in patients receiving palifermin compared with those receiving a placebo, however, no statistically significant difference are found in the incidence of aGVHD grade 2 to 4, 3 to 4, OM grade 2 to 4, 3 to 4. Parethesia and erythema are more prevalent among patients using palifermin. Therefore, advantages and disadvantages of palifermin should be considered when used in clinical.
ObjectiveTo develop a patient version of guideline for non-pharmacological interventions in breast cancer, aiming to support patients decision-making and self-management. MethodsAdhering to international guidelines and the World Health Organization's methodology for guideline development, health issues from the patient perspective were identified through sentiment dictionaries, in-depth individual interviews, and clinical surveys. Official websites of guidelines, professional association websites and comprehensive databases were systematically searched. The quality of evidence was assessed by the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. Resource utilization was assessed by integrating health economics evidence, and preliminary recommendations were formulated using an Evidence-to-Decision (EtD) framework. Subsequently, two rounds of online consensus meetings and one Delphi round were conducted to refine and finalize the recommendations, resulting in the final patient guideline. ResultsThe patient and public version of guideline for non-pharmacological interventions in breast cancer encompassed three modules: disease knowledge, symptoms, and psychological well-being. It covered core content, including disease awareness, wound recovery, dietary nutrition, reproductive health, symptom management, and psychological adjustment. ConclusionDeveloped from the patient perspective and based on rigorous methodological processes, the guideline formulated evidence - based recommendations, which serve as a reference for breast cancer patients in decision-making and self-management.