Objective To use meta-analysis method to assess the efficacy of fluorine-18fluorode-oxyglucose positron emission tomography/computed tomography (PET/CT) (18F-FDG-PET/CT) scan and 99Tcm-methylene diphosphonate (99Tcm-MDP) bone scan (BS) on early diagnosis of bone metastases of cancer. Methods Computer-based retrieval was conducted on MEDLINE, PubMed, EMbase, Ovid, and The Cochrane Library (from their establishment to 2010) to search reports about diagnosing bone metastases of cancer with 18FDG-PET/CT and 99Tcm-MDP Bone Scan. Three reviewers independently selected the studies according to the inclusion and exclusion criteria, collected the data, and evaluated the quality. MetaDisc software was adopted to conduct meta-analyses. The pooled sensitivity, specificity, and diagnostic odds ratio (DOR) were calculated, the summary receiving operating characteristic (SROC) curve was drawn, and the areas under the curve (AUC) and Q were measured. Results Five studies were included. The results of meta-analyses showed that the pooled sensitivity of 18FDG-PET/CT and 99Tcm-MDP BS in the diagnosis of bone metastases was 0.95 (95%CI 0.90 to 0.97) and 0.77 (95%CI 0.71 to 0.83), respectively; the pooled specificity was 0.98 (95%CI 0.97 to 0.99) and 0.90 (95%CI 0.88 to 0.92), respectively; the pooled DOR was 602.81 (95%CI 214.07 to 1697.51) and 41.37 (95%CI 8.15 to 210.05), respectively; the AUC was 0.984 2 and 0.901 7, respectively; and the Q index was 0.945 4 and 0.833 1, respectively. Conclusion The 18F-FDG PET/CT is more effective than the 99Tcm-MDP bone scan in the early diagnosis of bone metastases in cancer.
ObjectiveTo study the preventive effect of zoledronic acid on the bone metastases of breast cancer. MethodsFour hundred and eighteen female patients with infiltrating ductal carcinoma who were underwent surgery in The First Affiliated Hospital of Xinjiang Medical University from Jan. 2006 to Dec. 2009 were collected and divided into 2 group, patients of prevention group accepted the preventive remedy of zoledronic acid(n=216), but patients of control group didn't accept(n=202). Comparison of incidence of bone metastases and recurrence was performed. ResultsThere were 37(17.13%) patients suffered bone metastases in prevention group and 73(36.14%) patients in control group, so the incidence of bone metastases was higher in control group(χ2=19.45, P<0.05). But there were no significant difference on incidence of pulmonary metastasis, liver metastases, other parts of metastases, multiple organ metastases, and recurrence(P>0.05). ConclusionZoledronic acid could significantly reduce the incidence of bone metastases for patients with breast cancer, who underwent chemotherapy of conventional dose after operation, and it can effectively improve the prognosis of patients with breast cancer.
Objective To systemically review the efficacy and safety of strontium chloride for bone metastases from prostate cancer. Methods PubMed, The Cochrane Library, EMbase, VIP, CBM, CNKI and WanFang Data databases were electronically searched to collect randomized controlled trials (RCTs) about strontium chloride for bone metastases from prostate cancer from inception to November 2016. 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. Results A total of 7 RCTs involving 1 532 patients were included. The results of meta-analysis showed that strontium chloride was superior to placebo in the rate of pain relief (RR=1.79, 95%CI 1.35 to 2.37, P<0.000 1), but more likely to cause slight leucopenia (Peto OR=5.02, 95%CI 1.49 to 16.95,P=0.009). However, no significant difference was found in overall survival time between two groups (RR=0.87, 95%CI 0.58 to 1.30, P=0.49). In addition, strontium chloride was superior to radiotherapy in rate of bone pain relief (RR=1.28, 95%CI 1.12 to 1.47, P=0.0004), but it would cause thrombocy (Peto OR=2.61, 95%CI 1.04 to 6.57, P=0.04). Conclusion Current evidence shows that the strontium chloride is superior to placebo in the rate of pain relief, but it will cause slight leucopenia. The strontium chloride is superior to radiotherapy in rate of bone pain relief. Due to limited quality and quantity of the included studies, more high quality studies are needed to verify the above conclusion.
ObjectivesTo systematically review the value of cross-linked carboxy-terminal telopeptide of type I collagen (ICTP) in the diagnosis of bone metastases of lung cancer.MethodsThe Cochrane Library, PubMed, EMbase, WanFang Data and CBM databases were electronically searched to collect studies on ICTP in the diagnosis of lung cancer bone metastases from inception to November 2017. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies by QUADAS-2 standard. Meta-analysis was performed by using Meta-Disc 1.4 software.ResultsA total of 8 studies involving 781 patients were included. The results of meta-analysis showed that the pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnosis odds ratio and area under the curve of summary receiver operating characteristics were 71% (95%CI 0.65 to 0.76), 80% (95%CI 0.76 to 0.84), 3.79 (95%CI 2.31 to 6.21), 0.35 (95%CI 0.25 to 0.49), 14.67 (95%CI 6.99 to 30.81) and 0.860 3, respectively.ConclusionsICTP cooperate with imaging tests may be accurate and practical in diagnosis of bone metastases of lung cancer. Due to the limited quality and quantity of included studies, the above results should be validated by more studies.