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Both chemotherapy and radiotherapy reduce the risk of breast cancer recurring and the risk of dying from breast cancer. Generally, these therapies are given after surgery but there is uncertainty about whether they should be given at the same time (concurrently) or one after the other (sequentially). If they are used sequentially, the radiotherapy or the chemotherapy could be used first and concerns have been expressed that the effectiveness of the therapy that is delayed might be reduced. However, it has also been suggested that using chemotherapy and radiotherapy at the same time may be more toxic than keeping them separate. This review examined the current evidence on the best way to administer chemotherapy and radiotherapy following breast‐conserving surgery. We were able to include three randomised trials. Two of these, with 853 women, assessed radiotherapy and chemotherapy given at the same time versus chemotherapy given first followed by radiotherapy. The third trial randomised 244 women to radiotherapy followed by chemotherapy versus chemotherapy followed by radiotherapy. The evidence produced by these three well‐conducted trials suggests that recurrence of a woman's cancer and her chances of dying from breast cancer are similar regardless of the order of the treatments, provided that both radiotherapy and chemotherapy are commenced within seven months of the surgery. The trials provided limited information regarding adverse events, side effects or quality of life associated with the different sequences of treatment. The limited evidence available does suggest that the frequency and severity of side effects of chemotherapy and radiotherapy are similar regardless of which sequence is used. However, it should be noted that the women in these trials were treated, on average, in the early 2000s. As a result, the trials do not assess the modern types of radiotherapy, and new types of chemotherapy (such as taxanes) or other drugs (such as Herceptin). We will add relevant trials that include these more recent treatments to future updates of this review.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: April 30, 2013

Sclerotherapy has been used for centuries to treat spider veins. The technique involves the injection of a chemical into the veins. This is sometimes followed by compression with bandages or stockings.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: December 7, 2011

The authors concluded that foam sclerotherapy showed much greater efficacy than liquid sclerotherapy for saphenous veins. There was no conclusive evidence for reticular veins and telangiectases. The authors' conclusions represented the evidence presented, but no comparative measures were reported and the authors' conclusions should be interpreted with caution.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2009

This study identified published studies on the quantitative accuracy of fundus autofluorescence (FAF) imaging for the detection and diagnosis of retinal conditions. However, no studies were found that had quantitatively assessed the accuracy of FAF imaging for monitoring the progression of retinal conditions or their response to therapy. Key limitations of the published studies are that their methods do not accurately reflect how FAF imaging is likely to be used in clinical practice and they are at risk of several types of bias.

Health Technology Assessment - NIHR Journals Library.

Version: April 2016

The original Prostate Cancer: Diagnosis and Treatment Guideline published in 2008 was the first clinical guideline produced by the National Collaborating Centre for Cancer (NCC-C); accordingly this is now the first NCC-C clinical guideline to be reviewed and updated. Many areas of the original guideline are unchanged as there is little or no new evidence; other aspects have been completely rewritten. As ever there are still many topics where the research evidence is incomplete or conflicting, and so the Guideline Development Group (GDG) have been required to reach a consensus using the evidence available to them in several areas. In places where it was clear that further work needed to be done, new research recommendations have been made which we hope will be used as the basis for future research work.

NICE Clinical Guidelines - National Collaborating Centre for Cancer (UK).

Version: January 2014

To systematically review evidence addressing the diagnosis and management of infantile hemangiomas (IH).

Comparative Effectiveness Reviews - Agency for Healthcare Research and Quality (US).

Version: January 2016

Rosacea is a common skin condition causing flushing, redness, red pimples and pustules on the face, and should not be confused with acne. Dilated blood vessels may appear near the surface of the skin (telangiectasia). It can also cause inflammation of the eyes or eyelids, or both (ocular rosacea). Some people can develop a thickening of the skin, especially of the nose (rhinophyma). Although the cause of rosacea remains unclear, a wide variety of treatments are available for this persistent (chronic) and recurring and often distressing disease. These include medications applied directly to the skin (topical), oral medications and light‐based therapies. We wanted to discover how people assessed their treatments: if the treatments changed their quality of life, if they saw changes in their condition and if there were side effects. From the doctors, we wanted to discover whether treatments changed the severity of rosacea, as well as how long it took before symptoms reduced and reappeared.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: April 28, 2015

Expert-reviewed information summary about the treatment of childhood vascular tumors.

PDQ Cancer Information Summaries [Internet] - National Cancer Institute (US).

Version: December 21, 2017

Atopic eczema (atopic dermatitis) is a chronic inflammatory itchy skin condition that develops in early childhood in the majority of cases. It is typically an episodic disease of exacerbation (flares, which may occur as frequently as two or three per month) and remissions, except for severe cases where it may be continuous. Certain patterns of atopic eczema are recognised. In infants, atopic eczema usually involves the face and extensor surfaces of the limbs and, while it may involve the trunk, the napkin area is usually spared. A few infants may exhibit a discoid pattern (circular patches). In older children flexural involvement predominates, as in adults. Diagnostic criteria are discussed in Chapter 3. As with other atopic conditions, such as asthma and allergic rhinitis (hay fever), atopic eczema often has a genetic component. In atopic eczema, inherited factors affect the development of the skin barrier, which can lead to exacerbation of the disease by a large number of trigger factors, including irritants and allergens. Many cases of atopic eczema clear or improve during childhood while others persist into adulthood, and some children who have atopic eczema `will go on to develop asthma and/or allergic rhinitis; this sequence of events is sometimes referred to as the ‘atopic march’. The epidemiology of atopic eczema is considered in Chapter 5, and the impact of the condition on children and their families/caregivers is considered in Sections 4.2 and 4.3.

NICE Clinical Guidelines - National Collaborating Centre for Women's and Children's Health (UK).

Version: December 2007

Childhood ALL is a type of cancer in which the bone marrow makes too many immature lymphocytes (a type of white blood cell). Here’s what you need to know about the risk factors, signs, tests to diagnose, and treatment of newly diagnosed and recurrent ALL in this expert-reviewed summary.

PDQ Cancer Information Summaries [Internet] - National Cancer Institute (US).

Version: December 8, 2017

Ferumoxytol (Feraheme) is a colloidal superparamegnetic iron-carbohydrate complex that was specifically designed to reduce immunological reactivity. It can be rapidly administered (IV rate of 30–60 seconds) as a 510 mg dose with the second IV injection administered two to eight days later. The federal Food and Drug Administration (FDA) in the United States has listed ferumoxytol for the treatment of iron deficiency anemia (IDA, characterized by iron deficiency) in adult patients with chronic kidney disease (CKD). Health Canada has recently placed restrictions on the use of ferumoxytol due to the potential for serious allergic reactions. Therefore, this review was performed to assess the clinical effectiveness and safety of ferumoxytol compared with other IV iron therapies for patients with IDA. In addition, cost-effectiveness and evidence-based guidelines were also investigated to determine the costs associated with ferumoxytol and its use in patients with IDA. This is an update to a previous review on ferumoxytol which found limited evidence that stated that it seemed to have comparable efficacy to other iron complexes but that it was associated with an increased adverse event profile.

Rapid Response Report: Summary with Critical Appraisal - Canadian Agency for Drugs and Technologies in Health.

Version: November 21, 2014

Endocrine and neuroendocrine neoplasias may be inherited in syndromes such as multiple endocrine neoplasia types 1 and 2 (MEN1 and MEN2), familial pheochromocytoma and paraganglioma, and Carney-Stratakis syndrome. Learn about the genetics, clinical manifestations, and management of these hereditary cancer syndromes in this expert-reviewed summary.

PDQ Cancer Information Summaries [Internet] - National Cancer Institute (US).

Version: January 12, 2018

Since December 2000, two topical calcineurin inhibitors have been approved for use in patients with atopic dermatitis in the United States and Canada. Since the approval of these agents, several case reports of malignancies (skin and lymphoma) have been reported to the United States Food and Drug Administration, causing a black box warning to be placed in each product's labeling. Several pharmacokinetic analyses, commentaries, and editorials have been published refuting the addition of the black box warning. In light of these findings, this comparative effectiveness review of 2 topical calcineurin inhibitors was commissioned to identify whether additional good-quality studies on safety have been published and to determine whether differences in efficacy and effectiveness exist between the 2 topical agents. The purpose of this review is to compare the effectiveness and harms of topical calcineurin inhibitors in persons with atopic dermatitis or eczema.

Drug Class Reviews - Oregon Health & Science University.

Version: October 2008

Breast cancer is the most common cancer in women and its management often presents patients and their healthcare professionals with difficult decisions about the most appropriate treatment. For all those affected by breast cancer (including family and carers) it is important to recognise the impact of this diagnosis, the complexity of treatment options and the wide ranging needs and support required throughout this period of care and beyond. We hope that this document will provide helpful and appropriate guidance to both healthcare professionals and patients on the diagnosis and subsequent management of early and locally advanced breast cancer.

NICE Clinical Guidelines - National Collaborating Centre for Cancer (UK).

Version: February 2009

Constant evolution in techniques to treat varicose veins has been driven by the need for: better patient comfort, reduced side effects and the desire for better and longer-lasting clinical results. New developments towards foam sclerotherapy (FS) warrant questions regarding their clinical and economic evidence. The purpose of this review is therefore to compare the available evidence on FS for patient with varicose veins compared with alternative treatment modalities (i.e., surgery, endovascular thermal ablation, or liquid sclerotherapy) in terms of their comparative clinical effectiveness, safety, cost-effectiveness, and evidence-based guidelines.

Rapid Response Report: Summary with Critical Appraisal - Canadian Agency for Drugs and Technologies in Health.

Version: February 12, 2015

Expert-reviewed information summary about the treatment of rectal cancer.

PDQ Cancer Information Summaries [Internet] - National Cancer Institute (US).

Version: April 27, 2017

Expert-reviewed information summary in which cancer risk perception, risk communication, and risk counseling are discussed. The summary also contains information about recording and analyzing a family history of cancer and factors to consider when offering genetic testing.

PDQ Cancer Information Summaries [Internet] - National Cancer Institute (US).

Version: November 30, 2017

This study aims to determine the test accuracy and cost-effectiveness of the sentinel lymph node (SLN) biopsy with 99mTc and/or blue dye compared with inguinofemoral lymphadenectomy or clinical follow-up for test negatives in vulval cancer. A sensitive and specific combined metastatic SLN detection test and information on generic quality of life in vulval cancer is urgently required.

Health Technology Assessment - NIHR Journals Library.

Version: December 2013

Serious, disabling, and life-threatening chronic health conditions adversely affect the health of aging childhood cancer survivors. Learn about the cardiovascular, cognitive, psychosocial, digestive, endocrine, immune, musculoskeletal, reproductive, and urinary late effects and subsequent neoplasms that contribute to a high burden of morbidity in childhood cancer survivors.

PDQ Cancer Information Summaries [Internet] - National Cancer Institute (US).

Version: January 2, 2018

Women with early breast cancer who choose to keep their breast need to have radiotherapy (RT) as well as surgery to remove the cancer to make sure it does not regrow in the breast. RT is treatment with high energy x‐rays. Having RT for breast cancer usually means 25 to 30 visits to the RT department, five times per week.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: July 18, 2016

Systematic Reviews in PubMed

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