Short-term use of SPRMs resulted in improved quality of life, reduced menstrual bleeding and higher rates of amenorrhoea than were seen with placebo. Thus, SPRMs may provide effective treatment for women with symptomatic fibroids. Evidence derived from one RCT showed no difference between leuprolide acetate and SPRM with respect to improved quality of life and bleeding symptoms. Evidence was insufficient to show whether effectiveness was different between SPRMs and leuprolide. Investigators more frequently observed SPRM-associated endometrial changes in women treated with SPRMs than in those treated with placebo or leuprolide acetate. As noted above, SPRM-associated endometrial changes are benign, are not related to cancer and are not precancerous. Reporting bias may impact the conclusion of this meta-analysis. Well-designed RCTs comparing SPRMs versus other treatments are needed.

Black women had greater fibroid burden at baseline. Both ethnicities had similar improvement in fibroid symptomatology following UPA treatment, but white women experienced higher amenorrhea rates. Black women were more dissatisfied with UPA treatment, which may be related to the lower amenorrhea rates.

(2014) Radiation-induced lung injury after concurrent neoadjuvant chemoradiotherapy for locally advanced breast cancer, Acta Oncologica, 53:5, 697-701,

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