Effect of pre-treatment with gonadotropin-releasing hormone analogue GnRH-α on high-intensity focussed ultrasound ablation for diffuse adenomyosis: a preliminary study

Zhang, Xiaoying; Ying-Shu, Guo; Jiu-Mei, Chen; Wang, Jinjuan; Ye, Hong; Zang, Chunyi; Duan, Hua

doi:10.1080/02656736.2018.1440014

Cited by 11 publications

(7 citation statements)

References 23 publications

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“…Moreover, five studies reported adverse reactions after treatment (11,13,14,17,19), of which only two (17, 19) completely and uniformly reported specific data of the type and number of adverse reactions in the two groups. The results of the two articles indicated no statistically significant difference in the incidence of adverse reactions between the experimental and control groups (P > 0.05).…”

Section: Discussionmentioning

confidence: 99%

“…Sixty-nine full-text were assessed eligible, however, 60 were excluded for different reasons (11 articles' follow-up time were shorter than 3 months, 13 articles did not report recurrence, 17 articles were lack of other outcome indicators, and 19 articles had no control group). Nine studies with data for 766 patients were finally included in the present meta-analysis (11)(12)(13)(14)(15)(16)(17)(18)(19). The literature screening process is shown in Figure 1.…”

Section: Selected Study Characteristicsmentioning

confidence: 99%

“…The experimental group included 346 cases, and the control group included 420 cases. Three were randomized controlled trials (12,17,19) and six were clinical controlled trials (11,(13)(14)(15)(16)18). Last follow-up time was 3 months in one study, 6 months in two studies, 12 months in six studies.…”

Section: Selected Study Characteristicsmentioning

confidence: 99%

“…The quality assessment of the studies is shown in Figure 2. Among the nine included studies, only three (13,18,20) reported the method of generating the random allocation sequence, which was the random number table method. All the studies did not mention the random allocation hiding and blinding methods.…”

Section: Quality Assessmentmentioning

confidence: 99%

“…A total of five studies (11,13,14,17,18) (367 cases) used the VAS to assess the dysmenorrhea of patients. The meta-analysis results showed that the VAS scores for dysmenorrhea in the HIFU with GnRH-a group was lower than that in the HIFU alone group after the procedure (MD 1.27, 95% CI 0.54-2.01, p = 0.0007, I 2 = 83%; Figure 6).…”

Section: Vas Scores For Dysmenorrheamentioning

confidence: 99%

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Efficacy of High-Intensity Focused Ultrasound Combined With GnRH-a for Adenomyosis: A Systematic Review and Meta-Analysis

Pang

Jin

Fan

et al. 2021

Front. Public Health

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Objective: High-intensity focused ultrasound (HIFU) is an innovative non-invasive technology used for adenomyosis. Gonadotropin-releasing hormone agonist (GnRH-a) is a hormone commonly used for adenomyosis. We investigated and assessed the efficacy of HIFU combined with GnRH-a for adenomyosis.Methods: For this systematic review and meta-analysis, we searched Pubmed, Cochrane Library, Web of Science, Embase, CNKI, WanFang, and VIP databases for relevant articles published in Chinese or English that compared HIFU combined with GnRH-a vs. HIFU alone in patients with adenomyosis. The last literature search was completed on January 31, 2021. Two reviewers independently assessed study eligibility and assessed risk of bias. Another two reviewers extracted the data. The RevMan5.3 software was used for the data analysis. Changes in volume of the uterine and adenomyotic lesion were defined as the primary outcomes. The secondary outcomes were visual analog scale (VAS) scores for dysmenorrhea, menstrual volume scores, serum CA125 levels, and recurrence rate. This study is registered with PROSPERO (CRD42021234301).Results: Three hundred and ninety potentially relevant articles were screened. Nine studies with data for 766 patients were finally included. Compared with the HIFU alone group, the HIFU combined with GnRH-a group had a higher rate of uterine volume reduction (MD 7.51, 95% CI 5.84–9.17, p < 0.00001), smaller adenomyotic lesion volume (MD 4.11, 95% CI 2.93–5.30, p < 0.00001), lower VAS score for dysmenorrhea (MD 1.27, 95% CI 0.54–2.01, p = 0.0007) and menstrual volume score (MD 0.88, 95% CI 0.73–1.04, p < 0.00001), and lower CA125 level (SMD 0.31, 95% CI 0.05–0.56, p = 0.02) after the procedure. The recurrence rate in the HIFU combined with GnRH-a group was lower than that in the HIFU alone group (RR 0.28, 95% CI 0.10–0.82, p = 0.02).Conclusions: Compared with HIFU treatment alone, HIFU combined with GnRH-a for the treatment of adenomyosis has greater efficacy in decreasing the volumes of the uterine and adenomyotic lesions and alleviating symptoms. However, since the number of the included studies was too small and most of them were written in Chinese, this conclusion needs to be referenced with caution. And the long-term evidence of its efficacy is still insufficient.Systematic Review Registration: https://www.crd.york.ac.uk/prospero/ identifier [CRD42021234].

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Section: Discussionmentioning

confidence: 99%