Mei L.,China Womens University
The Cochrane database of systematic reviews | Year: 2013
Epithelial ovarian cancer accounts for about 90% of all cases of ovarian cancer. Debulking surgery and six courses of platinum-based chemotherapy results in complete clinical remission (CCR) in up to 75% of cases. However, 75% of the responders will relapse within a median time of 18 to 28 months and only 20% to 40% of women will survive beyond five years. It has been suggested that maintenance chemotherapy could assist in prolonging remission. To date, there has not been a systematic review on the impact of maintenance chemotherapy for epithelial ovarian cancer. To assess the effectiveness and toxicity of maintenance chemotherapy for epithelial ovarian cancer and to evaluate the impact on quality of life (QoL). In the original review we searched the Cochrane Gynaecological Cancer Review Group Specialised Register, The Cochrane Central Register of Controlled Trails (CENTRAL, The Cochrane Library 2009, Issue 1), MEDLINE, EMBASE, PubMed, CBMdisc, CNKI and VIP (to May 2009). We collected information from ongoing trials, checked reference lists of published articles and consulted experts in the field. For this update, the searches were extended to October 2012. Randomised controlled trials (RCTs) comparing maintenance chemotherapy with no further intervention, maintenance radiotherapy or other maintenance therapy. Two review authors independently assessed trials for eligibility and quality and extracted data. We analysed overall survival (OS) and progression-free survival (PFS) rates as dichotomous variables. Toxicity and QoL data were extracted where present. All analyses were based on intention-to-treat (ITT) on the endpoint of survival. We also analysed data by subgroups of drugs. We included eight trials (1644 women). When all chemotherapy regimens were combined, meta-analysis indicated no significant difference in three-, five- and 10-year OS or PFS. For five-year OS, the combined risk ratio (RR) was 1.03 (95% confidence interval (CI) 0.96 to 1.10) and for the five-year PFS, the combined RR was 1.06 (95% CI 0.97 to 1.17). Results were very similar when trials of different regimens were analysed. Comparing chemotherapy with radiotherapy, only the RR for 10-year PFS in pathological complete remission (PCR) was in favour of whole abdominal radiotherapy 0.51 (95% CI 0.27 to 1.00), while three- and five-year OS rates have no significant difference between the two groups. There is no evidence to suggest that the use of platinum agents, doxorubicin or paclitaxel used as maintenance chemotherapy is more effective than observation alone. Further investigations regarding the effect of paclitaxel used as maintenance chemotherapy are required.
Liu R.,Ghent University |
Liu R.,China Womens University |
Hoefkens C.,Ghent University |
Verbeke W.,Ghent University
Food Quality and Preference | Year: 2015
This paper investigated Chinese consumers' understanding and use of the Chinese food nutrition label and their determinants. Quantitative data were collected during March 2012 through a self-administrated structured questionnaire conducted in Beijing ( n= 213) and Baoding city ( n= 447). Questions assessed Chinese consumers' use and understanding (objective and subjective) of food nutrition labels, nutrition knowledge (objective and subjective), socio-demographic characteristics, diet status, diet-health awareness, body mass index (BMI) and familiarity with food nutrition labels. A moderate degree of subjective understanding and a low degree of objective understanding of food nutrition labels were found among the participants, and 70% of the participants claimed to rarely or never use nutrition labels when shopping for food. Nutrition knowledge (objective and subjective) positively affected participants' understanding (objective and subjective) of food nutrition labels. Familiarity with food nutrition labels had a strong positive effect on understanding of and use of food nutrition labels. Subjective nutrition knowledge and subjective understanding also played a significant and positive role in Chinese consumers' label use. Age yielded a negative effect on both subjective and objective understanding, while education only affected participants' objective understanding. None of the socio-demographic characteristics associated with self-reported use. Implications for future policies to improve Chinese consumers' understanding and promote their use of food nutrition labels are discussed. © 2014 Elsevier Ltd.
Fu J.,China Womens University
Cochrane database of systematic reviews (Online) | Year: 2012
Hydatidiform mole (HM), also called a molar pregnancy, is characterised by an overgrowth of foetal chorionic tissue within the uterus. HMs may be partial (PM) or complete (CM) depending on their gross appearance, histopathology and karyotype. PMs usually have a triploid karyotype, derived from maternal and paternal origins, whereas CMs are diploid and have paternal origins only. Most women with HM can be cured by evacuation of retained products of conception (ERPC) and their fertility preserved. However, in some women the growth persists and develops into gestational trophoblastic neoplasia (GTN), a malignant form of the disease that requires treatment with chemotherapy. CMs have a higher rate of malignant transformation than PMs. It may be possible to reduce the risk of GTN in women with HM by administering prophylactic chemotherapy (P-Chem). However, P-Chem given before or after evacuation of HM to prevent malignant sequelae remains controversial, as the risks and benefits of this practice are unclear. To systematically review the evidence for the effectiveness and safety of P-Chem to prevent GTN in women with a molar pregnancy. We performed electronic searches in the Cochrane Gynaecological Cancer Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL, Issue 2, 2012), MEDLINE (1946 to February week 4, 2012) and EMBASE (1980 to week 9, 2012). The search strategy was developed using free text and medical subject headings (MESH). We handsearched reference lists of relevant literature to identify additional studies. We included randomised controlled trials (RCTs) of P-Chem for HM. Two review authors independently assessed studies for inclusion in the review and extracted data using a specifically designed data collection form. Meta-analyses were performed by pooling data from individual trials using RevMan 5.1 software. We included three RCTs with a combined total of 613 participants. One study compared prophylactic dactinomycin to no prophylaxis (60 participants); the other two studies compared prophylactic methotrexate to no prophylaxis (420 and 133 participants). All participants were diagnosed with CMs. We considered the latter two studies to be of poor methodological quality.P-Chem reduced the risk of GTN occurring in women following a CM (3 studies, 550 participants; RR 0.37; 95% confidence interval (CI) 0.24 to 0.57; I(2) = 0%; P < 0.00001), However, owing to the poor quality of two of the included studies, we performed sensitivity analyses excluding these two studies. This left only one small study of high-risk women to contribute data for this primary outcome (59 participants; RR 0.28; 95% CI 0.10 to 0.73; P = 0.01), therefore we consider this evidence to be of a low quality.The time to diagnosis was longer in the P-Chem group than the control group (2 studies, 33 participants; mean difference (MD) 28.72; 95% CI 13.19 to 44.24; P = 0.0003) and the P-Chem group required more courses to cure subsequent GTN (1 poor-quality study, 14 participants; MD 1.10; 95% CI 0.52 to 1.68; P = 0.0002). We consider this evidence to be of a low to very low quality for similar reasons to those listed above.There were insufficient data to perform meta-analyses for toxicity, overall survival, drug resistance and reproductive outcomes. P-Chem may reduce the risk of progression to GTN in women with CMs who are at a high risk of malignant transformation; however, current evidence in favour of P-Chem is limited by the poor methodological quality and small size of the included studies. As P-Chem may increase drug resistance, delay treatment of GTN and expose women unnecessarily to toxic side effects, this practice cannot currently be recommended.
Zhang W.,China Womens University
Proceedings of the International Conference on E-Business and E-Government, ICEE 2010 | Year: 2010
Liu R.,Ghent University |
Liu R.,China Womens University |
Pieniak Z.,Ghent University |
Verbeke W.,Ghent University
Food Control | Year: 2014
This paper identifies segments of Chinese consumers based on their perception of personal risk, how worried they are and their subjective knowledge about seven possible food-related hazards: additives, residues, counterfeit, inferior, genetically modified, deteriorated and nutritionally imbalanced food. Data were collected through a consumer survey conducted in Beijing (534 participants) and in Baoding (437 participants). Three clusters were identified: worried and knowledgeable consumers (60.1%), worried and ignorant consumers (21.7%) and moderately worried consumers (18.2%). The first two groups reported a high level of worry and high perception of personal risk about food-related hazards in China. The two hazards they were most worried about were counterfeit food and inferior quality food. Television, internet and personal communication were the three information channels most frequently used by participants to obtain information about food safety. Worried and ignorant consumers reported less frequent use of magazines, books and brochures compared with other consumers. Medical doctors, personal experience and research institutes were the three most trusted information sources for the first two groups of consumers. Moderately worried consumers only placed high levels of trust in medical doctors and themselves. Consumers' perceptions about the knowledge, honesty and concern of different information sources significantly and positively affected their trust in those sources. The study concludes by making recommendations as to how to improve communications with the different identified consumer segments and identifies future research required to expand its validity. © 2014 Elsevier Ltd.