Study designs of evaluations included in the review
Comparative studies in which at least one of the evaluated treatments was a progestogen. It is unclear if included studies had to be randomised controlled trials (RCTs).
Specific interventions included in the review
Progestogens (medroxyprogesterone acetate 900-2000 mg/day; megestrol acetate 80-160 mg/day) compared with alternative progestogens or hormone antagonists (tamoxifen 20-40 mg/day; aminoglutethimide 250-500 mg/day with hydrocortisone 40-50 mg/day).
Participants included in the review
Breast cancer patients with bone metastases (measurable and/or evaluable) were included. Neither menopausal status nor level of hormonal receptors was a selection criterion.
Outcomes assessed in the review
Bone lesions were assessed by skeletal x-ray or bone scans every three months or after six weeks of treatment. Response to treatment was classified according to published criteria (see Other Publications of Related Interest), as follows: complete remission (complete clearance of all lesions, assessed with two examinations, four weeks apart), partial remission (partial decline of lytic lesions, recalcification of lytic lesions, or a reduction in density of shrinking lesions), stability (to be assessed after a minimum of eight weeks of treatment), or progression (increase in size of existing lesions, or appearance of new lesions). Most of the included studies used global response rates, i.e. complete/partial remission combined, and stability/progression combined.
How were decisions on the relevance of primary studies made?
The authors do not state how the papers were selected for the review, or how many of the authors performed the selection.