The efficacy and safety of neoadjuvant therapy followed by radical surgery versus definite chemoradiotherapy in the treatment of ⅠB2-ⅡB cervical cancer: a meta-analysis
10.3760/cma.j.issn.1004-4221.2019.06.007
- VernacularTitle:ⅠB2-ⅡB期宫颈癌新辅助治疗联合手术对比根治性同步放化疗疗效及安全性的Meta分析
- Author:
Ruilin XIE
1
,
2
;
Hui WANG
;
Shaodong TONG
;
Na LI
;
Qingwei QIN
;
Sheng WANG
;
Xue ZHAO
;
Zhaohui QI
;
Yuanhu YAO
Author Information
1. 徐州医科大学附属医院肿瘤放疗科 221002
2. 徐州医科大学研究生学院 221004
- Keywords:
Cervical neoplasm/surgery;
Cervical neoplasm/concurrent radiochemotherapy;
Prognosis;
Meta-analysis
- From:
Chinese Journal of Radiation Oncology
2019;28(6):428-431
- CountryChina
- Language:Chinese
-
Abstract:
Objective To systematically evaluate the efficacy and safety between neoadjuvant therapy followed by radical surgery and definite chemoradiotherapy in the treatment of Ⅰ B2-Ⅱ B cervical cancer.Methods A computerized search was performed in PubMed,Embase,Cochrane Library,Web of Science,CBM,Wanfang Data,CNKI and VIP to collect controlled clinical trials related to neoadjuvant therapy followed by radical surgery versus definite chemoradiotherapy in the treatment of ⅠB2-ⅡB cervical cancer.The meta-analysis of survival data and adverse events was performed by Review Manager 5.3 software.Results Nine controlled clinical trials involving 3 914 patients were included in this meta-analysis.There were no significant differences in overall survival (HR =0.83,P =0.31) and progression-free survival (HR=O.85,P=0.57) between two groups.Compared with patients receiving definite chemoradiotherapy,those in the neoadjuvant therapy group had a significantly lower risk of irradiation enteritis (RR=0.27,P=0.03),whereas no significant difference was observed in the risk of irradiation cystitis (RR=0.30,P=0.34) and grade ≥ 3 neutropenia (RR=0.77,P=0.46) between two groups.Conclusion In the treatment of locally advanced ⅠB2-Ⅱ B cervical cancer,two modalities show similar survival benefits.Although the neoadjuvant therapy group yields a lower incidence of irradiation enteritis,the incidence rates of irradiation cystitis and grade ≥3 neutropenia do not significantly differ between two groups.Neoadjuvant therapy followed by radical surgery is not superior to the standard therapeutic regime.
