Efficacy and safety of arterial interventional neoadjuvant chemotherapy for locally advanced cervical cancer in China:a Meta-analysis of randomized controlled trials and GRADE evidence score
10.12173/j.issn.2097-4922.202402031
- VernacularTitle:中国地区局限性晚期宫颈癌动脉介入新辅助化疗有效性与安全性:基于随机对照试验的Meta分析与GRADE证据评分
- Author:
Li ZHAO
1
;
Lei PENG
;
Shaohua ZHANG
;
Chunyan YANG
;
Manyun ZUO
;
Hongmei YANG
;
Jun BIE
Author Information
1. 首都医科大学附属北京安贞医院南充医院肿瘤科(四川南充 637000)
- Keywords:
Locally advanced cervical cancer;
Neoadjuvant chemotherapy;
Arterial interventional chemotherapy;
Intravenous chemotherapy;
Meta-analysis
- From:
China Pharmacist
2024;28(11):497-506
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the efficacy and safety of neoadjuvant arterial interventional chemotherapy(NAIC)and neoadjuvant intravenous chemotherapy(NIVC)for the treatment of locally advanced cervical cancer(LACC).Methods Randomized controlled trials(RCTs)which fit the theme were included by searching PubMed,Web of Science,Embase,CNKI,and Wanfang databases.After study quality assessment and data extraction,statistical analysis was performed using Stata 17.0,and outcome quality was assessed using the GRADE system.Results A total of 14 RCTs were included,with 1 063 LACC patients.The results of the Meta-analysis showed that NAIC and NIVC had a positive effect on the effectiveness indicators:complete response(CR)[RR=1.23,95％CI(0.91,1.67),P=0.174],partial response(PR)[RR=1.10,95％CI(0.86,1.20),P=0.874],total response(TR)[RR=1.10,95％CI(0.95,1.25),P=0.212],no change(NC)[RR=0.62,95％CI(0.33,1.16),P=0.137]and progressive disease(PD)[RR=1.43,95％CI(0.41,4.99),P=0.574]were not statistically significant.Differences in safety indicators:gastrointestinal reactions[RR=0.96,95％CI(0.76,1.23),P=0.755],hepatic and renal impairment[RR=0.71,95％CI(0.41,1.23),P=0.226]were not statistically significant.While in the incidence of myelosuppression[RR=0.62,95％CI(0.45,0.86),P=0.04],NAIC was superior to NIVC.In addition,the GRADE score results showed CR,PR,TR,and NC were high-quality evidence.Conclusion For LACC patients,the incidence of myelosuppression after treatment with NAIV is lower and safer than that with NIVC,and no significant difference was found between the two in terms of other efficacy and safety indicators.Clinicians should choose the appropriate neoadjuvant chemotherapy regimen based on a comprehensive assessment of the patient's actual condition.
