Back to Search
Start Over
Survival outcomes of neoadjuvant chemotherapy-related strategies compared with concurrent chemoradiotherapy for locally advanced cervical cancer: a meta-analysis of randomized controlled trials.
- Source :
-
Archives of Gynecology & Obstetrics . Aug2021, Vol. 304 Issue 2, p485-493. 9p. - Publication Year :
- 2021
-
Abstract
- Purpose: The survival benefits of neoadjuvant chemotherapy (NAC) compared with those of concurrent chemoradiotherapy (CRT) for locally advanced cervical cancer (LACC) patients remain uncertain. Meta-analysis was used to compare NAC and CRT. Methods: A systematic search was performed up to 9 September 2020. Survival outcomes were analyzed based on event frequency or hazard ratios (HRs). Multilevel mixed-effects logistic regression was applied to analyze the effect of regimen variables on survival outcomes. Results: Analysis based on Cox regression showed that CRT was better than NAC + radical hysterectomy (RT) (HR 1.25; 95% confidence interval (CI)) 1.02–1.54; p = 0.034) in terms of overall survival (OS). According to multilevel mixed-effects model analysis comparing NAC + RT and CRT, LACC patients who used cisplatin instead of carboplatin had a better Progression-free survival (PFS) (odds ratio (OR) 1.54; 95% CI 1.08–2.20; p = 0.016). When NAC + CRT and CRT were compared, gemcitabine administration was associated with a decrease in PFS (OR 0.47; 95% CI 0.22–0.99; p = 0.047). Increased doses of cisplatin and paclitaxel were associated with survival improvement. Conclusion: Based on traditional meta-analysis, CRT was better than NAC + RT in terms of OS. Carboplatin instead of cisplatin as part of the NAC + RT strategy or gemcitabine use in NAC + CRT may not be a good choice. An increased total dosage of paclitaxel and/or cisplatin as part of NAC + CRT and CRT strategies may improve the survival outcome of LACC patients. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 09320067
- Volume :
- 304
- Issue :
- 2
- Database :
- Academic Search Index
- Journal :
- Archives of Gynecology & Obstetrics
- Publication Type :
- Academic Journal
- Accession number :
- 151387320
- Full Text :
- https://doi.org/10.1007/s00404-020-05916-5