高级检索
当前位置: 首页 > 详情页

Chemoradiotherapy alone vs. chemoradiotherapy and hysterectomy for locally advanced cervical cancer: A systematic review and updated meta-analysis

文献详情

资源类型:
WOS体系:
Pubmed体系:

收录情况: ◇ SCIE ◇ 预警期刊

机构: [1]The Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong 510006 [2]Department of Laboratory, Foshan Sanshui Hospital of Chinese Medicine, Foshan, Guangdong 528100 [3]Division of Laboratory Science, Affiliated Cancer Hospital & Institute of Guangzhou Medical University,Guangzhou, Guangdong 510095 [4]Department of Radiotherapy, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong 510006, P.R. China
出处:
ISSN:

关键词: cervical cancer radiotherapy surgery chemoradiotherapy survival recurrence

摘要:
The benefit of adjuvant hysterectomy after definitive concurrent chemoradiotherapy (CCRT) for locally-advanced cervical cancer (LACC) is controversial. The purpose of the present study was to systematically search the literature and perform a meta-analysis to compare overall survival (OS) and disease-free survival (DFS) between patients subjected to CCRT with hysterectomy and those who underwent CCRT alone. The PubMed, Scopus, Embase and Google scholar databases were searched. A meta-analysis to determine hazard ratios (HRs) and odds ratios (ORs) with meta-regression was performed for the following moderators: Disease stage, histology and proportion of radical hysterectomy. Data from 14 studies were included. The results indicated that patients who received CCRT with hysterectomy had significantly better OS (HR, 0.72; 95% CI, 0.56 to 0.91; I-2=19%; P=0.007) and DFS (HR, 0.72; 95% CI, 0.56 to 0.93; I-2=27%; P=0.01) than those treated with CCRT alone. However, in a subgroup analysis by study type, the results were significant only for retrospective studies but not for randomized controlled trials (RCTs). However, only 2 RCTs were included with small sample size, heterogeneity and low overall quality. Subgroup analyses based on the use of brachytherapy in the CCRT with hysterectomy group demonstrated no difference in OS and DFS between the two groups. Regarding the absolute numbers of death and recurrence events, no significant difference in mortality (OR, 0.91; 95% CI, 0.62 to 1.33; I-2=0%; P=0.64) was determined between the two groups, but a significantly reduced incidence of recurrence was observed in the CCRT with hysterectomy group (OR, 0.61; 95% CI, 0.47-0.79; I-2=29%; P=0.0002). The meta-regression results point to a significant influence of the proportion of stage II patients on OS. Despite the overall analysis indicating improved OS and DFS with the use of adjuvant hysterectomy after CCRT, subgroup analysis based on similar treatment protocols failed to demonstrate any significant benefit of hysterectomy in LACC. However, the results indicated that the recurrence rate may be higher in patients undergoing CCRT without hysterectomy. The limited quality of the studies included and selection bias from retrospective studies restrict the possibility to draw strong conclusions.

语种:
WOS:
PubmedID:
中科院(CAS)分区:
出版当年[2020]版:
大类 | 4 区 医学
小类 | 4 区 肿瘤学
最新[2025]版:
大类 | 4 区 医学
小类 | 4 区 肿瘤学
JCR分区:
出版当年[2019]版:
Q3 ONCOLOGY
最新[2023]版:
Q3 ONCOLOGY

影响因子: 最新[2023版] 最新五年平均 出版当年[2019版] 出版当年五年平均 出版前一年[2018版] 出版后一年[2020版]

第一作者:
第一作者机构: [1]The Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong 510006
通讯作者:
通讯机构: [4]Department of Radiotherapy, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong 510006, P.R. China [*1]Department of Radiotherapy, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, 55 Neihuanxi Road, Guangzhou, Guangdong 510006, P.R. China
推荐引用方式(GB/T 7714):
APA:
MLA:

资源点击量:2022 今日访问量:0 总访问量:648 更新日期:2024-07-01 建议使用谷歌、火狐浏览器 常见问题

版权所有©2020 广东省中医院 技术支持:重庆聚合科技有限公司 地址:广州市越秀区大德路111号