He Du, Duan Chunyan, Chen Jun, Lai Lin, Chen Jiaquan, Chen Dian
Department of Oncology, The Central Hospital of Enshi Autonomous Prefecture Enshi, Hubei Province, China.
Int J Clin Exp Med. 2015 Sep 15;8(9):14693-700. eCollection 2015.
To evaluate the safety and efficacy of the preoperative neoadjuvant chemotherapy for patients with cervical cancer.
A systematic literature search was conducted using the PubMed, EMBASE and Cochrane databases. Studies comparing combined neoadjuvant chemotherapy treatment (NACT)/radical surgery treatment (RST) with RST alone in patients with cervical cancer were eligible for inclusion.
Eight studies were finally included in this meta analysis, involving a total of 1302 patients. Meta analysis shows that NACT might have lower lymph node metastasis than RST [OR=0.57, 95% CI (0.41, 0.79), P=0.0008]. However, there are no differentiation between two groups in operation time [SMD=0.16, 95% CI (-0.08, 0.48), P=0.19], intraoperative estimated blood loss [SMD=0.20, 95% CI (-0.19, 0.58), P=0.48], intraoperative and postoperative complication rates [OR=1.33, 95% CI (0.45, 3.92), P=0.60], overall survival rate [OR=1.07, 95% CI (0.48, 2.41), P=0.86] and recurrence rate [OR=1.06, 95% CI (0.56, 2.03), P=0.85].
The safety and efficacy of two treatments are similarly. However, NACT can reduce the rate of lymph node metastasis, which is an independent risk factor for cervical cancer prognosis and may improve the prognosis of cervical cancer.
评估术前新辅助化疗对宫颈癌患者的安全性和疗效。
使用PubMed、EMBASE和Cochrane数据库进行系统的文献检索。比较新辅助化疗联合根治性手术治疗（NACT）/根治性手术治疗（RST）与单纯RST治疗宫颈癌患者的研究符合纳入标准。
本荟萃分析最终纳入8项研究，共涉及1302例患者。荟萃分析表明，NACT的淋巴结转移率可能低于RST [OR = 0.57，95% CI（0.41，0.79），P = 0.0008]。然而，两组在手术时间[SMD = 0.16，95% CI（-0.08，0.48），P = 0.19]、术中估计失血量[SMD = 0.20，95% CI（-0.19，0.58），P = 0.48]、术中和术后并发症发生率[OR = 1.33，95% CI（0.45，3.92），P = 0.60]、总生存率[OR = 1.07，95% CI（0.48，2.41），P = 0.86]和复发率[OR = 1.06，95% CI（0.56，2.03），P = 0.85]方面无差异。
两种治疗方法的安全性和疗效相似。然而，NACT可降低淋巴结转移率，而淋巴结转移率是宫颈癌预后的独立危险因素，可能改善宫颈癌的预后。
