Osman Mohammed A
Clinical Oncology, General Organization for Teaching Hospitals, Institutes, Kasr Elaini Street, Cairo, Egypt.
J Obstet Gynaecol India. 2016 Oct;66(5):352-7. doi: 10.1007/s13224-015-0696-7. Epub 2015 May 16.
This meta-analysis was performed to compare the outcomes between NACT-S and RT for locally advanced cancer cervix. The primary end points were survival benefits.
The data sources for the search included medline, national library of medicine, and the embase search engines. Inclusion criteria included studies published between 2000 and 2012, and FIGO stages IB2 to IVA. Studies had to be properly randomized, prospective, or retrospective and only phase III. Further, the studies had to be with two arms, including one arm for neoadjuvant chemotherapy then-surgery (NACT-S), and the other arm for radiotherapy (RT).
Data were collected from 1171 patients enrolled in seven phase III trials. The 5-year PFS (progression-free survival) for NACT-S and RT were 62 and 45.5 %, respectively. The 5-year OS for NACT-S and RT were 66 and 49 %, respectively. NACT-S was associated with better late toxicities compared to RT.
NACT-S is a reasonable treatment option for locally advanced cancer cervix. It achieved better results than RT, especially for stages from IB2 to IIB.
本荟萃分析旨在比较局部晚期宫颈癌新辅助化疗后手术（NACT-S）与放疗（RT）的疗效。主要终点为生存获益。
检索的数据来源包括医学期刊数据库（Medline）、美国国立医学图书馆以及荷兰医学文摘数据库（Embase）搜索引擎。纳入标准包括2000年至2012年间发表的研究，以及国际妇产科联盟（FIGO）分期为IB2至IVA期的研究。研究必须为恰当随机、前瞻性或回顾性且仅为III期研究。此外，研究必须有两个治疗组，一组为新辅助化疗后手术（NACT-S），另一组为放疗（RT）。
从7项III期试验纳入的1171例患者中收集数据。NACT-S组和RT组的5年无进展生存率（PFS）分别为62%和45.5%。NACT-S组和RT组的5年总生存率（OS）分别为66%和49%。与RT相比，NACT-S的晚期毒性反应更小。
NACT-S是局部晚期宫颈癌的一种合理治疗选择。它比RT取得了更好的效果，尤其是对于IB2至IIB期。
