Liu Cheng, Cui Ran, Li Miaomiao, Feng Ying, Bai Huimin, Zhang Zhenyu
Department of Obstetrics and Gynecology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
Evid Based Complement Alternat Med. 2020 Feb 25;2020:5023405. doi: 10.1155/2020/5023405. eCollection 2020.
The aim of this study was to evaluate the safety and efficacy of intra-arterial versus intravenous neoadjuvant chemotherapy for the management of patients with locally advanced cervical cancer.
The PubMed, EMBASE, PMC, Web of Science, and Cochrane databases were searched to identify correlational studies published in English. Prospective controlled studies that evaluated the treatment effect of intra-arterial neoadjuvant chemotherapy or intravenous neoadjuvant chemotherapy in patients with locally advanced cervical cancer were pooled for a meta-analysis.
A total of three eligible studies with 112 patients with locally advanced cervical cancer were eventually included in this analysis. The baseline regimen of neoadjuvant chemotherapy was platinum-based chemotherapy. The total clinical response rate was 71.4%, and the overall pathological complete response (CR) rate was 11.5%. The grade 3/4 toxicity rate was 27.2%. In the intra-arterial group, the response rate was 83.1% (CR, 22.0%; partial response (PR), 61.0%), which was significantly higher than 58.5% (CR, 11.3%; PR, 47.2%) in the intravenous group (=0.01). The pathological CR rate was 15.5% in the intra-arterial group, which was higher than 6.5% in the intravenous group. The grade 3/4 toxicity rate was 17.2% in the intra-arterial group, which was higher than the rate of 13.8% in the intravenous group.
Platinum-based neoadjuvant chemotherapy was well tolerated in patients with locally advanced cervical cancer and showed moderate response activity. Compared to intravenous neoadjuvant chemotherapy, intra-arterial neoadjuvant chemotherapy had an evident advantage in terms of the clinical response while maintaining a similar toxicity rate. The clinical efficacy of intra-arterial neoadjuvant chemotherapy deserves further evaluation.
本研究旨在评估动脉内与静脉内新辅助化疗治疗局部晚期宫颈癌患者的安全性和疗效。
检索PubMed、EMBASE、PMC、Web of Science和Cochrane数据库，以识别用英文发表的相关研究。纳入评估动脉内新辅助化疗或静脉内新辅助化疗对局部晚期宫颈癌患者治疗效果的前瞻性对照研究，进行荟萃分析。
本分析最终纳入了3项符合条件的研究，共112例局部晚期宫颈癌患者。新辅助化疗的基线方案为铂类化疗。总临床缓解率为71.4%，总体病理完全缓解（CR）率为11.5%。3/4级毒性率为27.2%。动脉内组的缓解率为83.1%（CR，22.0%；部分缓解（PR），61.0%），显著高于静脉内组的58.5%（CR，11.3%；PR，47.2%）（P = 0.01）。动脉内组的病理CR率为15.5%，高于静脉内组的6.5%。动脉内组的3/4级毒性率为17.2%，高于静脉内组的13.8%。
铂类新辅助化疗在局部晚期宫颈癌患者中耐受性良好，并显示出适度的缓解活性。与静脉内新辅助化疗相比，动脉内新辅助化疗在临床缓解方面具有明显优势，同时毒性率相似。动脉内新辅助化疗的临床疗效值得进一步评估。
