Deng Ting, Gu Shequn, Wu Jianchi, Yu Yuanyi
Department of Gynecology, The First People's Hospital of Chenzhou City, No.102, Luojiajing, Beihu District, Chenzhou City, 423000, Hunan Province, China.
Department of Oncology, The First People's Hospital of Chenzhou City, Chenzhou City, 423000, Hunan Province, China.
Infect Agent Cancer. 2022 Apr 19;17(1):18. doi: 10.1186/s13027-022-00433-3.
To compare the survival outcomes and adverse events of patients with locally advanced cervical cancer (LACC) who received platinum monotherapy with concurrent chemoradiation therapy (CCRT) versus platinum-based dual drug therapy with CCRT.
All relevant literature was screened form the PubMed, EMBASE, Web of Science, The Cochrane Library and other databases from their establishment to October 2020. The main endpoint indicators included overall survival (OS) and progression-free survival (PFS). Grade 3 and above adverse events induced by chemotherapy were also compared.
This study involved 17 literature and 4,106 patients. There were 2,066 patients treated with CCRT with platinum-based dual drug therapy and 2,040 patients received CCRT with platinum monotherapy. Meta-analysis results showed that, compared to CCRT with platinum monotherapy, OS (HR = 0.68, 95% CI 0.58-0.79) and PFS (HR = 0.67, 95% CI 0.58-0.77) of LACC patients were significantly improved by CCRT with platinum-based dual drug therapy. In addition, CCRT with platinum-based dual drug therapy led to more adverse reactions such as neutropenia (OR = 4.92, 95% CI 3.55-6.84), anemia (OR = 1.99, 95% CI 1.17-3.39), diarrhea (OR = 1.70, 95% CI 1.30-2.22), leukopenia (OR = 2.42, 95%CI 1.84-3.17), thrombocytopenia (OR = 2.87, 95%CI 1.44-5.72), etc. CONCLUSION: CCRT with platinum-based dual drug therapy improved OS and PFS of LACC patients relative to the CCRT with platinum monotherapy. But it also increased the adverse reactions caused by multiple chemotherapy drugs. Thus, it is crucial to select a proper chemotherapy regimen based on the actual tolerance of patients in clinical practice.
比较接受铂类单药同步放化疗（CCRT）与铂类双药同步放化疗的局部晚期宫颈癌（LACC）患者的生存结局和不良事件。
从PubMed、EMBASE、Web of Science、Cochrane图书馆及其他数据库自建库至2020年10月筛选所有相关文献。主要终点指标包括总生存期（OS）和无进展生存期（PFS）。同时比较化疗引起的3级及以上不良事件。
本研究纳入17篇文献，共4106例患者。其中2066例患者接受铂类双药同步放化疗，2040例患者接受铂类单药同步放化疗。Meta分析结果显示，与铂类单药同步放化疗相比，铂类双药同步放化疗可显著改善LACC患者的OS（HR = 0.68，95%CI 0.58 - 0.79）和PFS（HR = 0.67，95%CI 0.58 - 0.77）。此外，铂类双药同步放化疗导致更多不良反应，如中性粒细胞减少（OR = 4.92，95%CI 3.55 - 6.84）、贫血（OR = 1.99，95%CI 1.17 - 3.39）、腹泻（OR = 1.70，95%CI 1.30 - 2.22）、白细胞减少（OR = 2.42，95%CI 1.84 - 3.17）、血小板减少（OR = 2.87，95%CI 1.44 - 5.72）等。结论：与铂类单药同步放化疗相比，铂类双药同步放化疗可改善LACC患者的OS和PFS。但也增加了多种化疗药物引起的不良反应。因此，在临床实践中根据患者的实际耐受性选择合适的化疗方案至关重要。
