Suh Young Ju, Lee Dae Hyung, Lee Hee Joong, Lee Banghyun
Department of Biomedical Sciences, Inha University College of Medicine, Incheon 22332, Republic of Korea.
The Biostatistics Center, Inha University Hospital, Incheon 22332, Republic of Korea.
Cancers (Basel). 2025 Jan 11;17(2):223. doi: 10.3390/cancers17020223.
BACKGROUND/OBJECTIVES: Neoadjuvant chemotherapy followed by concurrent chemoradiation therapy (NACT + CCRT) and adjuvant chemotherapy following CCRT (CCRT + ACT) have inconsistent effects on the survival of women with locally advanced cervical cancer (LACC) compared to CCRT. Moreover, the effects of NACT + CCRT and CCRT + ACT have not been clearly compared. This study compared the effects of NACT + CCRT and CCRT + ACT on survival using a network meta-analysis to select the optimal treatment in women with LACC.
The PubMed, Medline, and Embase databases were searched, and six randomized controlled trials assessing the progression-free survival (PFS) and overall survival (OS) in women with newly diagnosed LACC treated with NACT + CCRT, CCRT + ACT, or CCRT alone (controls) were identified. A network meta-analysis was conducted.
Indirect comparisons showed no significant differences in PFS and OS between NACT + CCRT and CCRT + ACT. Direct comparisons also showed similar PFS and OS between NACT + CCRT and CCRT and between CCRT + ACT and CCRT. CCRT + ACT exhibited the highest surface under the cumulative ranking curve (SUCRA) value as a better treatment option for the PFS and OS (CCRT + ACT vs. NACT + CCRT vs. CCRT: 72% vs. 26.8% vs. 51.2% in PFS and 64.3% vs. 45.1% vs. 40.7% in OS).
In women with LACC, NACT + CCRT had no different effects on the PFS and OS compared to CCRT + ACT, despite the relatively higher SUCRA value observed for CCRT + ACT. Further studies are warranted to clarify the effects of these strategies.
背景/目的：与同步放化疗（CCRT）相比，新辅助化疗后序贯同步放化疗（NACT + CCRT）以及CCRT后序贯辅助化疗（CCRT + ACT）对局部晚期宫颈癌（LACC）女性患者生存率的影响并不一致。此外，NACT + CCRT与CCRT + ACT的效果尚未得到明确比较。本研究采用网状Meta分析比较NACT + CCRT和CCRT + ACT对生存率的影响，以选择LACC女性患者的最佳治疗方案。
检索PubMed、Medline和Embase数据库，识别出6项评估新诊断LACC女性患者接受NACT + CCRT、CCRT + ACT或单纯CCRT（对照组）治疗后的无进展生存期（PFS）和总生存期（OS）的随机对照试验。进行网状Meta分析。
间接比较显示，NACT + CCRT与CCRT + ACT之间的PFS和OS无显著差异。直接比较也显示，NACT + CCRT与CCRT之间以及CCRT + ACT与CCRT之间的PFS和OS相似。CCRT + ACT在累积排序曲线下面积（SUCRA）值方面表现最高，是PFS和OS的更好治疗选择（CCRT + ACT vs. NACT + CCRT vs. CCRT：PFS分别为72% vs. 26.8% vs. 51.2%，OS分别为64.3% vs. 45.1% vs. 40.7%）。
在LACC女性患者中，NACT + CCRT与CCRT + ACT相比，对PFS和OS的影响并无差异，尽管CCRT + ACT的SUCRA值相对较高。有必要进一步研究以阐明这些治疗策略的效果。
