Survival and toxicity in neoadjuvant chemotherapy plus surgery versus definitive chemoradiotherapy for cervical cancer: A systematic review and meta-analysis.

Abstract:

PURPOSE:Neoadjuvant chemotherapy followed by surgery (NACT + S) has been compared with definitive chemoradiothherapy (CRT) in randomized clinical trials (RCTs) in stage IB2, IIA and IIB cervical cancer (1994 Figo stage). Our aim was to evaluate efficacy and toxicity of NACT + S and CRT and identify differences in clinical outcomes and severe toxicity frequency. METHODS:The PRISMA statement was applied. Random-effects models were used. RESULTS:Two RCTs representing 1259 patients were identified. NACT + S was not associated with significant OS improvement compared with CRT, with HR of 1.08 (95% CI = 0.86-1.36; p = 0.51). The HR of relapse was 1.32 (95%CI = 1.07-1.62) in favor of CRT. Severe acute toxicity was lower in CRT group. CONCLUSION:This meta-analysis showed similar OS rates between treatment and CRT superiority over NACT + S in terms of DFS and severe acute toxicity. Impact on long term toxicity and quality of life remain to be proven.

journal_name

Cancer Treat Rev

journal_title

Cancer treatment reviews

authors

Marchetti C,Fagotti A,Tombolini V,Scambia G,De Felice F

doi

10.1016/j.ctrv.2019.101945

subject

Has Abstract

pub_date

2020-02-01 00:00:00

pages

101945

eissn

0305-7372

issn

1532-1967

pii

S0305-7372(19)30166-5

journal_volume

83

pub_type

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