Adjuvant platinum-based chemotherapy for early stage cervical cancer.


BACKGROUND:Patients with early stage cervical cancer (stages IA2, IB1 or IIA) with risk factors such as lymph node metastasis, lympho vascular space invasion, depth invasion of more than 10mm, microscopic parametrial invasion, non-squamous histology and positive surgical margins have a high risk of recurrence when compared to patients with early stage cervical cancer with no risk factors for recurrence. OBJECTIVES:To evaluate the effectiveness and safety of platinum-based adjuvant chemotherapy after radical hysterectomy, radiotherapy, or both in the treatment of early stage cervical cancer (stages IA2, IB1 or IIA). SEARCH STRATEGY:We searched the Cochrane Gynaecological Cancer Group Trials Register, The Cochrane Central Register of Controlled Trials (CENTRAL) on The Cochrane Library Issue 1, 2009), MEDLINE, EMBASE, LILACS, BIOLOGICAL ABSTRACTS and Cancerlit, the National Research Register and Clinical Trials register, with no language restriction. Abstracts of scientific meetings and the citation lists of included studies and other relevant publications were checked through hand searching and experts in the field were contacted to identify further reports of trials. SELECTION CRITERIA:Randomised controlled trials (RCTs) comparing adjuvant radiotherapy with adjuvant radiotherapy and cisplatin-chemotherapy after radical surgery for early stage cervix cancer were included. DATA COLLECTION AND ANALYSIS:Two review authors extracted data independently to assess whether the studies met the specified inclusion criteria. Any discrepancies were solved by a third and a forth review author. Meta-analysis was performed using a random effects model, with death and disease progression as outcomes. MAIN RESULTS:Three trials were included. Two trials enrolling 325 participants, of whom 297 (91%) were assessed and compared radiotherapy and chemotherapy with radiotherapy alone found that adjuvant chemotherapy significantly reduced the risk of death (hazard ratio (HR) = 0.56, 95% confidence interval (CI): 0.36 to 0.87) and disease progression (HR = 0.47, 95%CI: 0.30 to 0.74), with no heterogeneity between trials (I(2) = 0% for both meta-analyses). One trial assessing 71 participants compared chemotherapy followed by radiotherapy with radiotherapy alone and found no significant difference between the two groups (HR = 1.34; 95%CI: 0.24 to 7.66). The median follow up of patients varied from 29 to 42 months. AUTHORS' CONCLUSIONS:The addition of platinum-based chemotherapy to radiotherapy may offer clinical benefit in the adjuvant treatment of early stage cervical cancer with risk factors for recurrence. However, the evidence is limited because the selected studies were quantitatively and qualitatively limited, with small number of patients and limited period of follow-up.


Rosa DD,Medeiros LR,Edelweiss MI,Bozzetti MC,Pohlmann PR,Stein AT,Dickinson HO




Has Abstract


2009-07-08 00:00:00








  • Dressings for the prevention of surgical site infection.

    abstract:BACKGROUND:Surgical wounds (incisions) heal by primary intention when the wound edges are brought together and secured - often with sutures, staples, clips or glue. Wound dressings, usually applied after wound closure, provide physical support, protection from bacterial contamination and absorb exudate. Surgical site i...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审


    authors: Dumville JC,Gray TA,Walter CJ,Sharp CA,Page T

    更新日期:2014-09-01 00:00:00

  • Cleavage stage versus blastocyst stage embryo transfer in assisted reproductive technology.

    abstract:BACKGROUND:Advances in cell culture media have led to a shift in in vitro fertilization (IVF) practice from early cleavage embryo transfer to blastocyst stage transfer. The rationale for blastocyst culture is to improve both uterine and embryonic synchronicity and enable self selection of viable embryos thus resulting ...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审


    authors: Glujovsky D,Blake D,Farquhar C,Bardach A

    更新日期:2012-07-11 00:00:00

  • Interventions for treating oral mucositis for patients with cancer receiving treatment.

    abstract:BACKGROUND:Treatment of cancer is increasingly effective but associated with short and long term side effects. Oral side effects, including oral mucositis (mouth ulceration), remain a major source of illness despite the use of a variety of agents to treat them. OBJECTIVES:To assess the effectiveness of interventions f...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审


    authors: Clarkson JE,Worthington HV,Furness S,McCabe M,Khalid T,Meyer S

    更新日期:2010-08-04 00:00:00

  • Mefloquine for preventing malaria during travel to endemic areas.

    abstract:BACKGROUND:Mefloquine is one of four antimalarial agents commonly recommended for preventing malaria in travellers to malaria-endemic areas. Despite its high efficacy, there is controversy about its psychological side effects. OBJECTIVES:To summarize the efficacy and safety of mefloquine used as prophylaxis for malari...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审


    authors: Tickell-Painter M,Maayan N,Saunders R,Pace C,Sinclair D

    更新日期:2017-10-30 00:00:00

  • Band ligation versus beta-blockers for primary prophylaxis of oesophageal variceal bleeding in children with chronic liver disease or portal vein thrombosis.

    abstract:BACKGROUND:Portal hypertension commonly accompanies advanced liver disease and often gives rise to life-threatening complications, including haemorrhage from oesophageal and gastrointestinal varices. Variceal haemorrhage commonly occurs in children with chronic liver disease or portal vein obstruction. Prevention is th...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章


    authors: Gana JC,Cifuentes LI,Gattini D,Villarroel Del Pino LA,Peña A,Torres-Robles R

    更新日期:2019-09-24 00:00:00

  • Sedatives for opiate withdrawal in newborn infants.

    abstract:BACKGROUND:Neonatal abstinence syndrome (NAS) due to opiate withdrawal may result in disruption of the mother-infant relationship, sleep-wake abnormalities, feeding difficulties, weight loss and seizures. Treatments used to ameliorate symptoms and reduce morbidity include opiates, sedatives and non-pharmacological trea...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审


    authors: Osborn DA,Jeffery HE,Cole MJ

    更新日期:2005-07-20 00:00:00

  • Interventions for treating headlice.

    abstract:BACKGROUND:Infection with head lice is a widespread condition in developed and developing countries. Infection occurs most commonly in children, but also affects adults. If left untreated the condition can become intensely irritating and skin infections may occur if the bites are scratched. OBJECTIVES:The aim of this ...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审


    authors: Dodd CS

    更新日期:2001-01-01 00:00:00

  • Antenatal breastfeeding education for increasing breastfeeding duration.

    abstract:BACKGROUND:Breastfeeding (BF) is well recognised as the best food for infants. The impact of antenatal BF education on the duration of BF has not been evaluated. OBJECTIVES:To evaluate the effectiveness of antenatal BF education for increasing BF initiation and duration. SEARCH METHODS:We searched the Cochrane Pregna...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审


    authors: Lumbiganon P,Martis R,Laopaiboon M,Festin MR,Ho JJ,Hakimi M

    更新日期:2011-11-09 00:00:00

  • Acupuncture for insomnia.

    abstract:BACKGROUND:Although conventional non-pharmacological and pharmacological treatments for insomnia are effective in many people, alternative therapies such as acupuncture are still widely practiced. However, it remains unclear whether the existing evidence is rigorous enough to support its use. OBJECTIVES:To determine t...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审


    authors: Cheuk DK,Yeung WF,Chung KF,Wong V

    更新日期:2007-07-18 00:00:00

  • Antiglucocorticoid treatments for mood disorders.

    abstract:BACKGROUND:Antiglucocorticoids may have antidepressant effects and have been reported to be efficacious in the treatment of severe psychiatric disorders. The efficacy and safety of antiglucocorticoid treatments for mood disorders is the subject of this systematic review. OBJECTIVES:To compare the efficacy and safety o...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审


    authors: Gallagher P,Malik N,Newham J,Young AH,Ferrier IN,Mackin P

    更新日期:2008-01-23 00:00:00

  • Ultra-radical (extensive) surgery versus standard surgery for the primary cytoreduction of advanced epithelial ovarian cancer.

    abstract:BACKGROUND:Ovarian cancer is the sixth most common cancer among women and the leading cause of death in women with gynaecological malignancies. Opinions differ regarding the role of ultra-radical (extensive) cytoreductive surgery in ovarian cancer treatment.  OBJECTIVES:To evaluate the effectiveness and morbidity asso...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审


    authors: Ang C,Chan KK,Bryant A,Naik R,Dickinson HO

    更新日期:2011-04-13 00:00:00

  • Preoperative bathing or showering with skin antiseptics to prevent surgical site infection.

    abstract:BACKGROUND:Surgical site infections (SSIs) are wound infections that occur after invasive (surgical) procedures. Preoperative bathing or showering with an antiseptic skin wash product is a well-accepted procedure for reducing skin bacteria (microflora). It is less clear whether reducing skin microflora leads to a lower...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审


    authors: Webster J,Osborne S

    更新日期:2012-09-12 00:00:00

  • Medical interventions for primary open angle glaucoma and ocular hypertension.

    abstract:BACKGROUND:Primary open angle glaucoma (POAG) is a progressive optic neuropathy with an elevated intraocular pressure (IOP), where the optic nerve head becomes pathologically excavated and the visual field (VF) is characteristically altered. Ocular hypertension (OHT) is a condition with elevated IOP but without discern...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审


    authors: Vass C,Hirn C,Sycha T,Findl O,Bauer P,Schmetterer L

    更新日期:2007-10-17 00:00:00

  • Platinum-containing regimens for metastatic breast cancer.

    abstract:BACKGROUND:Studies have reported high tumour response rates for platinum-containing regimens in the treatment of women with metastatic breast cancer. Most of these studies were conducted prior to the 'intrinsic subtype' era, and did not specifically focus on metastatic triple-negative breast cancers (mTNBCs). OBJECTIV...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审


    authors: Egger SJ,Willson ML,Morgan J,Walker HS,Carrick S,Ghersi D,Wilcken N

    更新日期:2017-06-23 00:00:00

  • Methadone maintenance therapy versus no opioid replacement therapy for opioid dependence.

    abstract:BACKGROUND:Methadone maintenance was the first widely used form of opioid replacement therapy developed to treat heroin dependence, and it remains the best-researched treatment for this problem. Despite the widespread use of methadone in maintenance treatment for opioid dependence in many countries, it is a controversi...

    journal_title:The Cochrane database of systematic reviews

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    authors: Mattick RP,Breen C,Kimber J,Davoli M

    更新日期:2002-01-01 00:00:00

  • Exercises for mechanical neck disorders.

    abstract:BACKGROUND:Neck disorders are common, disabling and costly. The effectiveness of exercise as a physiotherapy intervention remains unclear. OBJECTIVES:To improve pain, disability, function, patient satisfaction, quality of life and global perceived effect in adults with neck pain. SEARCH METHODS:Computerized searches ...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审


    authors: Kay TM,Gross A,Goldsmith CH,Rutherford S,Voth S,Hoving JL,Brønfort G,Santaguida PL

    更新日期:2012-08-15 00:00:00

  • Effectiveness of intermediate care in nursing-led in-patient units.

    abstract:BACKGROUND:The Nursing led inpatient Unit (NLU) is one of a range of services that have been considered in order to manage more successfully the transition between hospital and home for patients with extended recovery times. OBJECTIVES:To determine whether nursing-led inpatient units are effective in preparing patient...

    journal_title:The Cochrane database of systematic reviews

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    authors: Griffiths PD,Edwards MH,Forbes A,Harris RL,Ritchie G

    更新日期:2004-10-18 00:00:00

  • Physical training for asthma.

    abstract:BACKGROUND:Physical training programmes have been designed for asthmatic subjects with the aim of improving physical fitness, neuromuscular coordination and self-confidence. Habitual physical activity increases physical fitness and lowers ventilation during mild and moderate exercise thereby reducing the likelihood of ...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审


    authors: Ram FS,Robinson SM,Black PN,Picot J

    更新日期:2005-10-19 00:00:00

  • Perioperative ketamine for acute postoperative pain.

    abstract:BACKGROUND:Postoperative pain management is often limited by adverse effects such as nausea and vomiting. Adjuvant treatment with an inexpensive opioid-sparing drug such as ketamine may be of value in giving better analgesia with fewer adverse effects. OBJECTIVES:To evaluate the effectiveness and tolerability of ketam...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审


    authors: Bell RF,Dahl JB,Moore RA,Kalso E

    更新日期:2006-01-25 00:00:00

  • Botulinum toxin for myofascial pain syndromes in adults.

    abstract:BACKGROUND:Myofascial pain syndrome (MPS) is a regional muscular pain syndrome characterised by the presence of trigger points, which are painful points in one or more muscles. The pain can be felt at the site where the trigger point is located or it can be felt away from that place when the muscle is pressed (referred...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审


    authors: Soares A,Andriolo RB,Atallah AN,da Silva EM

    更新日期:2012-04-18 00:00:00

  • Anti-IgE therapy for allergic bronchopulmonary aspergillosis in people with cystic fibrosis.

    abstract:BACKGROUND:Cystic fibrosis is an autosomal recessive multisystem disorder with an approximate prevalence of 1 in 3500 live births. Allergic bronchopulmonary aspergillosis is a lung disease caused by aspergillus-induced hypersensitivity with a prevalence of 2% to 15% in people with cystic fibrosis. The mainstay of treat...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审


    authors: Jat KR,Walia DK,Khairwa A

    更新日期:2013-09-17 00:00:00

  • Factors influencing the uptake and use of nicotine replacement therapy and e-cigarettes in pregnant women who smoke: a qualitative evidence synthesis.

    abstract:BACKGROUND:Nicotine replacement therapy (NRT) delivers nicotine without the toxic chemicals present in tobacco smoke. It is an effective smoking cessation aid in non-pregnant smokers, but there is less evidence of effectiveness in pregnancy. Systematic review evidence suggests that pregnant women do not adhere to NRT a...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章


    authors: Campbell K,Coleman-Haynes T,Bowker K,Cooper SE,Connelly S,Coleman T

    更新日期:2020-05-22 00:00:00

  • Excisional surgery versus ablative surgery for ovarian endometriomata.

    abstract:BACKGROUND:Endometriomata are endometriotic deposits within the ovary. The surgical management of these blood filled cysts is controversial. The laparoscopic approach to the management of endometriomata is favoured for as it offers the advantage of a shorter hospital stay, faster patient recovery and decreased hospital...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审


    authors: Hart RJ,Hickey M,Maouris P,Buckett W,Garry R

    更新日期:2005-07-20 00:00:00

  • Psychosocial interventions to reduce alcohol consumption in concurrent problem alcohol and illicit drug users.

    abstract:BACKGROUND:Problem alcohol use is common among illicit drug users and is associated with adverse health outcomes. It is also an important factor in poor prognosis among drug users with hepatitis C virus (HCV) as it impacts on progression to hepatic cirrhosis or opiate overdose in opioid users. OBJECTIVES:To assess the...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审


    authors: Klimas J,Field CA,Cullen W,O'Gorman CS,Glynn LG,Keenan E,Saunders J,Bury G,Dunne C

    更新日期:2012-11-14 00:00:00

  • Chemotherapy for high-grade glioma.

    abstract:BACKGROUND:Trials on the effect of systemic chemotherapy on survival and recurrence in adults with high-grade glioma have had inconclusive results. We undertook a systematic review and meta-analysis to assess the effects of such treatment on survival and recurrence. OBJECTIVES:To compare radiotherapy plus chemotherapy...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审


    authors: Glioma Meta-Analysis Trialists (GMT) Group.

    更新日期:2002-01-01 00:00:00

  • WITHDRAWN: Drugs for preventing postoperative nausea and vomiting.

    abstract:BACKGROUND:Drugs can prevent postoperative nausea and vomiting, but their relative efficacies and side effects have not been compared within one systematic review. OBJECTIVES:The objective of this review was to assess the prevention of postoperative nausea and vomiting by drugs and the development of any side effects....

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审


    authors: Carlisle J,Stevenson CA

    更新日期:2017-07-17 00:00:00

  • Early erythropoiesis-stimulating agents in preterm or low birth weight infants.

    abstract:BACKGROUND:Preterm infants have low plasma levels of erythropoietin (EPO), providing a rationale for the use of erythropoiesis-stimulating agents (ESAs) to prevent or treat anaemia and to provide neuro protection and protection against necrotising enterocolitis (NEC). Darbepoetin (Darbe) and EPO are currently available...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析


    authors: Ohlsson A,Aher SM

    更新日期:2020-02-11 00:00:00

  • Exercise for preventing and treating osteoporosis in postmenopausal women.

    abstract:BACKGROUND:Osteoporosis is a condition resulting in an increased risk of skeletal fractures due to a reduction in the density of bone tissue. Treatment of osteoporosis typically involves the use of pharmacological agents. In general it is thought that disuse (prolonged periods of inactivity) and unloading of the skelet...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审


    authors: Howe TE,Shea B,Dawson LJ,Downie F,Murray A,Ross C,Harbour RT,Caldwell LM,Creed G

    更新日期:2011-07-06 00:00:00

  • Ganoderma lucidum mushroom for the treatment of cardiovascular risk factors.

    abstract:BACKGROUND:Ganoderma lucidum (also known as lingzhi or reishi) is a mushroom that has been consumed for its broad medicinal properties in Asia for over 2000 years. G lucidum is becoming increasingly popular in western countries as a complementary medicine for cardiovascular health. OBJECTIVES:To evaluate the effective...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审


    authors: Klupp NL,Chang D,Hawke F,Kiat H,Cao H,Grant SJ,Bensoussan A

    更新日期:2015-02-17 00:00:00

  • Environmental and behavioural interventions for reducing physical activity limitation in community-dwelling visually impaired older people.

    abstract:BACKGROUND:Impairment of vision is associated with a loss of function in activities of daily living. Avoidance of physical activity and consequent reduced functional capacity is common in older people with visual impairment and an important risk factor for falls. Indeed, the rate of falls and fractures is higher in old...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审


    authors: Skelton DA,Howe TE,Ballinger C,Neil F,Palmer S,Gray L

    更新日期:2013-06-05 00:00:00