Neoadjuvant chemotherapy plus surgery versus concurrent chemoradiotherapy in stage IB2-IIB cervical cancer: A systematic review and meta-analysis

English version

Autoři: Wen Zou ^aff001; Yiyu Han ^aff001; Yang Zhang ^aff001; Chunhong Hu ^aff001; Yeqian Feng ^aff001; Haixia Zhang ^aff001; Jingjing Wang ^aff001
Působiště autorů: Department of Oncology, The Second Xiangya Hospital of Central South University, Changsha, Hunan, People’s Republic of China ^aff001
Vyšlo v časopise: PLoS ONE 14(11)
Kategorie: Research Article
prolekare.web.journal.doi_sk: https://doi.org/10.1371/journal.pone.0225264

Souhrn

The optimal treatment strategy for stage IB2-IIB cervical cancer is controversial. This systematic review with meta-analysis evaluated the efficacy of concomitant chemoradiotherapy (CCRT) and neoadjuvant chemotherapy followed by radical surgery (NACT+S). Studies that evaluated NACT+S versus CCRT for patients with Federation of Gynecology and Obstetrics stage IB2-IIB cervical cancer were searched in MEDLINE, EMBASE, and the Cochrane Library database. Hazard ratios (HRs) with their respective 95% confidence intervals (CIs) were calculated using a random-effects model. Toxicity was also evaluated. Six qualified retrospective studies and one randomized controlled trial (2270 patients) were included in this review. The results suggested that compared with CCRT, NACT+S did not improve overall survival in all patients (HR 0.73, 95% CI 0.52–1.02) or stage IIB patients (HR 0.83, 95% CI 0.61–1.15). NACT+S did not improve disease-free survival (DFS) in stage IIB patients (HR 1.10, 95% CI 0.70–1.71). In the analysis of DFS in all patients, a high degree of heterogeneity was detected (I² = 84%). Sensitivity analysis that eliminated these heterogeneous data suggested that CCRT could improve DFS over NACT+S (HR 1.47, 95% CI 1.12–1.93). Diarrhea and rectal and bladder complications occurred at a lower rate in the NACT+S group than in the CCRT group. NACT+S had no survival advantage for patients with stage IB2-IIB cervical cancer compared with CCRT but was associated with fewer side effects. Further prospective studies with a larger sample size of treatment protocols for locally advanced cervical cancer are needed.

Klíčová slova:

Cancer treatment – Cervical cancer – Surgical and invasive medical procedures – Toxicity – Cancer chemotherapy – Radiation therapy – Surgical oncology

Zdroje

1. Vaccarella S, Laversanne M, Ferlay J, and Bray F. Cervical cancer in Africa, Latin America and the Caribbean and Asia: Regional inequalities and changing trends. INT J CANCER. 2017;141:1997–2001. doi: 10.1002/ijc.30901 28734013

2. Quinn MA, Benedet JL, Odicino F, Maisonneuve P, Beller U, Creasman WT, et al. Carcinoma of the Cervix Uteri. Int J Gynaecol Obstet. 2006;95 Suppl 1:S43–103.

3. Rose PG. Chemoradiotherapy for cervical cancer. EUR J CANCER. 2002;38:270–278. doi: 10.1016/s0959-8049(01)00352-5 11803143

4. Yang S, Gao Y, and Sun J, Xia B, Liu T, Zhang H, et al. Neoadjuvant chemotherapy followed by radical surgery as an alternative treatment to concurrent chemoradiotherapy for young premenopausal patients with FIGO stage IIB squamous cervical carcinoma. Tumour Biol. 2015;36:4349–4356. doi: 10.1007/s13277-015-3074-2 25874487

5. Gupta S, Maheshwari A, and Parab P, Mahantshetty U, Hawaldar R, Sastri Chopra S, et al. Neoadjuvant Chemotherapy Followed by Radical Surgery Versus Concomitant Chemotherapy and Radiotherapy in Patients With Stage IB2, IIA, or IIB Squamous Cervical Cancer: A Randomized Controlled Trial. J CLIN ONCOL. 2018;36:1548–1555. doi: 10.1200/JCO.2017.75.9985 29432076

6. Frei ER. Clinical cancer research: an embattled species. CANCER-AM CANCER SOC. 1982;50:1979–92.

7. Robova H, Rob L, Halaska MJ, Pluta M, and Skapa P. Review of neoadjuvant chemotherapy and trachelectomy: which cervical cancer patients would be suitable for neoadjuvant chemotherapy followed by fertility-sparing surgery? CURR ONCOL REP. 2015;17:446. doi: 10.1007/s11912-015-0446-0 25893880

8. Angioli R, Plotti F, and Montera R, Aloisi A, Luvero D, Capriglione S, et al. Neoadjuvant chemotherapy plus radical surgery followed by chemotherapy in locally advanced cervical cancer. GYNECOL ONCOL. 2012;127:290–6. doi: 10.1016/j.ygyno.2012.07.104 22819938

9. Peng YH, Wang XX, Zhu JS, and Gao L. Neo-adjuvant chemotherapy plus surgery versus surgery alone for cervical cancer: Meta-analysis of randomized controlled trials. J Obstet Gynaecol Res. 2016;42:128–135. doi: 10.1111/jog.12896 26807961

10. Kim HS, Sardi JE, and Katsumata N, Ryu HS, Nam JH, Chung HH, et al. Efficacy of neoadjuvant chemotherapy in patients with FIGO stage IB1 to IIA cervical cancer: an international collaborative meta-analysis. Eur J Surg Oncol. 2013;39:115–24. doi: 10.1016/j.ejso.2012.09.003 23084091

11. Iwata T, Miyauchi A, and Suga Y, Nishio H, Nakamura M, Ohno A, et al. Neoadjuvant chemotherapy for locally advanced cervical cancer. Chin J Cancer Res. 2016;28:235–240. doi: 10.21147/j.issn.1000-9604.2016.02.13 27199522

12. Yang Z, Chen D, and Zhang J, Yao D, Gao K, Wang H, et al. The efficacy and safety of neoadjuvant chemotherapy in the treatment of locally advanced cervical cancer: A randomized multicenter study. GYNECOL ONCOL. 2016;141:231–239. doi: 10.1016/j.ygyno.2015.06.027 26115978

13. Parmar MK, Torri V and Stewart L. Extracting summary statistics to perform meta-analyses of the published literature for survival endpoints. STAT MED. 1998;17:2815–2834. doi: 10.1002/(sici)1097-0258(19981230)17:24<2815::aid-sim110>3.0.co;2-8 9921604

14. Tierney JF, Stewart LA, Ghersi D, Burdett S, and Sydes MR. Practical methods for incorporating summary time-to-event data into meta-analysis. TRIALS. 2007;8:16. doi: 10.1186/1745-6215-8-16 17555582

15. Wells G, Shea B OCD, Peterson J, Welch V, and Losos M. The Newcastle–Ottawa Scale (NOS) for assessing the quality if nonrandomized studies in meta-analyses.; 2009, p. Available from: http://www.ohrica/programs/clinical_epidemiology/oxfordasp.

16. DerSimonian R and Laird N. Meta-analysis in clinical trials. Control Clin Trials. 1986;7:177–188. doi: 10.1016/0197-2456(86)90046-2 3802833

17. Higgins JP, Thompson SG, Deeks JJ, and Altman DG. Measuring inconsistency in meta-analyses. BMJ. 2003;327:557–560. doi: 10.1136/bmj.327.7414.557 12958120

18. Egger M, Davey SG, Schneider M, and Minder C. Bias in meta-analysis detected by a simple, graphical test. BMJ. 1997;315:629–634. doi: 10.1136/bmj.315.7109.629 9310563

19. Hsieh HY, Huang JW, Lu CH, Lin JC, and Wang L. Definite chemoradiotherapy is a competent treatment option in FIGO stage IB2 cervical cancer compared with radical surgery +/- neoadjuvant chemotherapy. J FORMOS MED ASSOC. 2019;118:99–108. doi: 10.1016/j.jfma.2018.01.015 29429800

20. Guo L, Liu X, and Wang L, Sun H, Huang K, Li X, et al. Outcome of international Federation of gynecology and obstetrics stage IIb cervical cancer from 2003 to 2012: an evaluation of treatments and prognosis: a retrospective study. INT J GYNECOL CANCER. 2015;25:910–918. doi: 10.1097/IGC.0000000000000430 25867278

21. Yin M, Zhao F, and Lou G, Zhang H, Sun M, Li C, et al. The long-term efficacy of neoadjuvant chemotherapy followed by radical hysterectomy compared with radical surgery alone or concurrent chemoradiotherapy on locally advanced-stage cervical cancer. INT J GYNECOL CANCER. 2011;21:92–99. doi: 10.1111/IGC.0b013e3181fe8b6e 21330834

22. Ryu HS, Kang SB, Kim KT, Chang KH, Kim JW, and Kim JH. Efficacy of different types of treatment in FIGO stage IB2 cervical cancer in Korea: results of a multicenter retrospective Korean study (KGOG-1005). INT J GYNECOL CANCER. 2007;17:132–136. doi: 10.1111/j.1525-1438.2007.00803.x 17291243

23. Lee DW, Lee KH, Lee JW, Park ST, Park JS, and Lee HN. Is neoadjuvant chemotherapy followed by radical surgery more effective than radiation therapy for stage IIB cervical cancer? INT J GYNECOL CANCER. 2013;23:1303–1310. doi: 10.1097/IGC.0b013e31829da105 23881101

24. Koh WJ, Abu-Rustum NR, and Bean S, Bradley K, Campos SM, Cho KR, et al. Cervical Cancer, Version 3.2019, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw. 2019;17:64–84. doi: 10.6004/jnccn.2019.0001 30659131

25. Kokka F, Bryant A, Brockbank E, Powell M, and Oram D. Hysterectomy with radiotherapy or chemotherapy or both for women with locally advanced cervical cancer. Cochrane Database Syst Rev. 2015:D10260.

26. Benedetti-Panici P, Greggi S, and Colombo A, Amoroso M, Smaniotto D, Giannarelli D, et al. Neoadjuvant chemotherapy and radical surgery versus exclusive radiotherapy in locally advanced squamous cell cervical cancer: results from the Italian multicenter randomized study. J CLIN ONCOL. 2002;20:179–188. doi: 10.1200/JCO.2002.20.1.179 11773168

27. Lee J, Kim TH, Kim GE, Keum KC, and Kim YB. Neoadjuvant chemotherapy followed by surgery has no therapeutic advantages over concurrent chemoradiotherapy in International Federation of Gynecology and Obstetrics stage IB-IIB cervical cancer. J GYNECOL ONCOL. 2016;27:e52. doi: 10.3802/jgo.2016.27.e52 27329200

28. Singh S, Mishra A, and Goel V, Talwar V., Raina S., Dodagaudar C., et al. 2727 Neo-adjuvant chemotherapy followed by surgery vs definitive chemo radiation as treatment for localized carcinoma cervix. EUR J CANCER. 2015;51:S539–540.

29. İE E, A D, U S, V E, A Ö, and Y Y. The Comparison of Four Different Treatment Modalities in Bulky Stage Ib ve IIa Cervix Cancers. Turk J Obstet Gynecol. 2013;10:42–47.

30. Khan N. 15th Biennial Meeting of the International Gynecologic Cancer Society. International Journal of Gynecologic Cancer. 2014;24:1.

31. Jung PS, Kim DY, and Lee SW, Park JY, Suh DS, Kim JH, et al. Clinical Role of Adjuvant Chemotherapy after Radical Hysterectomy for FIGO Stage IB-IIA Cervical Cancer: Comparison with Adjuvant RT/CCRT Using Inverse-Probability-of-Treatment Weighting. PLOS ONE. 2015;10:e132298.

32. He Y, Zhao Q, and Geng YN, Yang SL, Li XM, Finas D, et al. Analysis of short-term efficacy as defined by RECIST and pathological response of neoadjuvant chemotherapy comprised paclitaxel and cisplatin followed by radical surgery in patients with locally advanced cervical cancer: A prospective observational study. Medicine (Baltimore). 2018;97:e10913. doi: 10.1097/MD.0000000000010913 29851821

33. Kokka F, Bryant A, Brockbank E, Powell M, and Oram D. Hysterectomy with radiotherapy or chemotherapy or both for women with locally advanced cervical cancer. Cochrane Database Syst Rev 2015:D10260.

34. Yang Y, Qin T, Zhang W, Wu Q, Yang A, and Xu F. Laparoscopic nerve-sparing radical hysterectomy for bulky cervical cancer (> = 6 cm) after neoadjuvant chemotherapy: A multicenter prospective cohort study. INT J SURG. 2016;34:35–40. doi: 10.1016/j.ijsu.2016.08.001 27519498

35. Adams E, Boulton MG, and Horne A, Rose PW, Durrant L, Collingwood M, et al. The effects of pelvic radiotherapy on cancer survivors: symptom profile, psychological morbidity and quality of life. Clin Oncol (R Coll Radiol). 2014;26:10–7. doi: 10.1016/j.clon.2013.08.003 23992740

36. Andreyev HJ, Davidson SE, Gillespie C, Allum WH, and Swarbrick E. Practice guidance on the management of acute and chronic gastrointestinal problems arising as a result of treatment for cancer. GUT. 2012;61:179–192. doi: 10.1136/gutjnl-2011-300563 22057051

37. Welk B, Wallis C, D'Souza D, McGee J, and Nam RK. A Population-Based Assessment of Urologic Procedures and Operations After Surgery or Pelvic Radiation for Cervical Cancer. INT J GYNECOL CANCER. 2018;28:989–995. doi: 10.1097/IGC.0000000000001266 29664839

38. Falcone T, Attaran M, Bedaiwy MA, and Goldberg JM. Ovarian function preservation in the cancer patient. FERTIL STERIL. 2004;81:243–257. doi: 10.1016/j.fertnstert.2003.06.031 14967351

39. Maltaris T, Seufert R, and Fischl F, Schaffrath M, Pollow K, Koelbl H, et al. The effect of cancer treatment on female fertility and strategies for preserving fertility. Eur J Obstet Gynecol Reprod Biol. 2007;130:148–155. doi: 10.1016/j.ejogrb.2006.08.006 16979280

Neoadjuvant chemotherapy plus surgery versus concurrent chemoradiotherapy in stage IB2-IIB cervical cancer: A systematic review and meta-analysis

Souhrn

Klíčová slova:

Zdroje

PLOS One

Aktuální možnosti diagnostiky a léčby litiáz