文章：

新辅助化疗后同步放化疗与同步放化疗后辅助化疗治疗局部晚期宫颈癌的网络荟萃分析

Neoadjuvant Chemotherapy Followed by Concurrent Chemoradiation Versus Adjuvant Chemotherapy Following Concurrent Chemoradiation for Locally Advanced Cervical Cancer: A Network Meta-Analysis

原文发布日期：11 January 2025

DOI: 10.3390/cancers17020223

类型: Article

开放获取: 是

英文摘要：

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. Methods: 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. Results: 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). Conclusions: 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.

摘要翻译： 

背景/目的：与单纯同步放化疗相比，新辅助化疗后序贯同步放化疗以及同步放化疗后辅助化疗对局部晚期宫颈癌女性患者生存期的影响存在不一致的报道。此外，新辅助化疗序贯同步放化疗与同步放化疗后辅助化疗的疗效尚未得到明确比较。本研究通过网状荟萃分析比较这两种治疗方案对局部晚期宫颈癌患者生存期的影响，以确定最优治疗方案。方法：系统检索PubMed、Medline和Embase数据库，共纳入6项评估新辅助化疗序贯同步放化疗、同步放化疗后辅助化疗或单纯同步放化疗（对照组）对新诊断局部晚期宫颈癌患者无进展生存期和总生存期影响的随机对照试验，并进行网状荟萃分析。结果：间接比较显示，新辅助化疗序贯同步放化疗与同步放化疗后辅助化疗在无进展生存期和总生存期方面均无显著差异。直接比较也表明，新辅助化疗序贯同步放化疗与单纯同步放化疗之间、同步放化疗后辅助化疗与单纯同步放化疗之间的无进展生存期和总生存期均相似。累积排序曲线下面积分析显示，同步放化疗后辅助化疗在无进展生存期和总生存期方面均具有最高的优选概率值（三种方案对比：无进展生存期72% vs 26.8% vs 51.2%，总生存期64.3% vs 45.1% vs 40.7%）。结论：对于局部晚期宫颈癌女性患者，尽管同步放化疗后辅助化疗显示出相对较高的累积排序曲线下面积值，但新辅助化疗序贯同步放化疗在无进展生存期和总生存期方面与同步放化疗后辅助化疗无显著差异。需要进一步研究明确这些治疗策略的临床效果。

原文链接：

Neoadjuvant Chemotherapy Followed by Concurrent Chemoradiation Versus Adjuvant Chemotherapy Following Concurrent Chemoradiation for Locally Advanced Cervical Cancer: A Network Meta-Analysis