Meta-analysis Of The Prognosis Of Locally Cancer Cervical Cancer After Neoadjuvant Chemotherapy

Objective:By meta analysis method were evaluated, if neoadjuvant chemotherapy can reduce the operation complication, postoperative of high risk pathological results of occurrence rate, postoperative supplementary treatment and improve survival rate of the patients with locally advanced cervical cancer, in order to provide a reliable evidence for clinical treatment.Methods:From Pubmed, the Cochrane library, Ovid, Medline, Embase database and so on,We retrieve that compared neoadjuvant chemotherapy combined surgery(combination treatment group) and radical hysterectomy(surgical group) controlled clinical trials of patients with locally advanced cervical cancer, which main outcome indicators, including:chemotherapy regimens, intraoperative complications and postoperative pathologic results, postoperative supplementary treatment, and survival rate, between January 1990 and May 2015. According to the inclusion criteria, exclusion criteria, the research purpose of retrieving literatures, we need assess the quality of literature, exclude low quality of literature, extract of literature data. Revman 5.3 software is used to analyse the extracted data related to processing, and we will analyzes the cause of the result. By subgroup analysis,meta-regression analysis and sensitivity analysis, we can explore the causes of heterogeneity for existing of heterogeneity of researches. We will choose funnel figure to assess risk of bias.Results:In this paper, there are 11 into paper, including 1 piece of matching test, 5 case control studies, 5 randomized controlled trial. Participants included 1709 cases of patients, including combination treatment group 769 cases, 940 cases of surgical group.Combined treatment group compared with the surgical can reduce intraoperative complications [OR = 0.44, 95% CI(0.2-0.97), Z = 2.04, P = 0.04), improve disease-free survival in five years [RR = 1.18, 95% CI(1.06-1.32), Z = 2.98, P = 0.003), reduce lymph node positive rate(OR = 0.64, 95% CI(0.42-0.98), Z = 2.04, P = 0.04), reduce parametrial infiltration rate(RR = 0.71, 95% CI(0.56-0.89), Z = 2.95, P = 0.003), reduce vascular invasion rate(OR = 0.63, 95% CI(0.40-0.98), Z = 2.04, P = 0.04), decrease the rate of postoperative supplementary radiation, differences were statistically significant(P< 0.05). Combined treatment group compared with the surgical group, 5 years of survival rate(RR = 1.06, 95% CI(0.97-1.17), Z = 1.27, P = 0.2), the period of 5 years of survival rate between different chemotherapy period [RR = 1.05, 95% CI(0.96 1.14), Z = 1.07, P= 0.28), surgery cut edge positive rate(RR = 0.80, 95% CI(0.48 1.31), Z = 0.90, P =0.37), there were no statistically significant difference(P > 0.05).Conclusion:For locally advanced cervical cancer patients, neoadjuvant chemotherapy can reduce intraoperative complications and decrease the incidence of at high risk of postoperative pathologic results, reduce the postoperative radiation rate, improve patient disease-free surial for five years, does not affect patients’ long-term survival. Short cycle compared with the long cycle of chemotherapy, chemotherapy in patients with long-term survival did not obvious difference.