The Efficiency And Safety Of Postoperative Adjuvant Chemoradiotherapy In Cervical Cancer:A Meta-analysis

ObjectiveTo evaluate the efficiency and safety of postoperative adjuvant concurrent chemoradiotherapy (CCRT) and alone radiotherapy(RT) in cervical cancer.MethodsBy searching VIP, CNKI, CBM, Wanfang database, PubMed, EMBASE, The Cochrane Library, the studies were included if they are accord with inclusion criteria. Data were extracted and evaluated by two reviewers independently and data were analyzed using RevMan5.1.1.Results8studies were included with a total of892patients. Meta-analysis results are as follows:(1)CCRT group3-years disease-free survival rate [RR=1.22,95%CI (1.04-1.44), P=0.01] were higher than the RT group, the difference had statistical significance.(2)Pelvic recurrence [RR=0.50,95%CI (0.36-0.69), P＜0.0001] were lower than the RT group, the difference had statistical significance.(3) Distant metastasis [RR=0.66.95%CI (0.48-0.91), P=0.01] were lower than the RT group, the difference had statistical significance.(4)The incidence of radioactive cystitis [RR=1.26,95%CI (1.01-1.58), P=0.04], bone marrow suppression [RR=2.30,95%CI(1.67-3.15),P＜0.00001] and gastrointestinal reaction [RR=2.20,95%CI(1.39-3.47), P=0.001] were higher than the RT group, the difference had statistical significance.(5)There were no statistically differences on the5-years over-all survival [RR=1.24,95%CI (0.98-1.56), P=0.07] and radiation proctitis [RR=1.01,95%CI(0.83-1.23), P=0.91].ConclusionCompared with CCRT and alone RT in cervical cancer. The former can significantly improve the3-years disease-free survival, decrease the pelvic recurrence and distant metastasis, while it can increase radiation cystitis, bone marrow suppression and gastrointestinal reactions. It should be take patient’s condition into account when treatment measure was selected by clinical physicians. Simultaneously, the adverse reactions which associated with CCRT should be conduct timely.