POSTOPERATIVE ADJUVANT CHEMOTHERAPY IN STAGE IB-Ⅱ CERVICAL CARCINOMA:A META-ANALYSIS

Objecitves:To evaluate the efficiency and security of postoperative adjuvant chemotherapy in cervical cancer.Methods:We searched PUBMED database, EMbase database, Cochrane library database, CNKI database, Wanfang database, Chinese Biomedical Literature Database (CBM) in the Internet. We also hand-searched the related magazines, academic dissertations and conference articles. The language includes English and Chinese. The experiment group underwent adjuvant chemotherapy, and the control group underwent adjuvant radiotherapy, chemoradiotherapy or observation. Evaluate the collected trials and exclude trails that not meet the purpose.Results:Totally10articles involving1302patients were identified and included. Extract relevant data to perform a meta-analysis by Revman5.1. The findings implied that:1. The overall5-year survival rates of postoperative chemotherapy group was significantly higher than observation group (RR=1.10,95%CI=[1.00,1.21], P=0.04<0.05). The3-year accumulative survival rate of postoperative chemotherapy group was significantly higher than postoperative radiotherapy group (RR=1.36, 95%CI=[1.09,1.71], P=0.008<0.05). The5-year accumulative survival rates were no significant difference between two groups (RR=1.03,95%CI=[0.93,1.15], P=0.57>0.05). The overall3-year and5-year survival rates were no significant difference (RR=1.10,95%CI=[0.83,1.45], P=0.50>0.05; RR=1.07,95%CI=[0.98,1.18],P=0.15>0.05). The intrapelvic and extrapelvic recurrences were much the same. The5-year accumulative survival rates of postoperative chemotherapy group and postoperative chemoradiotherapy group were no significant difference (RR=1.14,95%CI=[0.92,1.42], P=0.22>0.05).2. The incidences of bowel and urinary disturbance of postoperative adjuvant chemotherapy group were significantly lower than postoperative radiotherapy group (RR=0.06,95%CI=[0.02,0.24], P<0.0001<0.05; RR=0.10,95%CI=[0.03,0.29], P=0.0001<0.05). The incidences of coleostenosis, asexual life and perimenopausal symptoms of postoperative adjuvant chemotherapy group were significantly lower than postoperative radiotherapy group, and the incidences of dyspareunia between two groups were no significant difference.Conclusions:The efficiency of postoperative adjuvant chemotherapy was better than observation after radical surgery, similar as radio-based postoperative adjuvant treatment and a lower incidences of adverse effects and complications. The postoperative adjuvant chemotherapy seems to be an efficient and safe treatment for patients with stage IB-II cervical carcinoma after radical surgery who has risk factors for recurrence.