| Objective: To analyze and compare the efficacy and safety of nedaplatin concurrent chemoradiotherapy and cisplatin concurrent chemoradiotherapy in the treatment of advanced cervical cancer by Meta-analysis.Methods: Computer have retrieved the published Chinese and English literatures until November 2018 from China Knowledge Network(CNKI),China Biomedical Database(CBM),Wanfang Database,VIP Chinese Science and Technology Journal Database(VIP),PubMed,EMbase,and Cochrane Library.The two researchers have rigorously screened these documents according to the inclusion and exclusion criteria,and then extracted the data features of the included documents.By selecting a randomized controlled trial(RCT)for the treatment of advanced cervical cancer with concurrent chemoradiotherapy with nedaplatin and cisplatin,and then evaluating the quality of the final selected literature by means of Jadad score sheet,the Meta-analysis of the extracted data is conducted finally.(RevMan5.3 software).Results: A total of 11 randomized controlled trials were included,involving a total of 928 patients,including 464 patients in the experimental group(nedaplatin group)and 464 patients in the control group(cisplatin group).Meta analysis results showed:1)There was no significant statistical difference in the treatment efficiency,3-year survival rate,3-year recurrence rate,3-year metastasis rate,leukopenia and its advanced reaction,thrombocytopenia and its advanced response,anemia,liver function damage between nedaplatin and cisplatin in the treatment of advanced cervical cancer when the dose was 30mg/m2(P>0.05).The cisplatin group was more prone to renal injury,nausea and vomiting and its advanced reaction than the nedaplatin group(P<0.05).2)There was no significant statistical difference in the treatment efficiency,3-year survival rate,leukopenia,anemia,liver function damage between nedaplatin and cisplatin in the treatment of advanced cervical cancer when the dose was 40mg/m2(P>0.05).The cisplatin group was more prone to a higher 3-year recurrence rate,3-year metastasis rate,renal injury,leukopenia and its advanced reaction,nausea and vomiting and its advanced reaction than the nedaplatin group(P<0.05).The nedaplatin group was more prone to thrombocytopenia than the cisplatin group(P<0.05),and there was no statistically significant difference between their high-grade reactions(P>0.05).Conclusion:(1)There was no significant statistical difference in terms of the treatment efficiency and three-year survival rate of the two drugs(Nedaplatin,Cisplatin)in concurrent chemoradiotherapy in the treatment of advanced cervical cancer.The incidence of nausea and vomiting and its advanced reaction and nephrotoxicity was lower in the nedaplatin group.As the dose increased,the 3-year recurrence rate,3-year metastasis rate,and leukopenia and its advanced reaction decreased in the nedaplatin group.While the incidence of thrombocytopenia increased,the patients were well tolerated.(2)In terms of efficacy and safety,nedaplatin could better replace cisplatin in concurrent chemoradiotherapy in the treatment of advanced cervical cancer,and further confirmation and determination of the optimal dose was needed. |
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