Adjuvant chemoradiotherapy versus chemotherapy or radiotherapy in advanced endometrial cancer: a systematic review and meta-analysis
Background Endometrial cancer is one of the most common gynecological cancer in the world. However, the available adjuvant therapies, chemotherapy (CT) and radiotherapy (RT), demonstrated several limitations when used alone. Therefore, we conducted a meta-analysis to investigate the clinical effecti...
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| Format: | Article |
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PeerJ Inc.
2022-11-01
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| Online Access: | https://peerj.com/articles/14420.pdf |
| _version_ | 1797425609681403904 |
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| author | Hariyono Winarto Naufal A. A. Ibrahim Yan M. Putri Faiqueen D. S. F. Adnan Eka D. Safitri |
| author_facet | Hariyono Winarto Naufal A. A. Ibrahim Yan M. Putri Faiqueen D. S. F. Adnan Eka D. Safitri |
| author_sort | Hariyono Winarto |
| collection | DOAJ |
| description | Background Endometrial cancer is one of the most common gynecological cancer in the world. However, the available adjuvant therapies, chemotherapy (CT) and radiotherapy (RT), demonstrated several limitations when used alone. Therefore, we conducted a meta-analysis to investigate the clinical effectiveness of chemoradiotherapy (CRT) based on overall survival (OS) and disease-free survival (DFS). Methods A literature search was performed on five databases and one clinical trial registry to obtain all relevant articles. Search for studies was completed on September 9, 2021. A meta-analysis was conducted to determine the overall hazard ratio with the 95% Confidence Interval. Results A total of 17 articles with 23,975 patients in the CRT vs RT group and 50,502 patients in the CRT vs CT group were included. The OS Hazard Ratios (HR) of CRT compared to RT was 0.66 (95% CI [0.59–0.75]; P < 0.00001). Compared to CT, the OS HR was 0.70 (95% CI [0.64–0.78]; P < 0.00001). CRT also significantly improved the DFS compared to CT only (HR 0.79, 95% CI [0.64–0.97]; P = 0.02) However, CRT did not improve the DFS compared to RT only, with HR of 0.71 (95% CI [0.46–1.09]; P = 0.12). Conclusion Adjuvant CRT can significantly improve OS compared to CT or RT alone and improve the DFS compared to CT alone in patients with advanced endometrial cancer. Further research is needed to identify the optimal CRT regimen, and to whom CRT will be most beneficial. |
| first_indexed | 2024-03-09T08:18:34Z |
| format | Article |
| id | doaj.art-6c76052debe94de1a4e41176f0c413f0 |
| institution | Directory Open Access Journal |
| issn | 2167-8359 |
| language | English |
| last_indexed | 2024-03-09T08:18:34Z |
| publishDate | 2022-11-01 |
| publisher | PeerJ Inc. |
| record_format | Article |
| series | PeerJ |
| spelling | doaj.art-6c76052debe94de1a4e41176f0c413f02023-12-02T21:55:20ZengPeerJ Inc.PeerJ2167-83592022-11-0110e1442010.7717/peerj.14420Adjuvant chemoradiotherapy versus chemotherapy or radiotherapy in advanced endometrial cancer: a systematic review and meta-analysisHariyono Winarto0Naufal A. A. Ibrahim1Yan M. Putri2Faiqueen D. S. F. Adnan3Eka D. Safitri4Gynecologic Oncology Division, Obstetrics and Gynecology Department, Dr. Cipto Mangunkusumo Hospital, Universitas Indonesia, Jakarta Pusat, Jakarta, IndonesiaFaculty of Medicine, Universitas Indonesia, Jakarta Pusat, Jakarta, IndonesiaFaculty of Medicine, Universitas Indonesia, Jakarta Pusat, Jakarta, IndonesiaFaculty of Medicine, Universitas Indonesia, Jakarta Pusat, Jakarta, IndonesiaThe Center for Clinical Epidemiology and Evidence-Based Medicine, Dr. Cipto Mangunkusumo Hospital, Universitas Indonesia, Jakarta Pusat, Jakarta, IndonesiaBackground Endometrial cancer is one of the most common gynecological cancer in the world. However, the available adjuvant therapies, chemotherapy (CT) and radiotherapy (RT), demonstrated several limitations when used alone. Therefore, we conducted a meta-analysis to investigate the clinical effectiveness of chemoradiotherapy (CRT) based on overall survival (OS) and disease-free survival (DFS). Methods A literature search was performed on five databases and one clinical trial registry to obtain all relevant articles. Search for studies was completed on September 9, 2021. A meta-analysis was conducted to determine the overall hazard ratio with the 95% Confidence Interval. Results A total of 17 articles with 23,975 patients in the CRT vs RT group and 50,502 patients in the CRT vs CT group were included. The OS Hazard Ratios (HR) of CRT compared to RT was 0.66 (95% CI [0.59–0.75]; P < 0.00001). Compared to CT, the OS HR was 0.70 (95% CI [0.64–0.78]; P < 0.00001). CRT also significantly improved the DFS compared to CT only (HR 0.79, 95% CI [0.64–0.97]; P = 0.02) However, CRT did not improve the DFS compared to RT only, with HR of 0.71 (95% CI [0.46–1.09]; P = 0.12). Conclusion Adjuvant CRT can significantly improve OS compared to CT or RT alone and improve the DFS compared to CT alone in patients with advanced endometrial cancer. Further research is needed to identify the optimal CRT regimen, and to whom CRT will be most beneficial.https://peerj.com/articles/14420.pdfAdjuvant chemoradiotherapyAdjuvant chemotherapyAdjuvant radiotherapyEndometrial cancerSurvivalSystematic review |
| spellingShingle | Hariyono Winarto Naufal A. A. Ibrahim Yan M. Putri Faiqueen D. S. F. Adnan Eka D. Safitri Adjuvant chemoradiotherapy versus chemotherapy or radiotherapy in advanced endometrial cancer: a systematic review and meta-analysis PeerJ Adjuvant chemoradiotherapy Adjuvant chemotherapy Adjuvant radiotherapy Endometrial cancer Survival Systematic review |
| title | Adjuvant chemoradiotherapy versus chemotherapy or radiotherapy in advanced endometrial cancer: a systematic review and meta-analysis |
| title_full | Adjuvant chemoradiotherapy versus chemotherapy or radiotherapy in advanced endometrial cancer: a systematic review and meta-analysis |
| title_fullStr | Adjuvant chemoradiotherapy versus chemotherapy or radiotherapy in advanced endometrial cancer: a systematic review and meta-analysis |
| title_full_unstemmed | Adjuvant chemoradiotherapy versus chemotherapy or radiotherapy in advanced endometrial cancer: a systematic review and meta-analysis |
| title_short | Adjuvant chemoradiotherapy versus chemotherapy or radiotherapy in advanced endometrial cancer: a systematic review and meta-analysis |
| title_sort | adjuvant chemoradiotherapy versus chemotherapy or radiotherapy in advanced endometrial cancer a systematic review and meta analysis |
| topic | Adjuvant chemoradiotherapy Adjuvant chemotherapy Adjuvant radiotherapy Endometrial cancer Survival Systematic review |
| url | https://peerj.com/articles/14420.pdf |
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