Adjuvant radiotherapy for stage i endometrial cancer: An updated cochrane systematic review and meta-analysis

Background The role of adjuvant radiotherapy in stage I endometrial cancer has changed in recent years. This updated Cochrane systematic review aimed to reexamine the efficacy and toxicity of adjuvant radiotherapy vs no treatment in stage I endometrial cancer. Methods We searched various databases i...

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Main Authors: Kong, A, Johnson, N, Kitchener, H, Lawrie, T
Format: Journal article
Language:English
Published: 2012
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author Kong, A
Johnson, N
Kitchener, H
Lawrie, T
author_facet Kong, A
Johnson, N
Kitchener, H
Lawrie, T
author_sort Kong, A
collection OXFORD
description Background The role of adjuvant radiotherapy in stage I endometrial cancer has changed in recent years. This updated Cochrane systematic review aimed to reexamine the efficacy and toxicity of adjuvant radiotherapy vs no treatment in stage I endometrial cancer. Methods We searched various databases including The Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, and the Specialised Register of the Cochrane Gynaecological Cancer Review Group (CGCRG) for randomized controlled trials that met the predefined inclusion criteria. The primary outcome was overall survival (OS); secondary outcomes were endometrial cancer-specific survival, locoregional recurrence, distant recurrence, and toxicity. Hazard ratios (HRs) were estimated and pooled if possible; otherwise, dichotomous data were extracted. All statistical tests were two-sided. Results Of the eight included trials, seven trials (3628 women) compared external beam radiotherapy (EBRT) and no EBRT (or vaginal brachytherapy [VBT]), and one trial (645 women) compared VBT and no additional treatment. EBRT statistically significantly reduced locoregional recurrence compared with no EBRT (or VBT alone) (HR = 0.36, 95% confidence Interval [CI] = 0.25 to 0.52; P < .001), but this did not translate into an improvement in OS (HR = 0.99, 95% CI = 0.82 to 1.20; P = .95), endometrial cancer-specific survival (HR = 0.96, 95% CI = 0.72 to 1.28; P = .80), or distant recurrence rates (risk ratio = 1.04, 95% CI = 0.80 to 1.35; P = .77). EBRT was associated with an increased risk of severe acute toxicity, severe late toxicity, and reduced quality of life scores. © 2012 The Author 2012.
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spelling oxford-uuid:4caad3b3-682b-4342-b92f-a7baa8ed8bb42022-03-26T15:50:51ZAdjuvant radiotherapy for stage i endometrial cancer: An updated cochrane systematic review and meta-analysisJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:4caad3b3-682b-4342-b92f-a7baa8ed8bb4EnglishSymplectic Elements at Oxford2012Kong, AJohnson, NKitchener, HLawrie, TBackground The role of adjuvant radiotherapy in stage I endometrial cancer has changed in recent years. This updated Cochrane systematic review aimed to reexamine the efficacy and toxicity of adjuvant radiotherapy vs no treatment in stage I endometrial cancer. Methods We searched various databases including The Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, and the Specialised Register of the Cochrane Gynaecological Cancer Review Group (CGCRG) for randomized controlled trials that met the predefined inclusion criteria. The primary outcome was overall survival (OS); secondary outcomes were endometrial cancer-specific survival, locoregional recurrence, distant recurrence, and toxicity. Hazard ratios (HRs) were estimated and pooled if possible; otherwise, dichotomous data were extracted. All statistical tests were two-sided. Results Of the eight included trials, seven trials (3628 women) compared external beam radiotherapy (EBRT) and no EBRT (or vaginal brachytherapy [VBT]), and one trial (645 women) compared VBT and no additional treatment. EBRT statistically significantly reduced locoregional recurrence compared with no EBRT (or VBT alone) (HR = 0.36, 95% confidence Interval [CI] = 0.25 to 0.52; P < .001), but this did not translate into an improvement in OS (HR = 0.99, 95% CI = 0.82 to 1.20; P = .95), endometrial cancer-specific survival (HR = 0.96, 95% CI = 0.72 to 1.28; P = .80), or distant recurrence rates (risk ratio = 1.04, 95% CI = 0.80 to 1.35; P = .77). EBRT was associated with an increased risk of severe acute toxicity, severe late toxicity, and reduced quality of life scores. © 2012 The Author 2012.
spellingShingle Kong, A
Johnson, N
Kitchener, H
Lawrie, T
Adjuvant radiotherapy for stage i endometrial cancer: An updated cochrane systematic review and meta-analysis
title Adjuvant radiotherapy for stage i endometrial cancer: An updated cochrane systematic review and meta-analysis
title_full Adjuvant radiotherapy for stage i endometrial cancer: An updated cochrane systematic review and meta-analysis
title_fullStr Adjuvant radiotherapy for stage i endometrial cancer: An updated cochrane systematic review and meta-analysis
title_full_unstemmed Adjuvant radiotherapy for stage i endometrial cancer: An updated cochrane systematic review and meta-analysis
title_short Adjuvant radiotherapy for stage i endometrial cancer: An updated cochrane systematic review and meta-analysis
title_sort adjuvant radiotherapy for stage i endometrial cancer an updated cochrane systematic review and meta analysis
work_keys_str_mv AT konga adjuvantradiotherapyforstageiendometrialcanceranupdatedcochranesystematicreviewandmetaanalysis
AT johnsonn adjuvantradiotherapyforstageiendometrialcanceranupdatedcochranesystematicreviewandmetaanalysis
AT kitchenerh adjuvantradiotherapyforstageiendometrialcanceranupdatedcochranesystematicreviewandmetaanalysis
AT lawriet adjuvantradiotherapyforstageiendometrialcanceranupdatedcochranesystematicreviewandmetaanalysis