Logo Medical Science Monitor

Call: +1.631.470.9640
Mon - Fri 10:00 am - 02:00 pm EST

Contact Us

Logo Medical Science Monitor Logo Medical Science Monitor Logo Medical Science Monitor

20 September 2020 : Meta-Analysis

Efficacy and Toxicity of Adjuvant Therapies for High-Risk Endometrial Cancer in Stage I–III: A Systematic Review and Network Meta-Analysis

Mengyin Ao12ABCDEF, Ting Ding12BF, Dan Tang12E, Mingrong Xi12E*

DOI: 10.12659/MSM.925595

Med Sci Monit 2020; 26:e925595

Abstract

BACKGROUND: The use of adjuvant therapy for high-risk endometrial cancer patients (HREC) in International Federation of Gynecology and Obstetrics (FIGO) stage I-III remains debatable. This network meta-analysis was conducted to compare and rank adjuvant therapies based on efficacies and toxicities to facilitate clinical decision-making and further research.

MATERIAL AND METHODS: We searched 3 databases – PubMed, EMBASE, and the Cochrane Central Register of Controlled Trials – from inception to December 9, 2019. Only randomized controlled trials that compared any of these adjuvant therapies (pelvic radiotherapy, vaginal brachytherapy, chemotherapy, and chemoradiotherapy) with each other or surgery alone were included. The network meta-analysis was performed in a frequentist framework using Stata software 15.0.

RESULTS: Fourteen RCTs with 5872 participants were eligible. No significant difference between treatments was observed in 5-year overall survival (OS) or distant metastasis. Compared with surgery alone, adjuvant pelvic radiotherapy plus chemotherapy (pelvic RT-CT) prolonged 5-year progression-free survival (PFS) and pelvic radiotherapy (pelvic RT) (RR=0.61, 95% CI 0.39–0.96; RR=0.779, 95% CI 0.63–0.95). Compared with surgery alone, pelvic RT, the combination of pelvic RT and vaginal brachytherapy (pelvic RT-VBT), chemotherapy (CT), and pelvic RT-CT led to fewer local recurrences (RR=0.33, 95% CI 0.21–0.50; RR=0.15, 95% CI 0.03–0.74; RR=0.39, 95% CI 0.21–0.73; RR=0.17, 95% CI 0.06–0.46). Adjuvant CT was found to result in more grade III/IV late toxicities than surgery alone (RR=11.8, 95% CI 1.02–137.14). Pelvic RT-CT ranked first for OS, PFS, distant metastasis, and local recurrence.

CONCLUSIONS: Pelvic RT-CT is superior to other treatments for PFS and local recurrence rate, and associated related toxicities are tolerable, suggesting it may be an ideal adjuvant therapy for HREC patients.

Keywords: meta-analysis, Chemoradiotherapy, Adjuvant, Chemotherapy, Adjuvant, Radiotherapy, Adjuvant, Endometrial Neoplasms

0 Comments

Weekly Editorial

18 October 2021 : Editorial

Editorial: Global Initiatives Support the Use and Regulation of Digital Health Technology During the COVID-19 Pandemic

Dinah V. Parums
Science Editor, Medical Science Monitor, International Scientific Information, Inc., Melville, NY, USA

DOI: 10.12659/MSM.935123

Med Sci Monit 2021; 27:e935123

SARS-CoV-2/COVID-19

20 October 2021 : Editorial

Editorial: The 2021 European Society of Cardiology (ESC) Guidelines on the Real-World Prevention of Atheros...

Med Sci Monit In Press; DOI: 10.12659/MSM.935172  

22 October 2021 : Clinical Research

A Novel Method for the Production of an Autologous Anti-Inflammatory and Anti-Catabolic Product (Cytorich) ...

Med Sci Monit In Press; DOI: 10.12659/MSM.934365  

11 October 2021 : Clinical Research

Clinical Features and Temporal Lung Radiographic Changes in 25 Patients Recovering from COVID-19 Pneumonia:...

Med Sci Monit In Press; DOI: 10.12659/MSM.933381  

08 September 2021 : Clinical Research

Acceptance of COVID-19 Vaccination and Its Associated Factors Among Cancer Patients Attending the Oncology ...

Med Sci Monit In Press; DOI: 10.12659/MSM.932788  

In Press

22 Oct 2021 : Clinical Research

Ulnar Groove Plasty Guided by a 3D Printing Technique for Moderate to Severe Cubital Tunnel Syndrome Caused...

Med Sci Monit In Press; DOI: 10.12659/MSM.933775  

22 Oct 2021 : Clinical Research

Total Fluoroscopy Time Reduction During Ultrasound- and Fluoroscopy-Guided Percutaneous Transhepatic Biliar...

Med Sci Monit In Press; DOI: 10.12659/MSM.933889  

22 Oct 2021 : Clinical Research

Correlation Between Severity of Illness and Levels of Free Triiodothyronine, Interleukin-6, and Interleukin...

Med Sci Monit In Press; DOI: 10.12659/MSM.933230  

22 Oct 2021 : Clinical Research

A Novel Method for the Production of an Autologous Anti-Inflammatory and Anti-Catabolic Product (Cytorich) ...

Med Sci Monit In Press; DOI: 10.12659/MSM.934365  

Most Viewed Current Articles

20 Mar 2020 : Clinical Research

Social Capital and Sleep Quality in Individuals Who Self-Isolated for 14 Days During the Coronavirus Diseas...

DOI :10.12659/MSM.923921

Med Sci Monit 2020; 26:e923921

15 Apr 2020 : Clinical Research

Psychological Impact and Coping Strategies of Frontline Medical Staff in Hunan Between January and March 20...

DOI :10.12659/MSM.924171

Med Sci Monit 2020; 26:e924171

05 May 2020 : Review article

An Evidence Based Perspective on mRNA-SARS-CoV-2 Vaccine Development

DOI :10.12659/MSM.924700

Med Sci Monit 2020; 26:e924700

26 Apr 2020 : Clinical Research

Comparison of Prevalence and Associated Factors of Anxiety and Depression Among People Affected by versus P...

DOI :10.12659/MSM.924609

Med Sci Monit 2020; 26:e924609

Your Privacy

We use cookies to ensure the functionality of our website, to personalize content and advertising, to provide social media features, and to analyze our traffic. If you allow us to do so, we also inform our social media, advertising and analysis partners about your use of our website, You can decise for yourself which categories you you want to deny or allow. Please note that based on your settings not all functionalities of the site are available. View our privacy policy.

Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750