Your browser doesn't support javascript.
loading
External beam radiotherapy boost versus surgical debulking followed by radiotherapy for the treatment of metastatic lymph nodes in cervical cancer: A systematic review and meta-analysis.
Bizzarri, Nicolò; Di Berardino, Stefano; Benkortbi, Khadidja; Balaya, Vincent; Gambacorta, Maria Antonietta; Macchia, Gabriella; Boulvain, Michel; Feki, Anis; Mathevet, Patrice; Lecuru, Fabrice; Querleu, Denis; Ferrandina, Gabriella; Scambia, Giovanni; Guani, Benedetta.
Afiliação
  • Bizzarri N; UOC Ginecologia Oncologica, Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy. Electronic address: nicolo.bizzarri@yahoo.com.
  • Di Berardino S; UOC Ginecologia Oncologica, Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy.
  • Benkortbi K; University Hospital of Vaud, CHUV, 1005 Lausanne, Switzerland.
  • Balaya V; Department of Obstetrics and Gynecology, Felix Guyon Hospital - CHU Nord Réunion, La Réunion Island, France.
  • Gambacorta MA; UOC Radioterapia Oncologica, Dipartimento Di Diagnostica Per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy.
  • Macchia G; Radiation Oncology Unit, Responsible Research Hospital, Campobasso, Italy.
  • Boulvain M; Cantonal Hospital of Fribourg HFR, 1705 Fribourg, Switzerland.
  • Feki A; Cantonal Hospital of Fribourg HFR, 1705 Fribourg, Switzerland; Faculty of Sciences and Medicine, University of Fribourg, 1700 Fribourg, Switzerland.
  • Mathevet P; University Hospital of Vaud, CHUV, 1005 Lausanne, Switzerland; Faculty of Biology and Medicine, University of Lausanne, 1005 Lausanne, Switzerland.
  • Lecuru F; Breast, Gynecology and Reconstructive Surgery Unit, Institut Curie, Paris University, Paris, France.
  • Querleu D; UOC Ginecologia Oncologica, Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy.
  • Ferrandina G; UOC Ginecologia Oncologica, Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy.
  • Scambia G; UOC Ginecologia Oncologica, Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy.
  • Guani B; Cantonal Hospital of Fribourg HFR, 1705 Fribourg, Switzerland; Faculty of Sciences and Medicine, University of Fribourg, 1700 Fribourg, Switzerland.
Eur J Surg Oncol ; 50(4): 108013, 2024 Apr.
Article em En | MEDLINE | ID: mdl-38401353
ABSTRACT

OBJECTIVE:

We aimed to assess disease-free survival (DFS), overall survival (OS) and treatment-related toxicity of two therapeutic strategies for treating bulky lymph nodes on imaging in patients with locally advanced cervical cancer (LACC) radiotherapy boost versus surgical debulking followed by radiotherapy.

METHODS:

We performed a systematic review of studies published up to October 2023. We selected studies including patients with LACC treated by external beam radiotherapy (EBRT) boost or lymph node debulking followed by EBRT (with or without boost).

RESULTS:

We included two comparative (included in the meta-analysis) and nine non-comparative studies. The estimated 3-year recurrence rate was 28.2% (95%CI18.3-38.0) in the EBRT group and 39.9% (95%CI22.1-57.6) in the surgical debulking plus EBRT group. The estimated 3-year DFS was 71.8% and 60.1%, respectively (p = 0.19). The estimated 3-year death rate was 22.2% (95%CI11.2-33.2) in the EBRT boost group and 31.9% (95%CI23.3-40.5) in the surgical debulking plus EBRT group. The estimated 3-year OS was 77.8% and 68.1%, respectively (p = 0.04). No difference in lymph node recurrence between the two comparative studies (p = 0.36). The meta-analysis of the two comparative studies showed no DFS difference (p = 0.13) but better OS in the radiotherapy boost group (p = 0.006). The incidence of grade≥3 toxicities (ranging 0-50%) was not different between the two approaches in the two comparative studies (p = 0.31).

CONCLUSION:

No DFS and toxicity difference when comparing EBRT boost with surgical debulking of enlarged lymph nodes and EBRT in patients with cervical cancer was evident. Radiotherapy boost had better OS. Further investigation is required to better understand the prognostic role of surgical lymph node debulking in light of radiotherapy developments.
Assuntos
Palavras-chave

Texto completo: 1 Coleções: 01-internacional Contexto em Saúde: 6_ODS3_enfermedades_notrasmisibles Base de dados: MEDLINE Assunto principal: Neoplasias do Colo do Útero / Metástase Linfática Limite: Female / Humans Idioma: En Revista: Eur J Surg Oncol Ano de publicação: 2024 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Contexto em Saúde: 6_ODS3_enfermedades_notrasmisibles Base de dados: MEDLINE Assunto principal: Neoplasias do Colo do Útero / Metástase Linfática Limite: Female / Humans Idioma: En Revista: Eur J Surg Oncol Ano de publicação: 2024 Tipo de documento: Article