Radiotherapy Combined with Concurrent Chemotherapy in the Treatment of Locally Advanced Cervical Cancer: A Systematic Review and Meta-Analysis
Authors: Y. Zhang, L. Wang, H. Li, J. Chen, S. Liu
Background: Locally advanced cervical cancer (LACC) is commonly treated with concurrent chemoradiotherapy (CCRT), but the optimal chemotherapy regimen and radiotherapy technique remain debated. This systematic review and meta-analysis aimed to evaluate the efficacy and safety of CCRT versus radiotherapy alone in LACC. Methods: We searched PubMed, Embase, and Cochrane Library for randomized controlled trials (RCTs) comparing CCRT with radiotherapy alone in LACC. The primary outcomes were overall survival (OS) and progression-free survival (PFS). Secondary outcomes included local control, distant metastasis, and grade 3-4 toxicities. Results: A total of 12 RCTs involving 3,456 patients were included. CCRT significantly improved OS (HR 0.78, 95% CI 0.70-0.87) and PFS (HR 0.72, 95% CI 0.64-0.81) compared with radiotherapy alone. Subgroup analyses showed that cisplatin-based regimens and intensity-modulated radiotherapy (IMRT) were associated with better outcomes. However, CCRT increased the risk of hematologic and gastrointestinal toxicities. Conclusion: CCRT is superior to radiotherapy alone in improving survival outcomes in LACC, with acceptable but manageable toxicity. Cisplatin-based chemotherapy and IMRT are recommended.
