دورية أكاديمية
A systematic review of stage IVA cervical cancer treatment: Challenges in the management of an understudied group.
| العنوان: | A systematic review of stage IVA cervical cancer treatment: Challenges in the management of an understudied group. |
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| المؤلفون: | Hunsberger KS; The University of Arizona, College of Medicine - Phoenix, Phoenix, Arizona., Treiman S; Creighton University School of Medicine, Phoenix, Arizona., Monk BJ; The University of Arizona, College of Medicine - Phoenix, Phoenix, Arizona; Creighton University School of Medicine, Phoenix, Arizona., Tewari KS; Division of Gynecologic Oncology, University of California, Irvine College of Medicine, Irvine, California., Taunk NK; Division of Gynecologic Oncology, David Geffen School of Medicine at UCLA, Los Angeles, California., Chase DM; Division of Radiation Oncology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania. Electronic address: dmchase@mednet.ucla.edu. |
| المصدر: | Gynecologic oncology [Gynecol Oncol] 2024 Aug; Vol. 187, pp. 120-127. Date of Electronic Publication: 2024 May 17. |
| نوع المنشور: | Journal Article; Systematic Review |
| اللغة: | English |
| بيانات الدورية: | Publisher: Academic Press Country of Publication: United States NLM ID: 0365304 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1095-6859 (Electronic) Linking ISSN: 00908258 NLM ISO Abbreviation: Gynecol Oncol Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: New York, Academic Press. |
| مواضيع طبية MeSH: | Neoplasm Staging* , Uterine Cervical Neoplasms*/pathology , Uterine Cervical Neoplasms*/therapy, Female ; Humans ; Chemoradiotherapy/methods ; Cisplatin/administration & dosage |
| مستخلص: | Objective: Stage IVA patients comprise a small proportion of participants in cervical cancer trials, yet survival outcomes are disproportionately poor. We aim to perform a systematic review evaluating stage IVA cervical cancer. Methods: This systematic review was completed via PRISMA 2020 guidelines using two databases. Inclusion criteria comprised Phase III trials (2004-2024) assessing stage IVA cervical cancer including patients by stage. Searches had MeSH terms: ((cervical cancer) AND (stage IVA) AND (locally advanced)). 761 were articles identified, including books, trials, reviews, and meta-analyses. Of the articles identified, 12 met inclusion criteria. Results: A total of 133 (3.8% of study populations) stage IVA and 818 (40% of study populations) stage III-IVA cervical cancer patients were analyzed. Two studies (stage IVA n = 15; 3.1%) established cisplatin as chemoradiotherapy agent of choice, while one study (stage IVA n = 2; 1%) showed no benefit with cisplatin versus radiotherapy alone. Four studies (stage IVA n = 32; 3.6%; stages IIIB-IVA n = 220; 24%) found no benefit with adjuvant chemotherapy, with one analyzing stage IIIB-IVA patients (progression-free survival (PFS) hazard ratio (HR) = 0.84; 95% confidence interval (CI): 0.57-1.23). Three studies (stage IVA n = 71; 5%) found no benefit adding immunomodulator (stage IVA overall survival HR = 3.48; 95% CI: 0.52-23.29), hypoxic cell sensitizer, or immunotherapy (stage III-IVA PFS HR = 0.71; 95% CI: 0.49-1.03) to chemoradiotherapy. One study (stages III-IVA n = 598; 56%) found benefit adding immunotherapy to chemoradiotherapy (stage III-IVA PFS HR = 0.58; 95% CI: 0.42-0.8). One study (stage IVA n = 13; 3.5%) showed benefit with induction chemotherapy. Conclusion: Trials have not included substantial IVA patients to draw reasonable conclusions. Despite mixed results for immunotherapy, adjuvant chemotherapy, and induction chemotherapy, the exact benefit for stage IVA patients remains unknown. Future clinical trials should include a greater number of stage IVA cervical cancer patients and analyze them individually. Competing Interests: Declaration of competing interest There are no conflicts of interest for this systematic review. (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.) |
| فهرسة مساهمة: | Keywords: Cervical cancer; Locally advanced; Stage IVA |
| المشرفين على المادة: | Q20Q21Q62J (Cisplatin) |
| تواريخ الأحداث: | Date Created: 20240517 Date Completed: 20240808 Latest Revision: 20240813 |
| رمز التحديث: | 20240813 |
| DOI: | 10.1016/j.ygyno.2024.04.027 |
| PMID: | 38759518 |
| قاعدة البيانات: | MEDLINE |
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Full Text Finder | تدمد: | 1095-6859 |
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| DOI: | 10.1016/j.ygyno.2024.04.027 |