A systematic review and meta-analysis of adjuvant chemotherapy after chemoradiation for locally advanced cervical cancer

Nanda Horeweg*, Prachi Mittal, Patrycja L. Gradowska, Ingrid Boere, Remi A. Nout, Supriya Chopra

*Corresponding author for this work

Research output: Contribution to journalReview articleAcademicpeer-review

13 Citations (Scopus)
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Abstract

We investigated whether the addition of adjuvant chemotherapy to chemoradiation improves overall survival (OS) and progression-free survival (PFS) by conducting a systematic review and meta-analysis. Systematic searches in the databases of PubMed, Embase and Web of Science yielded 881 articles. Two reviewer authors independently selected 31 articles for full text review and deemed eight studies eligible for inclusion. Two were randomised controlled trials (RCT), one was a large (n = 609) matched-case study and the remaining were small retrospective cohort studies; in total 2150 patients. Risk of bias assessment showed that the RCTs were at low risk and all other studies were at high risk of bias. Pooled hazard ratios for OS and PFS were 0.78 (95%CI 0.45–1.33, p = 0.36) and 0.85 (95%CI 0.65–1.10, p = 0.22), respectively. Analysis stratified by study design and sensitivity analysis showed similar results. Funnel plots showed significant publication bias due to a lack of small studies with negative outcomes.

Original languageEnglish
Article number103638
JournalCritical Reviews in Oncology/Hematology
Volume172
Early online date18 Feb 2022
DOIs
Publication statusPublished - Apr 2022

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