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The benefit of adjuvant chemotherapy combined with postoperative radiotherapy for endometrial cancer: a meta-analysis

Authors
 Hyun Jong Park  ;  Eun Ji Nam  ;  Sunghoon Kim  ;  Yong Bae Kim  ;  Young Tae Kim 
Citation
 EUROPEAN JOURNAL OF OBSTETRICS & GYNECOLOGY AND REPRODUCTIVE BIOLOGY, Vol.170(1) : 39-44, 2013 
Journal Title
EUROPEAN JOURNAL OF OBSTETRICS & GYNECOLOGY AND REPRODUCTIVE BIOLOGY
ISSN
 0301-2115 
Issue Date
2013
MeSH
Antineoplastic Agents/therapeutic use* ; Chemotherapy, Adjuvant* ; Endometrial Neoplasms/therapy* ; Female ; Humans ; Neoplasm Recurrence, Local/prevention & control* ; Postoperative Period ; Radiotherapy, Adjuvant
Keywords
Chemotherapy ; Endometrial cancer ; Meta-analysis ; Radiotherapy ; Survival
Abstract
The objective of our study was to determine whetheradjuvant chemotherapycombinedwithpostoperativeradiotherapywould have benefits for the disease-free survival and overall survival in patients with high-riskendometrial cancer. Electronic searches for studies ofadjuvant chemotherapycombinedwithpostoperativeradiotherapyinendometrial cancerpatients between March 1971 and March 2012 were made on MEDLINE, SCOPUS, and the Cochrane library. Articles with more than 4 stars on the Newcastle-Ottawa scale or a score of more than 4 on the modified Jadad scale were included. Ameta-analysiswas performed, and pooled hazard ratios (HR) of progression-free survival (PFS) and overall survival (OS) between patients whoseadjuvant chemotherapywascombinedwithradiotherapy(the CTx+RTx group) and patients withadjuvantradiotherapyonly (the RTx group) were derived from the fixed effect model or random effect model. Three observational studies and 3 randomized clinical trials (RCTs) were included in the final analysis. Subgroup analysis for FIGO stage showed that the CTx+RTx group had a more significant survivalbenefitcompared to that of the RTx group in advanced stageendometrial cancer(OS HR 0.53, 95% CI 0.36-0.80; PFS HR 0.54, 95% CI 0.37-0.77), but no significantbenefitin early stageendometrial cancer(OS HR 0.96, 95% CI 0.70-1.32; PFS HR 1.00, 95% CI 0.39-2.58). Thismeta-analysissuggests thatadjuvant chemotherapycombinedwithpostoperativeradiotherapycould probably reduce disease progression and overall death in patients with advanced-stage disease. In order to examine whether the multimodal treatment hasbenefitin high-riskendometrial cancer, we need further large-scale RCTs.
Full Text
http://www.sciencedirect.com/science/article/pii/S0301211513002686
DOI
10.1016/j.ejogrb.2013.06.009
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Obstetrics and Gynecology (산부인과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
Yonsei Authors
Kim, Sung Hoon(김성훈) ORCID logo https://orcid.org/0000-0002-1645-7473
Kim, Young Tae(김영태) ORCID logo https://orcid.org/0000-0002-7347-1052
Kim, Yong Bae(김용배) ORCID logo https://orcid.org/0000-0001-7573-6862
Nam, Eun Ji(남은지) ORCID logo https://orcid.org/0000-0003-0189-3560
Park, Hyun Jong(박현종)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/87947
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