{"title":"完整子宫颈癌最终放化疗后阴道毒性的发生率：一项荟萃分析。","authors":"Shraddha Raj, Rajiv Ranjan Prasad, Alok Ranjan","doi":"10.5114/jcb.2024.141402","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>Cervical cancer is a significant global health burden, with advancements in treatment modalities improving outcomes. However, vaginal toxicities following definitive chemoradiation remain a concern, impacting patients' quality of life. The aim of this systematic review and meta-analysis was to estimate the incidence of vaginal toxicities, explore associated factors, and assess the relationship with radiation dose in intact cervical cancer patients undergoing radical chemoradiation.</p><p><strong>Material and methods: </strong>A systematic search of PubMed, Google Scholar, and Cochrane databases was conducted. Studies reporting on vaginal toxicities post-radical chemoradiation in intact cervical cancer patients were included. Data extraction and analysis were performed according to PRISMA guidelines.</p><p><strong>Results: </strong>Twenty-four studies with various designs were included. The meta-analysis revealed a pooled estimate of 39% (95% CI: 21-56%) for overall vaginal toxicities among cervical cancer patients following definitive chemoradiation. Vaginal stenosis was the most commonly reported toxicity, with a median incidence of 61.5% (range, 20-77.8%) across the studies. Severe toxicities (grade ≥ 3) were reported at rates of 12.74% (CTCAE v. 4.0), 0.98% (CTCAE v. 3.0), 10.41% (RTOG/EORTC), and 0% (LENT-SOMA). Factors, such as age, initial vaginal involvement, and radiation dose were associated with increased toxicity risk. Significant heterogeneity was observed in study populations and methodologies.</p><p><strong>Conclusions: </strong>Vaginal toxicities are common following definitive chemoradiation in intact cervical cancer patients, with vaginal stenosis being predominant. Standardization of toxicity scoring methods and radiotherapy dose reporting parameters is crucial for accurate comparison and interpretation of findings. Future research should focus on optimizing treatment strategies to minimize vaginal toxicities while maximizing efficacy and patient outcomes.</p>","PeriodicalId":51305,"journal":{"name":"Journal of Contemporary Brachytherapy","volume":"16 3","pages":"241-256"},"PeriodicalIF":1.1000,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11609866/pdf/","citationCount":"0","resultStr":"{\"title\":\"Incidence of vaginal toxicities following definitive chemoradiation in intact cervical cancer: A meta-analysis.\",\"authors\":\"Shraddha Raj, Rajiv Ranjan Prasad, Alok Ranjan\",\"doi\":\"10.5114/jcb.2024.141402\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>Cervical cancer is a significant global health burden, with advancements in treatment modalities improving outcomes. However, vaginal toxicities following definitive chemoradiation remain a concern, impacting patients' quality of life. The aim of this systematic review and meta-analysis was to estimate the incidence of vaginal toxicities, explore associated factors, and assess the relationship with radiation dose in intact cervical cancer patients undergoing radical chemoradiation.</p><p><strong>Material and methods: </strong>A systematic search of PubMed, Google Scholar, and Cochrane databases was conducted. Studies reporting on vaginal toxicities post-radical chemoradiation in intact cervical cancer patients were included. Data extraction and analysis were performed according to PRISMA guidelines.</p><p><strong>Results: </strong>Twenty-four studies with various designs were included. The meta-analysis revealed a pooled estimate of 39% (95% CI: 21-56%) for overall vaginal toxicities among cervical cancer patients following definitive chemoradiation. Vaginal stenosis was the most commonly reported toxicity, with a median incidence of 61.5% (range, 20-77.8%) across the studies. Severe toxicities (grade ≥ 3) were reported at rates of 12.74% (CTCAE v. 4.0), 0.98% (CTCAE v. 3.0), 10.41% (RTOG/EORTC), and 0% (LENT-SOMA). Factors, such as age, initial vaginal involvement, and radiation dose were associated with increased toxicity risk. Significant heterogeneity was observed in study populations and methodologies.</p><p><strong>Conclusions: </strong>Vaginal toxicities are common following definitive chemoradiation in intact cervical cancer patients, with vaginal stenosis being predominant. Standardization of toxicity scoring methods and radiotherapy dose reporting parameters is crucial for accurate comparison and interpretation of findings. Future research should focus on optimizing treatment strategies to minimize vaginal toxicities while maximizing efficacy and patient outcomes.</p>\",\"PeriodicalId\":51305,\"journal\":{\"name\":\"Journal of Contemporary Brachytherapy\",\"volume\":\"16 3\",\"pages\":\"241-256\"},\"PeriodicalIF\":1.1000,\"publicationDate\":\"2024-06-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11609866/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Contemporary Brachytherapy\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.5114/jcb.2024.141402\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/6/29 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q4\",\"JCRName\":\"ONCOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Contemporary Brachytherapy","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.5114/jcb.2024.141402","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/6/29 0:00:00","PubModel":"Epub","JCR":"Q4","JCRName":"ONCOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
目的：宫颈癌是一个重大的全球健康负担，治疗方式的进步改善了结果。然而，明确放化疗后的阴道毒性仍然是一个问题，影响患者的生活质量。本系统综述和荟萃分析的目的是评估接受根治性放化疗的完整宫颈癌患者阴道毒性的发生率，探讨相关因素，并评估其与辐射剂量的关系。材料和方法：系统检索PubMed、谷歌Scholar和Cochrane数据库。完整宫颈癌患者根治性放化疗后阴道毒性的研究报告被纳入。根据PRISMA指南进行数据提取和分析。结果：纳入了24项不同设计的研究。荟萃分析显示宫颈癌患者在最终放化疗后阴道总毒性的汇总估计为39% （95% CI: 21-56%）。阴道狭窄是最常见的毒性报告，研究中位发生率为61.5%（范围20-77.8%）。严重毒性（≥3级）的发生率分别为12.74% （CTCAE vs . 4.0）、0.98% （CTCAE v. 3.0）、10.41% （RTOG/EORTC）和0% （LENT-SOMA）。年龄、阴道初始受累和辐射剂量等因素与毒性风险增加有关。在研究人群和研究方法中观察到显著的异质性。结论：完整宫颈癌患者终期放化疗后阴道毒性普遍存在，以阴道狭窄为主。毒性评分方法和放疗剂量报告参数的标准化对于结果的准确比较和解释至关重要。未来的研究应侧重于优化治疗策略，以尽量减少阴道毒性，同时最大限度地提高疗效和患者预后。
Incidence of vaginal toxicities following definitive chemoradiation in intact cervical cancer: A meta-analysis.
Purpose: Cervical cancer is a significant global health burden, with advancements in treatment modalities improving outcomes. However, vaginal toxicities following definitive chemoradiation remain a concern, impacting patients' quality of life. The aim of this systematic review and meta-analysis was to estimate the incidence of vaginal toxicities, explore associated factors, and assess the relationship with radiation dose in intact cervical cancer patients undergoing radical chemoradiation.
Material and methods: A systematic search of PubMed, Google Scholar, and Cochrane databases was conducted. Studies reporting on vaginal toxicities post-radical chemoradiation in intact cervical cancer patients were included. Data extraction and analysis were performed according to PRISMA guidelines.
Results: Twenty-four studies with various designs were included. The meta-analysis revealed a pooled estimate of 39% (95% CI: 21-56%) for overall vaginal toxicities among cervical cancer patients following definitive chemoradiation. Vaginal stenosis was the most commonly reported toxicity, with a median incidence of 61.5% (range, 20-77.8%) across the studies. Severe toxicities (grade ≥ 3) were reported at rates of 12.74% (CTCAE v. 4.0), 0.98% (CTCAE v. 3.0), 10.41% (RTOG/EORTC), and 0% (LENT-SOMA). Factors, such as age, initial vaginal involvement, and radiation dose were associated with increased toxicity risk. Significant heterogeneity was observed in study populations and methodologies.
Conclusions: Vaginal toxicities are common following definitive chemoradiation in intact cervical cancer patients, with vaginal stenosis being predominant. Standardization of toxicity scoring methods and radiotherapy dose reporting parameters is crucial for accurate comparison and interpretation of findings. Future research should focus on optimizing treatment strategies to minimize vaginal toxicities while maximizing efficacy and patient outcomes.
期刊介绍：
The “Journal of Contemporary Brachytherapy” is an international and multidisciplinary journal that will publish papers of original research as well as reviews of articles. Main subjects of the journal include: clinical brachytherapy, combined modality treatment, advances in radiobiology, hyperthermia and tumour biology, as well as physical aspects relevant to brachytherapy, particularly in the field of imaging, dosimetry and radiation therapy planning. Original contributions will include experimental studies of combined modality treatment, tumor sensitization and normal tissue protection, molecular radiation biology, and clinical investigations of cancer treatment in brachytherapy. Another field of interest will be the educational part of the journal.
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