阴道近距离放疗与联合盆腔外束放疗和阴道近距离放疗治疗中至高危子宫内膜癌的疗效和安全性比较:一项系统综述和荟萃分析。

IF 1.8 Q3 ONCOLOGY
Candra Novi Ricardo Sibarani, Siti Salima, Nicholas Adrianto
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引用次数: 0

摘要

目的:本综述评估EBRT + VBT与单独VBT治疗中至高危子宫内膜癌的疗效和安全性。方法:使用PubMed、EMBASE、ProQuest、Ovid和Scopus进行系统综述和荟萃分析(截至2025年2月18日)。比较EBRT + VBT与单独VBT的研究被纳入。主要结局是盆腔复发率,次要结局包括远处复发率、总生存期和毒性。进行数据提取、偏倚风险评估(rob2、ROBINS-I)和meta分析(RevMan中的随机效应模型)。使用GRADE评价证据的确定性。普洛斯彼罗注册号:CRD420250654411。结果:8项研究包括2,672例患者符合纳入标准(1,347例接受EBRT + VBT;1325人仅患有VBT)。EBRT + VBT可显著降低盆腔复发(OR 0.14, p = 0.001),但在阴道复发(OR 0.25, p = 0.14)、远处转移(OR 0.78, p = 0.45)或总生存率(HR 0.82, p = 0.29, I2 = 72%)方面无显著差异。EBRT + VBT与较高的胃肠道、泌尿生殖系统和血液学毒性相关。结论:EBRT + VBT可改善盆腔控制,但不提高生存率,并增加毒性。单独的VBT仍然是一个可行的选择,强调个性化治疗策略的必要性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Comparative efficacy and safety of vaginal brachytherapy versus combined pelvic external beam radiotherapy and vaginal brachytherapy in managing intermediate to high-risk endometrial cancer: a systematic review and meta-analysis.

Purpose: This review assesses the efficacy and safety of EBRT + VBT versus VBT alone in intermediate- to high-risk endometrial cancer.

Methods: A systematic review and meta-analysis were conducted using PubMed, EMBASE, ProQuest, Ovid, and Scopus (until February 18, 2025). Studies comparing EBRT + VBT to VBT alone were included. The primary outcome was pelvic recurrence rate, while secondary outcomes included distant recurrence, overall survival, and toxicity. Data extraction, risk of bias assessment (RoB-2, ROBINS-I), and meta-analysis (random-effects models in RevMan) were performed. Certainty of evidence was evaluated using GRADE. PROSPERO registration: CRD420250654411.

Results: Eight studies comprising 2,672 patients met inclusion criteria (1,347 received EBRT + VBT; 1,325 had VBT alone). EBRT + VBT significantly reduced pelvic recurrence (OR 0.14, p = 0.001) but showed no difference in vaginal recurrence (OR 0.25, p = 0.14), distant metastasis (OR 0.78, p = 0.45) or overall survival (HR 0.82, p = 0.29, I2 = 72%). EBRT + VBT was associated with higher gastrointestinal, genitourinary, and hematologic toxicity.

Conclusion: EBRT + VBT improves pelvic control but does not enhance survival and increases toxicity. VBT alone remains a viable option, highlighting the need for individualized treatment strategies.

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来源期刊
CiteScore
3.50
自引率
0.00%
发文量
46
审稿时长
11 weeks
期刊介绍: As the official publication of the National Cancer Institute, Cairo University, the Journal of the Egyptian National Cancer Institute (JENCI) is an open access peer-reviewed journal that publishes on the latest innovations in oncology and thereby, providing academics and clinicians a leading research platform. JENCI welcomes submissions pertaining to all fields of basic, applied and clinical cancer research. Main topics of interest include: local and systemic anticancer therapy (with specific interest on applied cancer research from developing countries); experimental oncology; early cancer detection; randomized trials (including negatives ones); and key emerging fields of personalized medicine, such as molecular pathology, bioinformatics, and biotechnologies.
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