Gynae BT 2017

BENEFIT FROM CONCOMITANT RADIOCHEMOTHERAPY

AUTHOR

RANDOMISATION ARMS STAGE

LOCOREGIONAL RECURRENCE

3 YEAR OVERALL SURVIVAL

RT + Cisplatin + HE RT+ HE SURVIVAL AND RECURRENCE AFTER CONCOMITANT CHEMOTHERAPY AND RADIOTHERAPY FOR CANCER OF UTERINE CERVIX: A SYSTEMATIC REVIEW AND META-ANALYSIS Bulky IB

9% 21% RR 0.51 (95% CI) 24.9% 30.4% RR 0.79 (90% CI)

83% 74% (p=0.008) 67% 57% (p=0.018) 65% 65% 47% (p=0.004) 75% 63% (p=0.004) 81% 71% (p=0.007) 69% 66% (p=0.42)

Keys et al N Engl J Med. 1999

RT + Cis/5-FU RT + HU

IIB,III, IVA

Whitney et al J Clin Oncol. 1999

3656 patients (19 studies)

Not reported LOCAL RECURRENCE RATE WAS SIGNIFICANTLY REDUCED BY CHEMORADIATION OR 0.61, 95% CI 0.51-0.73, p< 0.0001

RT + Cisplatin RT + Cis/5-FU+HU RT + HU

IIB,III, IVA

Rose et al N Engl J Med. 1999 Morris et al N Engl J Med. 1999 PFS OS

RCHT

RT

52%

40%

RT + Cis/5-FU RT (pelvis + paraaortal)

IB-IVA (~70% IB-IIB in each group) IA2,IB, IIA

19% 35% RR 0.47 (95% CI)

63%

47%

Toxicity Grade 3-4 Haematological Gastrointestinal

16% 9%

8% 4%

HE + RT + Cis/5-FU HE + RT

5.5% 17%

Peters et al J Clin Oncol. 2000

Green et al. Lancet 2001;358:781-86

RT+Cisplatin RT

IB-IVA Not reported

Pearcey et al J Clin Oncol. 2002