Abstract
BackgroundTo compare the efficacies and toxicities of intensity-modulated radiotherapy (IMRT) with three-dimensional conformal radiotherapy (3D-CRT) or conventional two-dimensional radiotherapy (2D-RT) for definitive treatment of cervical cancer.MethodsA meta-analysis was performed using search engines, including PubMed, Cochrane Library, Web of Science, and Elsevier. In the meta-analysis, odds ratios (ORs) were compared for overall survival (OS), disease-free survival (DFS), and acute and chronic toxicities.ResultsIncluded data were analysed using RevMan 5.2 software. Six studies encompassing a total of 1008 patients who received definitive treatment (IMRT = 350, 3-DCRT/2D-RT = 658) were included in the analysis. A comparison of 3-year OS and 3-year DFS revealed no significant differences between IMRT and 3D-CRT or 2D-RT (3-year OS: OR = 2.41, 95% confidence interval [CI]: 0.62–9.39, p = 0.21; 3-year DFS: OR = 1.44, 95% CI: 0.69–3.01, p = 0.33). The incidence of acute gastrointestinal (GI) toxicity and genitourinary (GU) toxicity in patients who received IMRT was significantly lower than that in the control group (GI: Grade 2: OR = 0.5, 95% CI: 0.28–0.89, p = 0.02; Grade 3 or higher: OR = 0.55, 95% CI: 0.32–0.95, p = 0.03; GU: Grade 2: OR = 0.41, 95% CI: 0.2–0.84; p = 0.01; Grade 3 or higher: OR = 0.31, 95% CI: 0.14–0.67, p = 0.003). Moreover, the IMRT patients experienced fewer incidences of chronic GU toxicity than did the control group (Grade 3: OR = 0.09, 95% CI: 0.01–0.67, p = 0.02).ConclusionIMRT and conventional radiotherapy demonstrated equivalent efficacy in terms of 3-year OS and DFS. Additionally, IMRT significantly reduced acute GI and GU toxicities as well as chronic GU toxicity in patients with cervical cancer.
Highlights
To compare the efficacies and toxicities of intensity-modulated radiotherapy (IMRT) with threedimensional conformal radiotherapy (3D-CRT) or conventional two-dimensional radiotherapy (2D-RT) for definitive treatment of cervical cancer
A comparison of 3-year overall survival (OS) and 3-year disease-free survival (DFS) revealed no significant differences between IMRT and Three-dimensional conformal radiotherapy (3D-CRT) or Two-dimensional radiotherapy (2D-RT) (3-year OS: odds ratios (ORs) = 2.41, 95% confidence interval [CI]: 0.62–9.39, p = 0.21; 3-year DFS: OR = 1.44, 95% CI: 0.69–3.01, p = 0.33)
The results suggested that patients with cervical cancer in the IMRT group and the 3D-CRT or 2D-RT groups did not exhibit significant differences with respect to 3-year OS
Summary
To compare the efficacies and toxicities of intensity-modulated radiotherapy (IMRT) with threedimensional conformal radiotherapy (3D-CRT) or conventional two-dimensional radiotherapy (2D-RT) for definitive treatment of cervical cancer. In the past few decades, conventional two-dimensional RT (2D-RT) has been widely used in the treatment of cervical cancer, but this treatment option suffers from a high frequency of acute and chronic complications, which affect the treatment efficacy as well as patient quality of life [3]. Three-dimensional conformal RT (3D-CRT) based on computed tomography is becoming a critical part of RT. This approach is relatively favourable in terms of the radiation dose and toxicity to organs in the exposure field [4]
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