Efficacy and safety of arterial interventional neoadjuvant chemotherapy for locally advanced cervical cancer in China: a Meta-analysis of randomized controlled trials and GRADE evidence score

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Author: ZHAO Li ^1# PENG Lei ^2# ZHANG Shaohua ^2# YANG Chunyan ¹ ZUO Manyun ¹ YANG Hongmei ¹  BIE Jun ¹

Affiliation: 1. Department of Oncology, Beijing Anzhen Nanchong Hospital, Capital Medical University & Nanchong Central Hospital, Nanchong 637000, Sichuan Province, China 2. Motor Robotics Research Institute, South China Hospital, Shenzhen University, Shenzhen 518000, Guangdong Province, China

Keywords: Locally advanced cervical cancer Neoadjuvant chemotherapy Arterial interventional chemotherapy Intravenous chemotherapy Meta-analysis

DOI: 10.12173/j.issn.2097-4922.202402031

Reference: ZHAO Li, PENG Lei, ZHANG Shaohua, YANG Chunyan, ZUO Manyun, YANG Hongmei, BIE Jun.Efficacy and safety of arterial interventional neoadjuvant chemotherapy for locally advanced cervical cancer in China: a Meta-analysis of randomized controlled trials and GRADE evidence score[J].Yaoxue QianYan Zazhi,2024, 28(3):497-506.DOI: 10.12173/j.issn.2097-4922.202402031.[Article in Chinese]  Copied

Abstract
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Abstract

Objective To evaluate the efficacy and safety of neoadjuvant arterial interventional chemotherapy (NAIC) and neoadjuvant intravenous chemotherapy (NIVC) for the treatment of locally advanced cervical cancer (LACC).

Methods Randomized controlled trials (RCTs) which fit the theme were included by searching PubMed, Web of Science, Embase, CNKI, and Wanfang databases. After study quality assessment and data extraction, statistical analysis was performed using Stata 17.0, and outcome quality was assessed using the GRADE system.

Results A total of 14 RCTs were included, with 1 063 LACC patients. The results of the Meta-analysis showed that NAIC and NIVC had a positive effect on the effectiveness indicators: complete response (CR) [RR=1.23, 95%CI (0.91, 1.67), P=0.174], partial response (PR) [RR=1.10, 95%CI (0.86, 1.20), P=0.874], total response (TR) [RR=1.10, 95%CI (0.95, 1.25), P=0.212], no change (NC) [RR=0.62, 95%CI (0.33, 1.16), P=0.137] and progressive disease (PD) [RR=1.43, 95%CI (0.41, 4.99), P=0.574] were not statistically significant. Differences in safety indicators: gastrointestinal reactions [RR=0.96, 95%CI (0.76, 1.23), P=0.755], hepatic and renal impairment [RR=0.71, 95%CI (0.41, 1.23), P=0.226] were not statistically significant. While in the incidence of myelosuppression [RR=0.62, 95%CI (0.45, 0.86), P=0.04], NAIC was superior to NIVC. In addition, the GRADE score results showed CR, PR, TR, and NC were high-quality evidence.

Conclusion For LACC patients, the incidence of myelosuppression after treatment with NAIV is lower and safer than that with NIVC, and no significant difference was found between the two in terms of other efficacy and safety indicators. Clinicians should choose the appropriate neoadjuvant chemotherapy regimen based on a comprehensive assessment of the patient's actual condition.

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References

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