Associations chimioradiothérapie chez les patientes atteintes d'un carcinome du col utérin [Concomitant chemoradiation in patients with cervix cancer].

Details

Serval ID
serval:BIB_9296BF8AC25C
Type
Article: article from journal or magazin.
Publication sub-type
Review (review): journal as complete as possible of one specific subject, written based on exhaustive analyses from published work.
Collection
Publications
Title
Associations chimioradiothérapie chez les patientes atteintes d'un carcinome du col utérin [Concomitant chemoradiation in patients with cervix cancer].
Journal
Bulletin du Cancer
Author(s)
Haie-Meder C., de Crevoisier R., Bruna A., Lhommé C., Pautier P., Morice P., Castaigne D., Bourhis J.
ISSN
1769-6917 (Electronic)
ISSN-L
0007-4551
Publication state
Published
Issued date
2005
Peer-reviewed
Oui
Volume
92
Number
12
Pages
1032-1038
Language
french
Notes
Publication types: English Abstract ; Journal Article ; Review Publication Status: ppublish
Abstract
Cervical cancer is the 2nd most common cancer among women, behind breast cancer. Concomitant chemoradiation has been assessed in more than 15 randomised clinical trials. A meta-analysis for overall survival showed a statistically significant difference in favour of chemoradiotherapy: relative risk (RR) = 1.20, 95% confidence interval (CI) = 1.14-1.26, p < 0.001, p hetero = 0.21). Disease-free survival was also statistically significantly higher in favour of chemoradiotherapy: RR = 1.26, 95%CI = 1.17-1.35, p < 0.001). The benefit was more pronounced in trials including a higher proportion of stage I and II patients. Concomitant chemoradiotherapy showed a significant benefit for both local control and distant metastasis. Gastrointestinal and haematological toxicities were significantly more frequent in the chemoradiotherapy group. Details of late toxicity were sparse and therefore it was not possible to conclude on an increase of late complication rate with concomitant chemoradiotherapy. The inclusion criteria were not the same in all the trials, resulting in populations with varying distributions in disease stages. In addition, the treatment schemas for both radiotherapy and chemotherapy used in these trials were different. These results were obtained with chemotherapy based on various molecules, including cisplatin, either alone or with other cytotoxic drugs, such as 5-fluorouracil. For a similar level of benefit, the combination of cisplatin, 5-fluorouracil and hydroxyurea was more toxic than cisplatin alone in one trial in which the two protocols were compared. Future randomised trials should also aim to establish optimal chemotherapy regimens for combination with radiotherapy.
Keywords
Antineoplastic Agents/therapeutic use, Cisplatin/therapeutic use, Combined Modality Therapy/methods, Female, Humans, Lymphatic Metastasis/radiotherapy, Radiation-Sensitizing Agents/therapeutic use, Radiotherapy Dosage, Randomized Controlled Trials as Topic, Treatment Outcome, Uterine Cervical Neoplasms/drug therapy, Uterine Cervical Neoplasms/radiotherapy
Pubmed
Create date
01/12/2014 17:39
Last modification date
20/08/2019 14:55
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