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

Détails

ID Serval
serval:BIB_9296BF8AC25C
Type
Article: article d'un périodique ou d'un magazine.
Sous-type
Synthèse (review): revue aussi complète que possible des connaissances sur un sujet, rédigée à partir de l'analyse exhaustive des travaux publiés.
Collection
Publications
Titre
Associations chimioradiothérapie chez les patientes atteintes d'un carcinome du col utérin [Concomitant chemoradiation in patients with cervix cancer].
Périodique
Bulletin du Cancer
Auteur(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
Statut éditorial
Publié
Date de publication
2005
Peer-reviewed
Oui
Volume
92
Numéro
12
Pages
1032-1038
Langue
français
Notes
Publication types: English Abstract ; Journal Article ; Review Publication Status: ppublish
Résumé
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.
Mots-clé
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
Création de la notice
01/12/2014 18:39
Dernière modification de la notice
03/03/2018 19:32
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