SYSTEMATIC REVIEW/META-ANALYSIS
Efficacy and safety of radio-chemotherapy combined with thermotherapy for advanced cervical cancer in Chinese women: a meta-analysis
More details
Hide details
Submission date: 2017-10-22
Final revision date: 2017-11-22
Acceptance date: 2017-12-12
Publication date: 2017-12-31
Arch Med Sci Civil Dis 2017;2(1):182-190
KEYWORDS
TOPICS
ABSTRACT
Introduction: Pelvic deep hyperthermia is an important treatment method for cervical cancer, and it has been widely used in Chinese clinics. However, this approach has not been widely adopted all over the world because of its uncertain efficacy and safety. This meta-analysis aims to review the efficacy and safety of radio-chemotherapy combined with local hyperthermia (HT) in the treatment of cervical cancer.
Material and methods: We searched foreign and domestic databases, and also searched the related references for additional information. Data extraction and quality assessment were conducted by two reviewers independently. Rev Man 5.3 software was used to perform the meta-analysis.
Results: The thermotherapy group had a significantly higher 1-year tumor-free survival rate (OR = 2.84, 95% CI (1.14–7.09), p = 0.03), complete remission rate (OR = 2.41, 95% CI (1.94–3.01), p < 0.00001) and overall effective rate (OR = 4.11, 95% CI (3.11–5.44), p < 0.00001) than the sole radio-chemotherapy group. The thermotherapy group had a significantly lower disease stability rate (OR = 0.44, 95% CI (0.32–0.62), p < 0.00001) and disease progression rate (OR = 0.15, 95% CI (0.08–0.28), p < 0.00001) when compared with the sole radio-chemotherapy group. Both groups were statistically similar with respect to adverse reactions.
Conclusions: Radio-chemotherapy combined with thermotherapy could significantly improve short-term curative effects for patients with cervical cancer. However, due to the limited quantity and quality of the included studies, more high-quality studies with a large sample size and long-term follow-up are still needed to verify the above conclusion and explore its long-term efficacy.
REFERENCES (31)
1.
Therasse P, Arbuck SG, Eisenhauer EA, et al. New guidelines to evaluate the response to treatment in solid tumors. European Organization for Research and Treatment of Cancer, National Cancer Institute of the United States, National Cancer Institute of Canada. J Natl Cancer Inst 2000; 92: 205-16.
2.
Hanawa S, Mitsuhashi A, Usui H, et al. Daily low-dose cisplatin-based concurrent chemo-radiotherapy for the treatment of cervical cancer in patients 70 years or older. Int J Gynecol Cancer 2015; 25: 891-6.
3.
Chen MF, Tseng CJ, Tseng CC. Adjuvant concurrent chemo-radiotherapy with intensity-modulated pelvic radiotherapy after surgery for high-risk, early stage cervical cancer patients. Cancer J 2008; 14: 200-6.
4.
Datta NR, Ordóñez SG, Gaipl US, et al. Local hyperthermia combined with radiotherapy and-/or chemotherapy: recent advances and promises for the future. Cancer Treat Rev 2015; 41: 742-53.
5.
Crezee J, van Leeuwen CM, Oei AL, et al. Biological modelling of the radiation dose escalation effect of regional hyperthermia in cervical cancer. Radiat Oncol 2016; 11: 14-6.
6.
Westermann A, Mella O, Van Der Zee J, et al. Long-term survival data of triple modality treatment of stage IIB–III–IVA cervical cancer with the combination of radiotherapy, chemotherapy and hyperthermia – an update. Int J Hyperthermia 2012; 28: 549-53.
7.
Lutgens LC, Koper PC, Jobsen JJ, et al. Radiation therapy combined with hyperthermia versus cisplatin for locally advanced cervical cancer: results of the randomized RADCHOC trial. Radiother Oncol 2016; 120: 378-82.
8.
Pang RR. Clinical observation of hyperthermia combined with cisplatin concurrent chemotherapy in treatment of locally advanced cervical cancer. Chin Count Med Educat 2016; 8: 134-6.
9.
Yang XJ, Fan LX, Song JX, Xie Y. Effect of synchronization of thermotherapy and chemo-radiotherapy on cervical cancer in middle and late stage and CD4+T cells dysequilibrium. Mod J Tradit Med 2016; 26: 2871-4.
10.
Lei JH, Yu XJ, Yu YD, Di QF, Cao FJ. A clinical observation of short term effects of local thermotherapy combined with chemo-radiotherapy in treatment of stage betab cervical cancer. Mod Oncol 2016; 24: 1441-3.
11.
Zhang AY, Yan J, Xu W, Fu J, Yi JF. Clinical observation and nursing intervention of pelvic hyperthermia combined with concurrent chemo-radiotherapy for advanced cervical cancer. Nurs Pract Res 2016; 3: 087-089.
12.
Xiang L, Zhong L, Ye H, Zhang ZH, Luo HQ, Wang LY. The clinical observation of the treatment of locally advanced cervical cancer with hyperthermia combined with cisplatin. J Luzhou Med College 2015; 38: 260-3.
13.
Li GH. Effect of deep, radiotherapy and concurrent chemo-radiotherapy for locally advanced cervical cancer. Chin J Med Gu 2015; 17: 206-7.
14.
Yan J, Fu J, Du JH, Xu FW, Zhang HN. Studies of concurrent chemotherapy combined with pelvic hyperthermia in the treatment of locally advanced cervical cancer effect. Pract Clin Med J 2015; 19: 59-61.
15.
Wang P, Hui H, Wu L, Han SX, Wu L. The clinical application of hyperthermia combined with synchronous radiotherapy chemotherapy in locally advanced cervical cancer. Med J West China 2014; 26: 1596-8.
16.
Tian XF, Liu AL, Han ZH, Wang J, He QB, Bai LH. Clinical research on the treatment of advanced cervical cancer with hyperthermia combined with radiotherapy and chemotherapy. Shaanxi Med J 2014; 43: 871-3.
17.
Wang R, Yang CY. Efficacy of deep hyperthermia combined with radiotherapy chemotherapy on locally advanced cervical cancer. Clin Med 2014; 34: 70-1.
18.
Liu XL, Bao YN. Efficiency of deep hyperthermia combined with concurrent chemo-radiotherapy for locally advanced cervical cancer. J Chengdu Med College 2014; 9: 38-40.
19.
Mao HH, Zhong Y. Clinical study on endogenetic field tumor hyperthermia combined with chemotherapy and radiotherapy in the treatment of advanced cervical cancer. Chin J Clin Oncol Rehabil 2014; 21: 585-8.
20.
Xu MZ, Li XB, Zou YB, Xiong Y, Ding W. Short-term curative effect of concurrent thermotherapy and radiotherapy in the treatment of advanced cervical cancer. Jiangxi Med J 2014; 49: 736-8.
21.
Yang CY, Long AE. The short term efficacy of hyperthermia radiotherapy and chemotherapy for advanced cervical cancer patients. Mod Oncol 2013; 21: 385-7.
22.
Du K, Jin YQ, Li Q. Clinical study of hyperthermia combined with radio-chemotherapy for the treatment of advanced cervical cancers. Hainan Med J 2013; 24: 1185-6.
23.
Qi HX, Du K, Sun QS. Clinical observation of intra-modulation radiation therapy combined with hyperthermia therapy for advanced cervical cancer. J Pract Med 2013; 29: 2928-9.
24.
Ma AP, Zhong SJ, Li F, Wang Y. Efficiency of deep hyperthermia combined with concurrent radio-chemotherapy in the treatment of stage betab cervical cancer. Mod Oncol 2011; 19: 1409-11.
25.
Xu JL, Wang Y, Ren L, Gao D. Clinical study on deep hyperthermia combined with concurrent radio-chemotherapy for the treatment of advanced cervical cancers. Inner Mongolia Med J 2011; 43: 1045-7.
26.
Dong JL, Yao J. The clinical curative effect observation concomitant chemo-radiation combined deep heat treatment for cervical cancer. Adv Biomed Engineer 2011; 32: 233-5.
27.
Kok HP, Kotte ANTJ, Crezee J. Planning, optimisation and evaluation of hyperthermia treatments. Int J Hyperthermia 2017; 33: 593-607.
28.
Michalakis J, Georgatos SD, Romanos J, et al. Micromolar taxol, with or without hyperthermia, induces mitotic catastrophe and cell necrosis in HeLa cells. Cancer Chemother Pharmacol 2005; 56: 615-22.
29.
Sawaji Y, Sato T, Takeuchi A, Hirata M, Ito A. Anti-angiogenic action of hyperthermia by suppressing gene expression and production of tumour-derived vascular endothelial growth factor in vivo and in vitro. Br J Cancer 2002; 86: 1597-603.
30.
Frey B, Weiss EM, Rubner Y, et al. Old and new facts about hyperthermia-induced modulations of the immune system. Int J Hyperthermia 2012; 28: 528-42.
31.
Brüningk SC, Ijaz J, Rivens I, Nill S, Ter Haar G, Oelfke U. A comprehensive model for heat-induced radio-sensitisation. Int J Hyperthermia 2017: 1-11. doi: 10.1080/02656736.2017.1341059.