Analysis of Clinical Effect of Concurrent Chemo/radiotherapy in the Treatment of Advanced Cervical Cancer

The study aimed to analyze the efficacy and adverse effects of concurrent chemo/radiotherapy in the treatment of advanced cervical cancer,and the efficacy and safety of concurrent chemo/radiotherapy were evaluated to standardize the treatment.First of all,retrospective analysis was carried out,and 30 cases of advanced cervical cancer treated in hospitals from 2013 to 2018 were included in the study.30 cases of concurrent chemo/radiotherapy were included in the synchronous group,and 30 cases of radical radiotherapy alone were included in the radiotherapy group.The results showed that the CR rate and remission rate in the synchronous group were 43.3%and 93.3%,which were higher than those in the radiotherapy group(26.7%and 80.0%).The 3-year survival rate of the synchronous group was 80.0%,which was higher than that of the radiotherapy group,with a statistically significant difference(P<0.05).There was no significant difference in 3-year all-cause mortality,5-year survival and 5-year allcause mortality between the two groups.The tumor-free survival time in the synchronous group was(24.4±8.2)months,which was higher than that in the radiotherapy group(17.0±8.5)months,and the difference was statistically significant(P<0.05).Therefore,compared with radiotherapy alone,concurrent chemo/radiotherapy in the treatment of advanced cervical cancer can improve the 3-year survival rate and prolong the tumor-free survival time.However,it did not increase 5-year survival rate,and bone marrow suppression and gastrointestinal reactions were increased.

Role of adjuvant(chemo)radiotherapy for resected extrahepatic cholangiocarcinoma:a meta-analysis

Background:Adjuvant(chemo)radiotherapy(A(C)RT)may be an important supplement to surgery for extrahepatic cholangiocarcinoma(EHCC).However,whether all patients would achieve benefits from A(C)RT and which adjuvant regimen,adjuvant radiotherapy(ART)or adjuvant chemoradiotherapy(ACRT),would be preferred,are still undetermined.The low incidence of EHCC makes it difficult to carry out randomized controlled trials(RCTs);therefore,almost all clinical studies on radiotherapy are retrospective.We have conducted a meta-analysis of these retrospective studies.Methods:We conducted a meta-analysis of current retrospective studies using PubMed,Embase,and ClinicalTrials databases.All studies published in English that were related to A(C)RT and which analyzed overall survival(OS),disease-free survival(DFS),or locoregional recurrence-free survival(LRFS)were included.Estimated hazard ratios(HRs)were calculated for OS,DFS,and LRFS.Results:Data from eight studies including 685 patients were included.Our analysis showed that A(C)RT significantly improved OS(HR 0.69,95%confidence interval(CI)0.48–0.97,P=0.03),DFS(HR 0.60,95%CI 0.47–0.76,P<0.0001),and LRFS(HR 0.27,95%CI 0.17–0.41,P<0.00001)of EHCC overall.In subgroups,patients with microscopically positive resection margin(R1)could achieve a benefit from A(C)RT(HR 0.44,95%CI 0.27–0.72,P=0.001).No statistically OS difference was observed in negative resection margin(R0)subgroup(HR 0.98,95%CI 0.30–3.19,P=0.98).Significant OS benefit was found in patients who received concurrent ACRT(HR 0.40,95%CI 0.26–0.62,P<0.0001),while the result of ART without chemotherapy showed no significant benefit(HR 1.14,95%CI 0.29–4.50,P=0.85).In the distal cholangiocarcinoma subgroup,no significant difference was seen when ACRT and ART were included(HR 0.61,95%CI 0.14–2.72,P=0.52),but a significant difference was seen ewOshSpe,enDc iaFanlSla,yl yianzn iddn igsL ttRahlF ep Sca iotinne cEnutHrsr.C eCnt pAaCtieRnTt so,nelys p(eHcRi a0 ll.y2 i9 n,t9 h5 o%s eC Iw i0 t.h13 R–10 r.e6 s4 e,cPti=o0 n.0 m0 a2 r).g iCnso.n AclCusRioT nms:aAy(bCe)RsTu pmeraiyo ri tmop rAoRvTe .