Asian Pac J Cancer Prev. 2025 Aug 1;26(8):2793-2802. doi: 10.31557/APJCP.2025.26.8.2793.
ABSTRACT
INTRODUCTION: This systematic review and meta-analysis assessed the efficacy and safety of neoadjuvant chemotherapy (NACT) followed by concurrent chemoradiotherapy (CCRT) compared to CCRT alone in locally advanced cervical cancer (LACC).
METHODS: We systematically searched PubMed, ScienceDirect, Cochrane Library, EBSCOHost, ProQuest, and grey literature (Google Scholar, OpenGrey, WorldCat) up to April 26, 2024 (PROSPERO: [CRD42024540599]). Seven studies were included (stages IB2-IVA, FIGO 2018), involving 446 participants. Outcomes included complete response (CR), progression-free survival (PFS), overall survival (OS), and adverse effects.
RESULTS: Seven studies were included (n = 1,638), with 825 patients receiving NACT+CCRT and 813 receiving CCRT alone. The NACT+CCRT group showed higher CR rates (77% vs. 70.9%), but the difference was not statistically significant (OR 1.23, 95% CI 0.40-3.83). No significant differences were found in PFS (HR 0.94, 95% CI 0.53-1.69) or OS (HR 1.07, 95% CI 0.56-2.03). Adverse effects, including anemia, neutropenia, thrombocytopenia, nausea, vomiting, fatigue, and creatinine elevation, showed no significant differences between the groups.
CONCLUSION: In patients with locally advanced cervical cancer, NACT followed by CCRT is associated with comparable survival outcomes and a similar safety profile to standard CCRT, with a non-significant trend toward improved CR.
PMID:40849695 | DOI:10.31557/APJCP.2025.26.8.2793
