Adjuvant radiotherapy for stage I endometrial cancer: systematic review and meta-analysis
Identifieur interne : 001060 ( Istex/Curation ); précédent : 001059; suivant : 001061Adjuvant radiotherapy for stage I endometrial cancer: systematic review and meta-analysis
Auteurs : A. Kong ; I. Simera ; M. Collingwood ; C. Williams ; H. Kitchener [Royaume-Uni]Source :
- Annals of Oncology [ 0923-7534 ] ; 2007-03-07.
Abstract
The role of adjuvant radiotherapy in stage I endometrial cancer following surgery remains unclear. The management for these patients varies widely, particularly in stage I patients with different risk factors. Using the methodology of Cochrane Collaboration, we did a systematic and meta-analysis of all know randomised controlled trials which compared adjuvant radiotherapy versus no radiotherapy following surgery for patients with stage I endometrial cancer. The meta-analysis was carried out on four trials (three published and one unpublished) and a total of 1770 patients. The addition of pelvic external beam radiotherapy to surgery reduced locoregional recurrence, a relative risk (RR) of 0.28 [95% confidence interval (CI) 0.170.44, P < 0.00001], which is a 72% reduction in the risk of pelvic relapse (95% CI 56% to 83%) and an absolute risk reduction of 6% (95% CI of 4% to 8%). The reduction in the risk of locoregional recurrence did not translate into a reduction in the risks of death from all causes, endometrial cancer death or distant recurrence. A subgroup analysis showed a trend towards the reduction in the risks of death from all causes and endometrial cancer in patients with multiple high risk factors (including stage 1c and grade 3). External beam pelvic radiotherapy should be considered in patients with multiple high-risk features including stage 1c and grade 3. However, it carries an inherent risk of damage and toxicity and should be avoided in stage 1 endometrial cancer patients with no high risk factors.
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DOI: 10.1093/annonc/mdm066
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A. Kong<affiliation><mods:affiliation>E-mail: anthonyhkong@hotmail.com</mods:affiliation><wicri:noCountry code="no comma">E-mail: anthonyhkong@hotmail.com</wicri:noCountry></affiliation><affiliation><mods:affiliation>Centre for Statistics in Medicine, Wolfson College Annexe, University of Oxford, Linton Road, Oxford OX2 6UD</mods:affiliation><wicri:noCountry code="subField">6UD</wicri:noCountry></affiliation><affiliation><mods:affiliation>Radiotherapy Department, Churchill Hospital, Old Road, Headington, Oxford OX3 7LJ</mods:affiliation><wicri:noCountry code="subField">7LJ</wicri:noCountry></affiliation><affiliation><mods:affiliation>Bristol Haematology and Oncology Centre, Horfield Road, Bristol BS2 8ED</mods:affiliation><wicri:noCountry code="subField">8ED</wicri:noCountry></affiliation>Le document en format XML
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Simera</name><affiliation><mods:affiliation>Centre for Statistics in Medicine, Wolfson College Annexe, University of Oxford, Linton Road, Oxford OX2 6UD</mods:affiliation><wicri:noCountry code="subField">6UD</wicri:noCountry></affiliation></author><author><name sortKey="Collingwood, M" sort="Collingwood, M" uniqKey="Collingwood M" first="M." last="Collingwood">M. Collingwood</name><affiliation><mods:affiliation>Radiotherapy Department, Churchill Hospital, Old Road, Headington, Oxford OX3 7LJ</mods:affiliation><wicri:noCountry code="subField">7LJ</wicri:noCountry></affiliation></author><author><name sortKey="Williams, C" sort="Williams, C" uniqKey="Williams C" first="C." last="Williams">C. 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Kitchener</name><affiliation wicri:level="1"><mods:affiliation>Academic Unit of Obstetrics and Gynaecology, University of Manchester, St Mary's Hospital, Whitworth Park, Manchester M13 0JH, UK</mods:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Academic Unit of Obstetrics and Gynaecology, University of Manchester, St Mary's Hospital, Whitworth Park, Manchester M13 0JH</wicri:regionArea></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:23E2E2B26193FBCFAC9B85695FD37C776BCCDF46</idno><date when="2007" year="2007">2007</date><idno type="doi">10.1093/annonc/mdm066</idno><idno type="url">https://api.istex.fr/document/23E2E2B26193FBCFAC9B85695FD37C776BCCDF46/fulltext/pdf</idno><idno type="wicri:Area/Istex/Corpus">001060</idno><idno type="wicri:explorRef" wicri:stream="Istex" wicri:step="Corpus" wicri:corpus="ISTEX">001060</idno><idno type="wicri:Area/Istex/Curation">001060</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a">Adjuvant radiotherapy for stage I endometrial cancer: systematic review and meta-analysis</title><author><name sortKey="Kong, A" sort="Kong, A" uniqKey="Kong A" first="A." last="Kong">A. Kong</name><affiliation><mods:affiliation>Radiotherapy Department, St Bartholomew's Hospital, London EC1</mods:affiliation></affiliation><affiliation><mods:affiliation>E-mail: anthonyhkong@hotmail.com</mods:affiliation><wicri:noCountry code="no comma">E-mail: anthonyhkong@hotmail.com</wicri:noCountry></affiliation></author><author><name sortKey="Simera, I" sort="Simera, I" uniqKey="Simera I" first="I." last="Simera">I. Simera</name><affiliation><mods:affiliation>Centre for Statistics in Medicine, Wolfson College Annexe, University of Oxford, Linton Road, Oxford OX2 6UD</mods:affiliation><wicri:noCountry code="subField">6UD</wicri:noCountry></affiliation></author><author><name sortKey="Collingwood, M" sort="Collingwood, M" uniqKey="Collingwood M" first="M." last="Collingwood">M. Collingwood</name><affiliation><mods:affiliation>Radiotherapy Department, Churchill Hospital, Old Road, Headington, Oxford OX3 7LJ</mods:affiliation><wicri:noCountry code="subField">7LJ</wicri:noCountry></affiliation></author><author><name sortKey="Williams, C" sort="Williams, C" uniqKey="Williams C" first="C." last="Williams">C. Williams</name><affiliation><mods:affiliation>Bristol Haematology and Oncology Centre, Horfield Road, Bristol BS2 8ED</mods:affiliation><wicri:noCountry code="subField">8ED</wicri:noCountry></affiliation></author><author><name sortKey="Kitchener, H" sort="Kitchener, H" uniqKey="Kitchener H" first="H." last="Kitchener">H. Kitchener</name><affiliation wicri:level="1"><mods:affiliation>Academic Unit of Obstetrics and Gynaecology, University of Manchester, St Mary's Hospital, Whitworth Park, Manchester M13 0JH, UK</mods:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Academic Unit of Obstetrics and Gynaecology, University of Manchester, St Mary's Hospital, Whitworth Park, Manchester M13 0JH</wicri:regionArea></affiliation></author></analytic><monogr></monogr><series><title level="j">Annals of Oncology</title><idno type="ISSN">0923-7534</idno><idno type="eISSN">1569-8041</idno><imprint><publisher>Oxford University Press</publisher><date type="published" when="2007-03-07">2007-03-07</date><biblScope unit="volume">18</biblScope><biblScope unit="issue">10</biblScope><biblScope unit="page" from="1595">1595</biblScope><biblScope unit="page" to="1604">1604</biblScope></imprint><idno type="ISSN">0923-7534</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0923-7534</idno></seriesStmt></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract">The role of adjuvant radiotherapy in stage I endometrial cancer following surgery remains unclear. The management for these patients varies widely, particularly in stage I patients with different risk factors. Using the methodology of Cochrane Collaboration, we did a systematic and meta-analysis of all know randomised controlled trials which compared adjuvant radiotherapy versus no radiotherapy following surgery for patients with stage I endometrial cancer. The meta-analysis was carried out on four trials (three published and one unpublished) and a total of 1770 patients. The addition of pelvic external beam radiotherapy to surgery reduced locoregional recurrence, a relative risk (RR) of 0.28 [95% confidence interval (CI) 0.170.44, P < 0.00001], which is a 72% reduction in the risk of pelvic relapse (95% CI 56% to 83%) and an absolute risk reduction of 6% (95% CI of 4% to 8%). The reduction in the risk of locoregional recurrence did not translate into a reduction in the risks of death from all causes, endometrial cancer death or distant recurrence. A subgroup analysis showed a trend towards the reduction in the risks of death from all causes and endometrial cancer in patients with multiple high risk factors (including stage 1c and grade 3). External beam pelvic radiotherapy should be considered in patients with multiple high-risk features including stage 1c and grade 3. However, it carries an inherent risk of damage and toxicity and should be avoided in stage 1 endometrial cancer patients with no high risk factors.</div></front></TEI></record>Pour manipuler ce document sous Unix (Dilib)
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