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High-dose-rate vs. low-dose-rate intracavitary brachytherapy for carcinoma of the uterine cervix: Systematic review and meta-analysis

Title
High-dose-rate vs. low-dose-rate intracavitary brachytherapy for carcinoma of the uterine cervix: Systematic review and meta-analysis
Authors
Lee, Kang KyooLee, Jong YoungNam, Jung MoKim, Chun BaePark, Kyung Ran
Ewha Authors
박경란
SCOPUS Author ID
박경란scopus
Issue Date
2015
Journal Title
BRACHYTHERAPY
ISSN
1538-4721JCR Link1873-1449JCR Link
Citation
vol. 14, no. 4, pp. 449 - 457
Keywords
High-dose-rateLow-dose-rateIntracavitary brachytherapyCarcinoma of the uterine cervixMeta-analysis
Publisher
ELSEVIER SCIENCE INC
Indexed
SCIE; SCOPUS WOS scopus
Abstract
PURPOSE: We performed a meta-analysis to compare the treatment outcomes between high-dose-rate (HDR) and low-dose-rate (LDR) intracavitary brachytherapy (ICBT) for the treatment of cervical cancer. METHODS AND MATERIALS: We searched the PubMed database for articles and the related referenced articles that compared HDR-ICBT and LDR-ICBT. A total of 15 published articles, 3 prospective randomized trials, and 12 retrospective studies performed between 1966 and December 2013 were selected using predefined inclusion and exclusion criteria for each study. The effect sizes were obtained from the odds ratios of the 5-year overall survival, 5-year disease-free survival (DFS), pelvic (locoregional) recurrence, and rectal and bladder complication rates in each study. The common effect sizes and 95% confidence intervals (CIs) were calculated using either the fixed or the random-effect model, according to the results of the homogeneity tests. RESULTS: We analyzed the outcome data for 18,937 patients, including 10,807 patients in the HDR-ICBT treatment group and 8,130 patients in the LDR-ICBT group. The common effect sizes (95% CI) for the 5-year survival rate, 5-year DFS rate, and pelvic recurrence rate were 1.1350 (0.9231-1.3955), 1.0777 (0.4896-2.3720), and 0.9521 (0.7624-1.1890), respectively. The common effect sizes (95% CI) for moderate-to-severe complication rates of the rectum and the bladder were 0.7645 (0.5099-1.1463) and 0.9051 (0.6140-1.3342), respectively. There were no significant differences between HDR- and LDR-ICBT considering the 5-year survival, 5-year DFS, pelvic recurrence, and the rectal and bladder complication rates. CONCLUSION: The treatment outcome after HDR-ICBT seems to be equivalent to that following LDR-ICBT in terms of survival, pelvic recurrence, and major complications. (C) 2015 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.
DOI
10.1016/j.brachy.2015.02.390
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의료원 > 의료원 > Journal papers
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