Comparison Of Combined Chemoradiotherapy For Advanced Cervical Squamous Cell:A Meta-analysis

Objective:To discuss the clinical efficacy of two different concurrent chemoradiation which nedaplatin combined chemoradiotherapy and cisplatin combined chemoradiotherapy in the treatment of advanced cervical squamous cell carcinoma and significance in the treatment of advanced squamous cell carcinoma of the cervix of these two treatment.Methods:Search PubMed,Cochrane Collaboration(No.1 of 2018),Embase Database,China Knowledge Network,VIP Database and Wanfang Database,adding manual search,and collect information of randomized controlled study(RCT)or case-control study comparing chemotherapy regimens of nedaplatin and cisplatin for middle and advanced cervical squamous cell carcinoma A.Retrieval time is limited to building libraries until January 2018.The literature that meets the conditions was selected and screened out.Two investigators evaluated the quality of documents that meet the requirements independently,and the filtered articles were used for meta-analysis using RevMan 5.3 software.Results:A total of 20 articles were included,including 5 case-control studies and 15 Single-blind Randomly Controlled Trials.Meta analysis results:① wo kinds of single-drug concurrent chemotherapy and radiotherapy in the treatment of patients with advanced cervical squamous cell carcinoma,short-term efficacy,long-term efficacy was there was no difference in the incidence of leukopenia(all P>0.05)in three-year survival rate,local recurrence rate,distant metastasis rate,and adverse reactions.②The incidence of renal impairment in the nedaplatin concurrent chemoradiation group was significantly lower than that in the cisplatin group[OR= 5.00,95%CI(3.32,7.52),P<0.00001]③nedplatin Combined chemoradiotherapy group could 2 reduce the incidence of Gastrointestinal reaction of the cervic cancer patients[OR= 4.30,95%CI(3.43,5.39),P<0.00001].④ nedplatin Combined chemoradiotherapy group could reduce the incidence of Thrombopenia of the cervic cancer patients[OR= 0.44,95%CI(0.30,0.63),P<0.0001]. Conclusion:Concurrent chemoradiotherapy with cisplatin and nedaplatin both can improve the short-and long-term efficacy and reduce the local recurrence and distant metastasis of patients with advanced uterine cervical cancer,but tends to elevate in Nedaplatin.The side effects of Cisplatin including renal toxicity,gastrointestinal toxicity and Thrombopenia in treatment regimens.Nedaplatin is less toxic which is worth to give further clinical research.