Meta-analysis Of The Application Value Of Radiotherapy And Chemotherapy After Operation In High-risk Endometrial Cancer Compared With Radiotherapy Alone

Objective:To systematically evaluate the application value of two adjuvant treatment schemes,radiochemotherapy and radiotherapy alone,in patients with high-risk endometrial cancer.Methods:Computer Retrieval: Randomized Controlled Trials of Postoperative Radiotherapy and Radiotherapy for High Risk Endometrial Carcinoma,including Medline,Pubmed,Library,Cochrane,Embase,OVID,Web of Science,CNKI,Wanfang Data,Chongqing Vip Chinese Journal Full Text Database(VIP)and Simple Radiotherapy,showed no improvement in 5-year survival rate and 5-year survival rate of each study.The extended survival rate,5-year overall recurrence rate,3-4 grade complications related to treatment and 5-year tumour-specific survival rate were analyzed with Revman 5.3 software to evaluate the benefits of the two treatment schemes for patients with endometrial cancer.Results:Five RCTs and Mate analysis showed that there was no significant difference in 5-year overall survival rate(RR = 1.00,95% CI: 0.78,1.27,Z = 0,P > 0.05),5-year progression-free survival rate(RR = 1.35,95% CI: 1.04,1.76,Z = 2.25,P < 0.05),5-year overall recurrence rate(RR = 0.64,95% CI: 0.50,0.82,Z = 3.63,P < 0.05)compared with radiotherapy alone.The 5-year tumor-specific survival rate(RR = 1.58,95% CI: 1.16,2.15,Z = 2.88,P < 0.05)was better than that of post-operative radiotherapy alone,while the treatment-related complications of grade 3-4(RR = 10.62,95% CI: 7.28,15.51,Z = 12.25,P < 0.0001,P < 0.05)were higher than that of post-operative radiotherapy alone.Conclusion:Compared with postoperative radiotherapy alone,postoperative combined chemoradiotherapy can improve 5-year progression-free survival rate,5-year tumor-specific survival rate and reduce 5-year overall recurrence rate of patients with high-risk endometrial cancer,but it has many adverse reactions and can not improve 5-year overall survival rate.