Adjuvant chemotherapy for endometrial cancer after hysterectomy

作者：Nick P. Johnson, Andrew Bryant, Tracie Miles, Thomas Högberg, Paul Cornes · 发表于：Cochrane Database of Systematic Reviews · 年份：2011 · DOI：10.1002/14651858.cd003175.pub2 · 被引用次数：111 · 研究领域：Endometrial and Cervical Cancer Treatments、Sarcoma Diagnosis and Treatment、Gynecological conditions and treatments

BACKGROUND: Endometrial adenocarcinoma (womb cancer) is a malignant growth of the lining (endometrium) of the womb (uterus). It is distinct from sarcomas (tumours of the uterine muscle). Survival depends the risk of microscopic metastases after surgery. Adjuvant (postoperative) chemotherapy improves survival from some other adenocarcinomas, and there is evidence that endometrial cancer is sensitive to cytotoxic therapy. This systematic review examines the effect of chemotherapy on survival after hysterectomy for endometrial cancer. OBJECTIVES: To assess efficacy of adjuvant (postoperative) chemotherapy for endometrial cancer. SEARCH STRATEGY: We searched the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library 2010, Issue 3), MEDLINE and EMBASE up to August 2010, registers of clinical trials, abstracts of scientific meetings, reference lists of included studies and contacted experts in the field. SELECTION CRITERIA: Randomised controlled trials (RCTs) comparing adjuvant chemotherapy with any other adjuvant treatment or no other treatment. DATA COLLECTION AND ANALYSIS: We used a random-effects meta-analysis to assess hazard ratios (HR) for overall and progression-free survival and risk ratios (RR) to compare death rates and site of initial relapse. MAIN RESULTS: Five RCTs compared no additional treatment with additional chemotherapy after hysterectomy and radiotherapy. Four trials compared platinum based combination chemotherapy directly with radiother...