AUTHOR=Qiao Yunfeng , Li Huijun , Peng Bing 

TITLE=Neoadjuvant and Adjuvant Treatments Compared to Concurrent Chemoradiotherapy for Patients With Locally Advanced Cervical Cancer: A Bayesian Network Meta-Analysis

JOURNAL=Frontiers in Oncology

VOLUME=Volume 12 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2022.745522

DOI=10.3389/fonc.2022.745522

ISSN=2234-943X

ABSTRACT=Aim: This study aimed to identify the most effective treatment mode for locally advanced cervical cancer (LACC) by adopting a network meta-analysis (NMA).
Methods: RandomizeEmbased controlled trials about treatments were retrieved from PubMed, Medline and . Odds ratios (OR) of overall survival (OS) and progression-free survival (PFS) were calculated by synthesizing direct and indirect evidence to rank the efficacy of nine treatments. Consistency was assessed by node-splitting method. Begg’s test was performed to evaluate publication bias. The surface under cumulative ranking curve (SUCRA) was also used in this NMA.
Results: A total of 24 eligible randomized controlled trials with 6,636 patients were included in our NMA. These trials compared a total of nine different regimens: radiotherapy (RT) alone; surgery; RT followed by adjuvant chemotherapy (CT); concurrent chemoradiotherapy (CCRT); neoadjuvant CT followed by CCRT; CCRT followed by adjuvant CT; neoadjuvant CT, RT, CCRT followed by surgery. Among those therapeutic modalities, we found the two interventions with the highest SUCRA for OS and PFS were CCRT and CCRT plus adjuvant CT, respectively. ORs and 95% confidence interval (CI) for the two best strategies were CCRT versus CCRT plus adjuvant CT (OR, 0.84; 95% CI, 0.53-1.31) for OS, CCRT plus adjuvant CT versus CCRT (OR, 0.60; 95% CI, 0.38-0.96) for PFS. 
Conclusions: This NMA supported that CCRT and CCRT plus adjuvant CT are likely to be the most optimal treatments in terms of both OS and PFS for LACC. Future study should focus on comparing CCRT and CCRT plus adjuvant CT in the treatment of LACC