SynthesisGynecologic oncology2017
Does para-aortic irradiation reduce the risk of distant metastasis in advanced cervical cancer? A systematic review and meta-analysis of randomized clinical trials.
Synthesis in Gynecologic oncology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Extended-field radiotherapy for locally advanced cervical cancer.The Cochrane database of systematic reviews · 2018Pooled it
- Does postoperative prophylactic irradiation of para-aortic lymph nodes reduce the risk of recurrence in uterine cervical cancer with positive pelvic lymph nodes?International journal of clinical oncology · 2019Trial
- Trial
- Risk Factor Analysis and Prediction of Para-Aortic Lymph Node Metastases in Locally Advanced Cervical Cancer.Cancer medicine · 2024Article
- Controversies in the Staging of Patients with Locally Advanced Cervical Cancer.Diagnostics (Basel, Switzerland) · 2023Review
- Tertiary Cytoreduction for Isolated Lymphnode Recurrence (ILNR) Ovarian Cancer in a BRCA2 Mutated Patient: Our Experience and Prevalence of BRCA 1 or 2 Genes Mutational Status in ILNR.Medicina (Kaunas, Lithuania) · 2023Article
- The impact of para-aortic lymph node irradiation on disease-free survival in patients with cervical cancer: A systematic review and meta-analysis.Clinical and translational radiation oncology · 2022Review
- False negative rate atBMC cancer · 2021Article
- Prophylactic Extended-Field Irradiation in Patients With Cervical Cancer: A Literature Review.Frontiers in oncology · 2020Review
- Chemoradiotherapy for locally advanced cervix cancer without aortic lymph node involvement: can we consider metabolic parameters of pretherapeutic FDG-PET/CT for treatment tailoring?European journal of nuclear medicine and molecular imaging · 2019Article
- Analysis of prognostic factors and clinical outcomes in uterine cervical carcinoma with isolated para-aortic lymph node recurrence.American journal of translational research · 2019Article
- Prophylactic extended-field irradiation with concurrent chemotherapy for pelvic lymph node-positive cervical cancer.Radiation oncology journal · 2017Article
- The role of para-aortic nodal irradiation in cervical cancer.Reports of practical oncology and radiotherapy : journal of Greatpoland Cancer Center in Poznan and Polish Society of Radiation OncologyReview
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
purposeTo evaluate the impact of the extension of the radiotherapy field cranially toward para-aortic lymph nodes (EF-RT) in advanced cervical cancer. MATERIALS AND
methodsA systematic search of databases (PubMed, CENTRAL, Clinical Trials) was performed and included studies that were published between 1960 and November 2015 without language restrictions. All randomized clinical trials (RCTs) were analyzed further. All patients must have undergone pelvic radiotherapy and the same systemic therapy in both arms. The primary endpoints were locoregional failure, incidence of distant metastasis, para-aortic failure, and cancer related death. The Mantel-Haenszel method was used in the meta-analysis. The risk of bias analysis was determined using the 7-domain method per the Cochrane Handbook for Systematic Reviews of Interventions V5.1.0. A review of the treatment technique and toxicity was also performed.
resultsA total of 1309 studies were evaluated, 4 RCTs of which met the inclusion criteria; 506 patients were allocated to standard pelvic irradiation, and 494 underwent EF-RT. The risk of bias was considered to be low in nearly 80% of the domains. EF-RT significantly reduced the rate of para-aortic failure (HR 0.35, 95% CI 0.19-0.64; p<0.01) and the incidence of other distant metastases (HR 0.69, 95% CI 0.50-0.96; p=0.03). Locoregional failure and cancer-related death were not significantly altered (OR 1.06 [0.80-1.42]; p=0.67, and 0.68 [0.45-1.01]; p=0.06, respectively). The radiotherapy technique was conventional in 3 studies and conformational in 1 study. In total, 10 treatment-related deaths occurred-4 in pelvic radiation and 6 in EF-RT (OR 2.12 [0.71-6.27]; p=0.18).
conclusionsEF-RT that targets the para-aortic lymphatic chain reduces distant metastatic events, but its impact on survival is unknown. Future studies should examine the value of EF-RT using modern radiation techniques.
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