Evidence map›Paper›PMID 34312220›Full record

ArticleInternational journal of gynecological cancer : official journal of the International Gynecological Cancer Society2021

Chemoradiation versus radiation alone in stage IIIB cervical cancer patients with or without human immunodeficiency virus.

Surbhi Grover, Matthew S Ning, Michelle Bale, Katie E Lichter, Sidrah Shah, Memory Bvochora-Nsingo, Sebathu Chiyapo, Dawn Balang, Gwendolyn J McGinnis, Tlotlo Ralefala and 5 more

Open access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in International journal of gynecological cancer : official journal of the International Gynecological Cancer Society, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 2 pooled it
0.5field-weighted citation impact, top 36% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 2 syntheses or guidelines pooled it, 6 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Review
  4. Review
  5. Article
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors at 7 institutions in 3 countries.

Surbhi GroverRadiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania, USA surbhi.grover@pennmedicine.upenn.edu.
Matthew S NingRadiation Oncology, University of Texas MD Anderson Cancer Center Division of Radiation Oncology, Houston, Texas, USA.
Michelle BaleRadiation Oncology, The University of British Columbia, Vancouver, British Columbia, Canada.
Katie E LichterRadiation Oncology, University of California San Francisco, San Francisco, California, USA.
Sidrah ShahThe University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Memory Bvochora-NsingoLife Gaborone Private Hospital, Gaborone, Gaborone, Botswana.
Sebathu ChiyapoLife Gaborone Private Hospital, Gaborone, Gaborone, Botswana.
Dawn BalangLife Gaborone Private Hospital, Gaborone, Gaborone, Botswana.
Gwendolyn J McGinnisRadiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
Tlotlo RalefalaPrincess Marina Hospital, Gaborone, Gaborone, Botswana.
Thabo MoloiPrincess Marina Hospital, Gaborone, Gaborone, Botswana.
Rebecca LuckettObstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.
Doreen Ramogola-MasireObstetrics & Gynaecology - Faculty of Medicine, University of Botswana, Gaborone, Botswana.
Erle S RobertsonMicrobiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Nicola M ZetolaBotswana-University of Pennsylvania Partnership, Philadelphia, Pennsylvania, USA.
The University of Texas MD Anderson Cancer Center · USUniversity of Botswana · BWUniversity of Pennsylvania · USBeth Israel Deaconess Medical Center · USThe University of Texas Southwestern Medical Center · USUniversity of British Columbia · CAUniversity of California, San Francisco · US

Funding

Virus & Reservoirs CoreP30AI045008 · NIAID · UNIVERSITY OF PENNSYLVANIA · PI ROBERT GROSS · 1999 to 2026
$78.6M
Shared Resources CoreU54CA190158 · NCI · UNIVERSITY OF PENNSYLVANIA · PI ROBERTSON, ERLE S. · 2014 to 2023
$4.2M
Prognostic value of quantitative HPV viral load in determining cervical cancer treatment response and recurrenceK08CA230170 · NCI · UNIVERSITY OF PENNSYLVANIA · PI GROVER, SURBHI · 2019 to 2023
$1.4M
NCI NIH HHS K08 CA230170NCI NIH HHS U54 CA190158NIAID NIH HHS P30 AI045008
6 · The paper itself

Abstract

objectiveCervical cancer remains the most common cancer among women in sub-Saharan Africa and is also a leading cause of cancer related deaths among these women. The benefit of chemoradiation in comparison with radiation alone for patients with stage IIIB disease has not been evaluated prospectively in women living with human immunodeficiency virus (HIV). We assessed the survival of chemoradiation versus radiation alone among stage IIIB cervical cancer patients based on HIV status.

methodsBetween February 2013 and June 2018, patients with International Federation of Gynecology and Obstetrics (FIGO) 2009 stage IIIB cervical cancer with or without HIV and treated with chemoradiation or radiation alone, were prospectively enrolled in an observational cohort study. Overall survival was evaluated using the Kaplan-Meier method. Cox proportional hazards modeling was used to analyze associations with survival.

resultsAmong 187 patients, 63% (n=118) of women had co-infection with HIV, and 48% (n=69) received chemoradiation. Regardless of HIV status, patients who received chemoradiation had improved 2 year overall survival compared with those receiving radiation alone (59% vs 41%, p<0.01), even among women living with HIV (60% vs 38%, p=0.02). On multivariable Cox regression analysis, including all patients regardless of HIV status, 2 year overall survival was associated with receipt of chemoradiation (hazard ratio (HR) 0.63, p=0.04) and total radiation dose ≥80 Gy (HR 0.57, p=0.02). Among patients who received an adequate radiation dose of ≥80 Gy, adjusted overall survival rates were similar between chemoradiation versus radiation alone groups (HR 1.07; p=0.90). However, patients who received an inadequate radiation dose of <80 Gy, adjusted survival was significantly higher in chemoradiation versus radiation alone group (HR 0.45, p=0.01).

conclusionsAddition of chemotherapy to standard radiation improved overall survival, regardless of HIV status, and is even more essential in women who cannot receive full doses of radiation.

Indexed as

AdultAgedChemoradiotherapyFemaleHIV InfectionsHumansMiddle AgedNeoplasm StagingSurvival AnalysisUterine Cervical Neoplasmscervical cancerradiation oncologyuterine cervical neoplasms

Identifiers

PMID34312220
PMCPMC8675879
OpenAlexW3183967008

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.