Weekly vs. tri-weekly cisplatin based chemoradiation in carcinoma cervix: a prospective randomized study of toxicity and compliance

Katke, Aradhana; Nanda, Ranjan Kumar; Thejaswini, B; Pasha, Tanvir; Giri, G.V.; Babu, Govind; Pawar, Yashwant

doi:10.5603/rpor.a2021.0115

Cited by 7 publications

(6 citation statements)

References 27 publications

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“…Gastrointestinal reactions are known to be significant adverse effects of chemoradiotherapy. [ 34 ] However, in patients treated with Xihuang Pills/Capsules combined with Western medicine, the frequency of digestive tract reactions (such as nausea, vomiting, and diarrhea) was markedly reduced (RR = 0.52, 95% CI: 0.42–0.64, P < .00001, 7 studies, 722 patients). [ 24 , 26 , 27 , 29 – 31 , 33 ] The heterogeneity test showed a value of χ 2 = 10.90, P = .09, and I 2 = 45% (Fig.…”

Section: Resultsmentioning

confidence: 99%

Meta-analysis of the efficacy and safety of Xihuang Pills/capsules in adjuvant treatment of uterine cervical neoplasms

Xu,

Tian,

et al. 2023

Medicine

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Background: Xihuang Pills/Capsules have a longstanding history of utilization in traditional Chinese medicine (TCM) for treating cancer. Nevertheless, a comprehensive investigation is required regarding the specific impacts and safety of Xihuang Pills/Capsules in individuals with uterine cervical neoplasms. Thus, conducting a meta-analysis is essential to evaluate the clinical effectiveness of combining Xihuang Pills/Capsules with Western medicine in patients with cervical neoplasms. Methods: The research involved searching 5 English and 4 Chinese databases for randomized controlled trials (RCTs) investigating the use of Xihuang Pills/Capsules in conjunction with Western medicine for treating uterine cervical neoplasms. Subsequently, statistical analysis was carried out using Review Manager software (version 5.3). Results: This research encompassed 10 RCTs involving 937 patients. The findings revealed that the combination of Xihuang Pills/Capsules with Western medicine treatment led to improvements in various aspects of the patients’ condition. Specifically, there was an enhancement in the short-term efficacy rate (risk ratio [RR] = 1.14, 95% confidence interval [CI]: 1.06–1.22, P = .0003), Karnofsky performance score (KPS) (mean difference [MD] = 5.90, 95% CI: 0.54–11.26, P = .03), survival rates, CD3+, CD3 + CD4+, CD3 + CD8+, CD3–CD56 + cells, and immunoglobulin M in patients with uterine cervical neoplasms. Moreover, the combination treatment resulted in a reduction of adverse reactions, including gastrointestinal reactions (RR = 0.52, 95% CI: 0.42–0.64, P < .00001), radiation proctitis (RR = 0.47, 95% CI: 0.33–0.68, P < .0001), myelosuppression (RR = 0.41, 95% CI: 0.26–0.64, P < .0001), as well as carcinoembryonic antigen (CEA) and squamous cell carcinoma antigen (SCC-Ag) levels. Additionally, the treatment exhibited an inhibitory effect on white blood cells (WBCs) and platelets (PLTs). Conclusion: The amalgamation of Xihuang Pills/Capsules with conventional anti-tumor therapy proves to be both effective and safe in the treatment of cervical neoplasms. However, further validation through high-quality RCTs is necessary to substantiate these findings.

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Section: Resultsmentioning

confidence: 99%

Meta-analysis of the efficacy and safety of Xihuang Pills/capsules in adjuvant treatment of uterine cervical neoplasms

Xu,

Tian,

et al. 2023

Medicine

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“…The toxicity and compliance of this cohort of patients is already documented and published in the year 2021 [ 24 ]. A meta-analysis of six randomized and two retrospective studies, comparing tri-weekly vs .…”

Section: Discussionmentioning

confidence: 99%

Ten years survival results of randomized study comparing weekly vs. triweekly cisplatin with concurrent radiation in locally advanced carcinoma cervix

Nanda,

Katke,

et al. 2023

Rep Pract Oncol Radiother.

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Background The current standard of treatment for locally advanced cervical cancer is concurrent chemo-radiation with improved overall survival (OS) by 6% with manageable toxicities. The cisplatin 40 mg/m 2 given weekly is the widely practiced regimen for 4–6 cycles concurrently with irradiation. Materials and methods Two hundred and twelve patients with histologically proven squamous cell carcinoma of cervix with stages IIB to IIIB were enrolled between 2007–2011. External beam radiation dose of 45 Gy in 25 fractions was delivered over 5 weeks. Brachytherapy was delivered by manual afterloading cesium-137 (Cs137) low dose brachytherapy (LDR) using modified Fletcher suit intracavitary applicators to a total dose of 30 Gy to Point A or interstitial template to dose of 21 Gy/3 fractions with remote afterloading iridium-192 (Ir192) high dose brachytherapy (HDR). Patients were randomized to arm A receiving 40 mg/m 2 of concurrent cisplatin weekly and arm B receiving 100 mg/m 2 of concurrent cisplatin triweekly. Results One hundred and nine patients were randomized to weekly cisplatin and one hundred and three patients to triweekly cisplatin at the end of recruitment. At ten years, the OS was higher in the weekly arm (79.8%) compared to triweekly arm (70.9%). Disease free survival (DFS) was almost equal (76.1% and 73.8%) in the weekly and three-weekly arms. There is definite significance in overall DFS with patients receiving the cumulative cisplatin doses of more than 250 mg (p = 0.028). The patients with more than 45 years of age had better overall survival (OS) (79%) with statistical significance 31 (p = 0.020). Conclusion Both cisplatin based triweekly and weekly concurrent chemotherapy are equally effective in terms of OS and DFS.

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“…Классифицировать радиосенсибилизаторы довольно сложно, поскольку некоторые химические вещества обладают сочетанным действием, например препараты металловцисплатин, гадолиний. Химиолучевая терапия на основе цисплатина является стандартным методом лечения ряда опухолей, в том числе рака легкого, карциномы шейки матки [7].…”

Section: механизмы радиосенсибилизацииunclassified

Radioprotection and Radiosensitization: A Modern View on Radiomodulators in Pharmacology

Tretyakova¹,

Belousov²,

Plotnikov³

2022

СПНО (MPSE)

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Томский национальный исследовательский медицинский центр, НИИ Психического здоровья, Томск Лучевая терапия, или «радиотерапия» -один из главных методов лечения пациентов с онкологическими заболеваниями наравне с химиотерапией и хирургическим вмешательством. Несмотря на современные достижения в лучевой терапии, по-прежнему существует противоречивая задача по усилению радиационного повреждения опухолевых клеток и снижению побочных эффектов на здоровые ткани. В значительной степени дальнейший прогресс лучевой терапии связан с правильной разработкой стратегий радиомодуляции, т.е. новых подходов и препаратов -радиопротекторов и радиосенсибилизаторов. Радиосенсибилизаторы представляют собой химические или фармацевтические агенты, которые могут усиливать эффект уничтожения опухолевых клеток за счет ускорения повреждения ДНК, косвенного образования свободных радикалов и других эффектов. Радиопротекторы в целом оказывают защитное влияние на нормальные ткани. В последние годы было использовано несколько стратегий для разработки радиосенсибилизаторов, обладающих высокой эффективностью и низкой токсичностью. В данном обзоре особое внимание уделяется механизмам действия радиомодуляторов, обобщен опыт применения радиосенсибилизаторов и радиопротекторов, включая малые молекулы, макромолекулы и наноматериалы. Рассмотрены перспективные подходы, возможные механизмы повышения эффективности и новые разработки в этом направлении. Ключевые слова: радиомодуляция, лучевая терапия, цитотоксичность радиопротекторы, радиосенсибилизаторы.

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Weekly vs. tri-weekly cisplatin based chemoradiation in carcinoma cervix: a prospective randomized study of toxicity and compliance

Abstract: This article has been peer reviewed and published immediately upon acceptance.It is an open access article, which means that it can be downloaded, printed, and distributed freely, provided the work is properly cited.

Cited by 7 publications

References 27 publications

Meta-analysis of the efficacy and safety of Xihuang Pills/capsules in adjuvant treatment of uterine cervical neoplasms

Meta-analysis of the efficacy and safety of Xihuang Pills/capsules in adjuvant treatment of uterine cervical neoplasms

Ten years survival results of randomized study comparing weekly vs. triweekly cisplatin with concurrent radiation in locally advanced carcinoma cervix

Radioprotection and Radiosensitization: A Modern View on Radiomodulators in Pharmacology

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