Abstract
BACKGROUND: There is no conclusive evidence on whether neoadjuvant chemotherapy (NACT) is suitable for locally advanced cervical cancer (LACC). This study aimed to evaluate the efficacy and safety of NACT combined with concurrent chemoradiotherapy (CCRT) and CCRT alone in LACC. This evaluation aims to offer valuable insights for clinical diagnosis and treatment decisions. METHODS: A thorough investigation was performed across the CNKI, Medline, Cochrane Library, PubMed, and EMBASE records to search for studies that evaluated NACT in combination with CCRT, as well as CCRT alone, for individuals suffering from LACC. Subsequently, we computed the odds ratios (ORs) along with their respective 95% confidence intervals (CIs). Additionally, we considered the incidence of adverse events in our analysis. RESULTS: The review encompassed 12 eligible randomized controlled trials, comprising a total of 2,609 patients (Experiment: 1,313, Control: 1,296). NACT combined with chemoradiotherapy had higher complete response rate (CRR, OR =2.06, 95% CI: 1.27-3.34) and objective response rate (ORR, OR =2.41, 95% CI: 1.20-4.87), but there was no difference in disease control rate (DCR) and 3-year survival rate. However, leucopenia was more frequent (OR =2.37, 95% CI: 1.09-5.14), and there was no difference in other adverse reactions. CONCLUSIONS: Compared with CCRT alone, combined NACT had a higher initial effect on individuals with LACC, rather than a sustained benefit. Taxol and platinum (TP) regimen may be a better option but more attention should be paid to leucopenia. Further prospective studies with larger sample sizes are needed for the development of therapy regimens for LACC.