PURPOSE Neoadjuvant chemotherapy followed by surgery (NACT + S) has been compared with definitive chemoradiothherapy (CRT) in randomized clinical trials (RCTs) in stage IB2, IIA and IIB cervical cancer (1994 Figo stage). Our aim was to evaluate efficacy and toxicity of NACT + S and CRT and identify differences in clinical outcomes and severe toxicity frequency. METHODS The PRISMA statement was applied. Random-effects models were used. RESULTS Two RCTs representing 1259 patients were identified. NACT + S was not associated with significant OS improvement compared with CRT, with HR of 1.08 (95% CI = 0.86-1.36; p = 0.51). The HR of relapse was 1.32 (95%CI = 1.07-1.62) in favor of CRT. Severe acute toxicity was lower in CRT group. CONCLUSION This meta-analysis showed similar OS rates between treatment and CRT superiority over NACT + S in terms of DFS and severe acute toxicity. Impact on long term toxicity and quality of life remain to be proven.

中文翻译：

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新辅助化疗加手术与确定性放化疗在宫颈癌中的生存率和毒性：系统评价和荟萃分析。

目的在IB2，IIA和IIB期宫颈癌（1994 Figo期）的随机临床试验（RCT）中，已将新辅助化疗后进行手术（NACT + S）与确定性化学放射治疗（CRT）进行了比较。我们的目的是评估NACT + S和CRT的疗效和毒性，并确定临床结果和严重毒性反应频率之间的差异。方法采用PRISMA声明。使用随机效应模型。结果确定了代表1259例患者的两个RCT。与CRT相比，NACT + S与OS的显着改善无关，HR为1.08（95％CI = 0.86-1.36; p = 0.51）。复发的HR为1.32（95％CI = 1.07-1.62），支持CRT。CRT组严重急性毒性较低。结论这项荟萃分析显示，在DFS和严重急性毒性方面，治疗和CRT优于NACT + S的OS发生率相似。对长期毒性和生活质量的影响仍有待证明。