Comparison of global treatment guidelines for locally advanced cervical cancer to optimize best care practices: A systematic and scoping review
Comparison of global treatment guidelines for locally advanced cervical cancer to optimize best care practices: A systematic and scoping review
复制标题
局部晚期宫颈癌全球治疗指南的比较，以优化最佳护理实践：系统性和范围界定审查
DOI：
10.1016/j.ygyno.2022.08.013
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发表时间：
2022
影响因子：
4.7
通讯作者：
Monk Bradley J.
中科院分区：
文献类型：
--
作者：
Pujade-Lauraine Eric;Tan David S.P.;Leary Alexandra;Mirza Mansoor Raza;Enomoto Takayuki;Takyar Jitender;Nunes Ana Tablante;Chag?i Jos? David Hern?ndez;Paskow Michael J.;Monk Bradley J.
背景宫颈癌的生存结果在国家和世界各地区之间存在差异。局部晚期宫颈癌（LACC）与早期疾病相比预后较差。诊断和治疗建议的国别差异可能导致各国LACC结果的差异。我们比较了LACC诊断成像和治疗建议的国际和国别指南。MethodsA系统性文献综述和有针对性的检索用于识别1999年1月至2021年8月期间发表的宫颈癌治疗指南。通过文献数据库、卫生技术评估数据库、疾病特异性网站和卫生组织网站确定指南。有针对性的搜索包括来自已知宫颈癌患病率或死亡率高的地区的国家的指南。非英语指南翻译的母语或在线translation service. ResultsForty 6准则从31个国家，地区和国际组织进行了比较（41/46使用分期标准，其中27个使用2009年FIGO）。大多数指南建议进行成像检查以进行诊断和分期。胸部X线、静脉肾盂造影、CT和MRI通常被推荐用于诊断和分期，而MRI和PET-CT被推荐用于评估淋巴结状态和远处转移，PET-CT优于MRI。全球一致认为，以顺铂为基础的同步放化疗是IIB至IVA期的主要治疗方法，少数例外。IB 2至IIA 2期的治疗建议各不相同。大多数指南同意根治性子宫切除术后，当有高复发风险时，辅助同步放化疗，当有中等复发风险时，辅助放疗。其他辅助和新辅助治疗的建议各不相同的guidelines.ConclusionsDifferences治疗指南LACC阶段可能会影响分期标准，资源的可用性，和预防计划的有效性。解决这些问题可以统一指导方针，改善全球成果。随着LACC新疗法的出现，对指南的审查和更新将非常重要。
BackgroundSurvival outcomes for cervical cancer differ between countries and world regions. Locally advanced cervical cancer (LACC) is associated with poorer outcomes than early-stage disease. Country-specific variations in diagnostic and treatment recommendations might contribute to differences in LACC outcomes among countries.ObjectiveWe compared international and country-specific guidelines for LACC diagnostic imaging and treatment recommendations.MethodsA systematic literature review and targeted search were used to identify cervical cancer treatment guidelines published between January 1999—August 2021. Guidelines were identified via literature databases, health technology assessment databases, disease-specific websites, and health organization websites. The targeted search included guidelines from countries in regions known to have high cervical cancer prevalence or mortality. Non-English guidelines were translated by native speakers or online translation services.ResultsForty-six guidelines from 31 countries, regions, and international organizations were compared (41/46 using staging criteria, 27 of which used 2009 FIGO). Most guidelines recommended imaging tests for diagnosis and staging. Chest X-ray, intravenous pyelogram, CT, and MRI were commonly recommended for diagnosis and staging while MRI and PET-CT were recommended for the assessment of lymph node status and distant metastases, with a preference for PET-CT over MRI. There was global consensus for cisplatin-based concurrent chemoradiation as primary treatment for stages IIB to IVA, with few exceptions. Treatment recommendations for stages IB2 to IIA2 varied. Most guidelines agreed on adjuvant concurrent chemoradiation after radical hysterectomy when there is a high recurrence risk, and adjuvant radiotherapy when there is an intermediate recurrence risk. Recommendations for other adjuvant and neoadjuvant therapies varied among the guidelines.ConclusionsDifferences among treatment guidelines by LACC stage might be influenced by staging criteria used, resource availability, and prevention program effectiveness. Addressing these areas may unify guidelines and improve global outcomes. Review and update of guidelines will be important as novel LACC therapies become available.