Cancer Cervix- NACT vs RT+CCT

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Sheh Rawat

Saúde e medicina

Three things we can all agree on: ,[object Object]

Three things we can all agree on: ,[object Object],[object Object]

Three things we can all agree on: ,[object Object],[object Object],[object Object]

NACT+ Surgery vs CCT-RT in locally advanced Ca Cervix ,[object Object]

NACT+ Surgery vs CCT-RT in locally advanced Ca Cervix ,[object Object],[object Object]

NACT+ Surgery vs CCT-RT in locally advanced Ca Cervix ,[object Object],[object Object],[object Object]

NACT+ Surgery vs CCT-RT in locally advanced Ca Cervix ,[object Object],[object Object],[object Object],[object Object],[object Object]

Clinical trials Randomised trials Meta-analysis NCCN practice guidelines NCI practice guidelines MDACC/MSKCC

Metanalysis ,[object Object],[object Object],[object Object],Eur J Cancer. 2003 Nov;39(17):2470-86. NACT-SX RT Alone NACT-RT RT Alone

Metanalysis (NACCCMA) ,[object Object],[object Object],[object Object],[object Object],NACT-RT Vs RT Alone NACT-Surgery Vs RT Alone

Metanalysis (NACCCMA) : REVIEWERS' CONCLUSIONS: ,[object Object]

3 rd Metanalysis -Cancer Treat Rev. 2003 Oct;29(5):389-99. Modern management of locally advanced cervical carcinoma. Duenas-Gonzalez A, Cetina L, Mariscal I, de la Garza J.Unidad de Investigacion Biomedica en Cancer, Instituto Nacional de Cancerologia,Instituto de Investigaciones Biomedicas, UNAM, 14080 Tlalpan, Mexico. ,[object Object],[object Object]

Meta analysis 4: Eur J Cancer . 1999 Mar;35(3):406-9. Can the published data tell us about the effectiveness of neoadjuvantchemotherapy for locally advanced cancer of the uterine cervix?Tierney JF, Stewart LA, Parmar MK.MRC Clinical Trials Unit, Cambridge, U.K. ,[object Object]

Meta-analysis 5 :Int J Radiat Oncol Biol Phys. 1998 Mar 1;40(4):889-96. Neoadjuvant chemotherapy followed by radiotherapy should not be a standardapproach for locally advanced cervical cancer.Shueng PW, Hsu WL, Jen YM, Wu CJ, Liu HS.Department of Radiation Oncology, Far Eastern Memorial Hospital, Taipei, Taiwan, ,[object Object]

Trials favouring NACT-surgery ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

NACT-Surgery trials ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Do not close the door to future investigations

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Take home message…. ,[object Object],[object Object]

Take home message…. ,[object Object],[object Object],[object Object],[object Object]

What else can I say? Ab to maan jayo.. Meta-analysis Randomized trials Clinical trials NCI practice guidelines NCCN MDACC DeVita

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