Chemo-resistance challenges the clinical management of pancreatic ductal adenocarcinoma (PDAC). A limited admittance of chemotherapeutics to PDAC tissues is a key obstacle in chemotherapy of the malignancy. An enhanced uptake of drugs into PDAC cells is required for a more effective treatment. Extracellular vesicles (EVs), especially small EVs (sEVs), have emerged as drug carriers for delivering chemotherapeutics due to their low immunogenicity and propensity for homing toward tumor cells. The present study evaluated sEVs derived from six different human cell lines as carriers for paclitaxel (PTX). The encapsulation of the chemotherapeutics was achieved using incubation, sonication and electroporation. The cytotoxicity of the EV drugs was evaluated by MTS assay. While sonication led to a higher efficiency of drug loading than incubation and electroporation, PTX loaded through incubation with HPNE-derived sEVs (HI-PTX) was the most efficacious in killing PDAC cells. Furthermore, HI-PTX was taken up by PDAC cells more efficiently than other EV drugs, implying that the efficacy of HI-PTX is associated with its efficient uptake. This was supported by the observation that the cytotoxicity and uptake of HI-PTX is mediated via the clathrin-dependent endocytosis. Our results indicate that the hTERT-HPNE cell-derived EVs are effective drug carriers to enhance paclitaxel's efficacy in PDAC cells.

Objective: This study investigates the relationship between the mRNA expression of nuclear factor erythroid 2 -related factor 2 (NRF2) and Tumor protein p53 (TP53) in circulating tumor cells (CTC) and sensitivity to radiotherapy in patients with esophageal cancer. To investigate the relationship between cytokines IL-6, CD8+, and NRF2 during patient treatment and their predictive role for treatment.Methods: Radiosensitivity was assessed by measuring a morphological or functional change in the tumor in response to ionizing radiation. Fasting venous anticoagulated blood (EDTA anticoagulation) was drawn from patients, and the Trizol-chloroform two-step method was used for RNA extraction. Data were collected from 45 patients admitted with radiotherapy alone from January 2018 to December 2021. The expression levels of NRF2mRNA (Messenger Ribose Nucleic Acid) and TP53mRNA in CTCs were detected by reverse transcription-polymerase chain reaction (RT-PCR). Pre-and post-treatment changes in IL-6 and CD8+ were recorded. The correlation between their expression level and the clinical stage, radiotherapy sensitivity, and efficacy of patients was analyzed.Results: Twenty-six cases were sensitive to radiotherapy, and 19 were resistant, for a radiotherapy sensitivity rate of 58.8%. NRF2mRNA and TP53mRNA values increased in 19 radiotherapy-resistant patients and decreased in 26 radiotherapy-sensitive patients compared with those before radiotherapy (P = 0.001, P<0.05). The Delta CT values of NRF2mRNA and TP53mRNA before treatment were moderately correlated with prognosis (P < 0.002). Inflammatory cytokine IL-6 was elevated in 22 of 45 patients after radiation, P = 0.04. NRF2 mRNA level was consistently elevated with CD8+ in 10 patients, P = 0.02.Conclusions: The expression of NRF2mRNA and TP53mRNA in the CTCs found in the peripheral blood of patients with esophageal squamous carcinoma was significantly associated with the sensitivity to radiotherapy. NRF2 mRNA level was consistently elevated with CD8+ and IL-6 in patients.

2019年12月徐州医科大学第二附属医院放疗科收治非小细胞肺癌(non-small-cell lung cancer, NSCLC)1例,男性,60岁,既往体建,否认高血压、心脏病、糖尿病及遗传性疾病史.2019年10月在外院支气管镜及头颅MR确诊左上肺黏液腺癌并脑转移,表皮生长因子受体(epidermal growth factor receptor,EGFR)基因突变阴性,患者拒绝手术治疗,入院前1个月2019年11月在当地医院行培美曲塞联合顺铂化疗(培美曲塞1.0 g,顺铂120 mg) 1个周期,疗效评估疾病稳定(stable disease,SD).2019年12月1日收住徐州医科大学第二附属医院后,查体:全身皮肤黏膜无出血点.头颅无明显异常,两肺呼吸音粗,无干湿性啰音,心律齐,腹部软,无明显肝脾肿大,未触及肿块,四肢活动正常.于2019年12月2日开始在放疗科行胸部原发肿瘤病灶和脑部转移病灶同时单纯放疗,胸部放疗剂量为60 Gy/30 F,脑部50 Gy/25 F,未行化疗.

1Department of Radiation, The Affiliated Suzhou Hospital of Nanjing Medical University and Second Affiliated Hospital of Xuzhou Medical University, Suzhou, Jiangsu, People’s Republic of China; 2Department of Radiation, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, People’s Republic of China; 3Department of Gynecologic Oncology, Cancer Hospital of University of Chinese Academy of Sciences, Hangzhou, Zhejiang, People’s Republic of China Purpose: Patterns of recurrence in cervical cancer may be useful as prognostic indicators. The aim of the present study was to determine the value of patterns of recurrence for predicting prognosis of early-stage cervical cancer. Patients and Methods: Of the 1934 patients diagnosed with primary cervical cancer between August 2008 and July 2013, 167 experienced recurrence after radical hysterectomy, including pelvic lymphadenectomy, and adjuvant postoperative treatment. The patterns of recurrence were classified into four groups: central, pelvic, distant only, and combined metastases, and the relationship between patterns of recurrence and prognosis was evaluated. Results: The patterns of lung only (21.6%), central (21.0%), and pelvic recurrence (17.4%) were the most common sites, followed by distant lymph nodes and lung with other sites. The longest 5-year survival period occurred in patients with central recurrence (70.5%), followed by distant lymph nodes (58.4%), peritoneum (58.3%), and lung only (36.8%). Late recurrence was detected in 28 patients (1.4%), who showed a better prognosis than those with early recurrence (p = 0.003). Conclusion: The patterns of recurrence help to predict prognosis. A central pattern of recurrence, distant lymph node recurrence, and peritoneal recurrence were associated with favorable outcomes after salvage therapy; however, patients who suffered other recurrent patterns, along with early recurrence, require more effective therapeutic strategies to improve survival.

Background Radiation pneumonia (RP) is the most common complication of radiotherapy to the thorax and seriously affects the survival rate and quality of life of patients. Radix Salviae Miltiorrhizae (RSM) is an ancient Chinese medicine, whose main pharmacological effect is to promote blood circulation and remove stasis. A growing number of studies have proved that RSM has a good effect on RP. However, the underlying mechanism is still unclear and needs to be fully elucidated. Methods The effective components and predictive targets of RSM were analyzed by Traditional Chinese Medicine Systems Pharmacology (TCMSP) database, and the related targets of RP were predicted by GeneCards database. The common targets of the two targets mentioned above were analyzed by protein-protein interaction on the STRING website, GO and KEGG analysis on the DAVID website, visualization by CytoScape3.7.0, and screening for Hubber gene by cytoHubber plug-in. Results A search of the TCMSP database revealed that RSM contains 65 chemical constituents and 165 potential protein targets. A total of 2,162 protein targets were found to be associated with RP. The top 10 hub genes were obtained by MCC algorithm for 70 common genes, including TP53, CASP3, MAPK1, JUN, VEGFA, STAT3, PTGS2, IL6, AKT1, and FOS. By analyzing the Gene Ontology, The anti-radiation pneumonia effect of RSM is that it performs molecular functions (protein homodimerization activity) in the nucleus through three biological processes (positive regulation of transcription from RNA polymerase II promoter,Extrinsic apoptotic signaling pathway in absence of ligand and lipopolysaccharide-mediated signaling pathway). Through KEGG analysis, the mechanism of RSM treatment of radiation pneumonia may be through PI3K-Akt, HIF-1, TNF signaling pathways. Conclusions Through network pharmacology analysis, we found the possible target genes of RSM on RP and revealed the most likely signaling pathway, providing theoretical basis for further elucidating the potential mechanism of RSM on RP.

Esophageal squamous cell carcinoma (ESCC) is one of the most lethal cancers with rapid progression and a high mortality rate. Our previous study demonstrated that DNA polymerase iota (Pol ι) is overexpressed in ESCC tumors and correlates with poor prognosis. However, its role in ESCC proliferation remains obscure. We report here that Pol ι promotes ESCC proliferation and progression through Erk- O-GlcNAc transferase (OGT) regulated Glucose-6-phosphate dehydrogenase (G6PD) overactivation. Cell clonogenic ability was assessed by colony formation assay. Cell proliferation was assessed by EdU incorporation assay. Our transcriptome data was reanalyzed by GSEA and validated by analysis of cellular metabolism, G6PD activity, and cellular NADPH concentration. The level of Pol ι, OGT, G6PD and O-GlcNAcylation in ESCC cells and patient samples were analyzed. The MEK inhibitor PD98059 was applied to confirm OGT expression regulation by the Erk signaling. The G6PD inhibitor polydatin was used to examine the role of G6PD activation in Pol ι promoted proliferation. We found that Pol ι promotes ESCC proliferation. It shunted the glucose flux towards the pentose phosphate pathway (PPP) by activating G6PD through OGT-promoted O-GlcNAcylation. The expression of OGT was positively correlated with Pol ι expression and O-GlcNAcylation. Notably, elevated O-GlcNAcylation was correlated with poor prognosis in ESCC patients. Pol ι was shown to stimulate Erk signaling to enhance OGT expression, and the G6PD inhibitor polydatin attenuated Pol ι induced tumor growth in vitro and in vivo. In conclusion, Pol ι activates G6PD through Erk-OGT-induced O-GlcNAcylation to promote the proliferation and progression of ESCC, supporting the notion that Pol ι is a potential biomarker and therapeutic target of ESCC.

BACKGROUND:Patients with cancer are at a high risk of venous thromboembolism (VTE), studies have shown that high expression of podoplanin (PDPN) in tumors is associated with increased risk of VTE.METHODS:Two human malignant cell lines (NCI-H226 and C8161) expressing high levels of PDPN were selected to explore the role of platelet in cancer-associated venous thrombosis in vitro and in vivo. Immunohistochemical staining using anti-PDPN antibody was performed in the pulmonary carcinoma patients.RESULTS:Both NCI-H226 and C8161 cells expressing high PDPN triggered platelet activation via CLEC-2 in vitro, which was abrogated by an anti-PDPN antibody SZ-168. Furthermore, the in vivo study revealed that injection of CHO-PDPN or C8161 in two mouse model of venous thrombosis activated platelets, increased platelet counts and enhanced thrombosis. More importantly, PDPN-enhanced thrombosis was reduced in mice treated with SZ168. A total of 63.3% tumor specimens stained positive for PDPN. High PDPN expression was associated with an increased risk of VTE and poor prognosis.CONCLUSIONS:PDPN expression in tumors induced platelet activation and was related to a high risk of VTE via platelet activation. SZ168 inhibited PDPN-induced platelet activation in vitro and decreased the incidence of VTE in mice.

Purpose Patterns of recurrence in cervical cancer may be useful as prognostic indicators. The aim of the present study was to determine the value of patterns of recurrence for predicting prognosis of early-stage cervical cancer. Patients and Methods Of the 1934 patients diagnosed with primary cervical cancer between August 2008 and July 2013, 167 experienced recurrence after radical hysterectomy, including pelvic lymphadenectomy, and adjuvant postoperative treatment. The patterns of recurrence were classified into four groups: central, pelvic, distant only, and combined metastases, and the relationship between patterns of recurrence and prognosis was evaluated. Results The patterns of lung only (21.6%), central (21.0%), and pelvic recurrence (17.4%) were the most common sites, followed by distant lymph nodes and lung with other sites. The longest 5-year survival period occurred in patients with central recurrence (70.5%), followed by distant lymph nodes (58.4%), peritoneum (58.3%), and lung only (36.8%). Late recurrence was detected in 28 patients (1.4%), who showed a better prognosis than those with early recurrence (p = 0.003). Conclusion The patterns of recurrence help to predict prognosis. A central pattern of recurrence, distant lymph node recurrence, and peritoneal recurrence were associated with favorable outcomes after salvage therapy; however, patients who suffered other recurrent patterns, along with early recurrence, require more effective therapeutic strategies to improve survival.

RAD18 is an E3 ubiquitin-protein ligase that has a role in carcinogenesis and tumor progression owing to its involvement in error-prone replication. Despite its significance, the function of RAD18 has not been fully examined in colorectal cancer (CRC). In the present research, by collecting clinical samples and conducting immunohistochemical staining, we found that RAD18 expression was significantly increased in the CRC tissue compared with that noted in the adjacent non-cancerous normal tissues and that high expression of RAD18 was associated with lymph node metastasis and poor prognosis in CRC patients. In vitro, as determined by cell transfection, scratch, and Transwell experiments, it was also demonstrated that RAD18 increased the invasiveness and migration capacity of CRC cells (HCT116, DLD-1, SW480). The signaling pathway was analyzed by western blotting and the clinical data were analyzed by immunohistochemical staining and RT-PCR, indicating that the process of epithelial-mesenchymal transition (EMT) may be involved in RAD18-mediated migration and invasion of CRC cells. All of the above data indicate that RAD18 is a novel prognostic biomarker that may become a potential therapeutic target for CRC in the future.

Extracellular vesicles (EVs) are small lipid bilayer-delimited nanoparticles released from all types of cells examined thus far. Several groups of EVs, including exosomes, microvesicles, and apoptotic bodies, have been identified according to their size and biogenesis. With extensive investigations on EVs over the last decade, it is now recognized that EVs play a pleiotropic role in various physiological processes as well as pathological conditions through mediating intercellular communication. Most notably, EVs have been shown to be involved in cancer initiation and progression and EV signaling in cancer are viewed as potential therapeutic targets. Furthermore, as membrane nanoparticles, EVs are natural products with some of them, such as tumor exosomes, possessing tumor homing propensity, thus leading to strategies utilizing EVs as drug carriers to effectively deliver cancer therapeutics. In this review, we summarize recent reports on exploring EVs signaling as potential therapeutic targets in cancer as well as on developing EVs as therapeutic delivery carriers for cancer therapy. Findings from preclinical studies are primarily discussed, with early phase clinical trials reviewed. We hope to provide readers updated information on the development of EVs as cancer therapeutic targets or therapeutic carriers.

目的:探讨65岁以上老年食管癌放疗病人血清白介素(IL)-37水平与放疗疗效、无进展生存期(PFS)等的相关性及其临床意义.方法:采用酶联免疫吸附实验(ELISA)法检测107例食管癌病人及107例健康对照的血清IL-37水平,分析两组之间的差异,并评估IL-37水平与食管癌分期、放疗疗效、PFS之间的相关性.结果:食管癌组与健康对照组相比,血清IL-37水平显著增高.IL-37水平与老年食管癌放疗病人的淋巴结转移、临床分期及疗效评估相关,生存分析显示高血清IL-37水平的病人放疗后PFS时间短.结论:血清IL-37水平是老年食管癌病人病情评估的重要指标,并与放疗后的预后相关.

目的:探讨奥沙利铂不同给药方式治疗复发性卵巢癌的疗效及对机体免疫状态、远期生存率的影响.方法:116例晚期复发性卵巢癌患者,随机数表法分为静脉给药组、腹腔热灌注组,每组58例.静脉给药组患者接受多西他赛联合奥沙利铂静脉给药,腹腔热灌注组患者接受多西他赛联合奥沙利铂腹腔热灌注给药,治疗3个疗程后评估疗效并记录药物相关不良反应发生情况,随访2年远期生存情况.结果:化疗后,腹腔热灌注组的治疗有效率高于静脉给药组;血清中糖类抗原125(CA125)、人附睾蛋白4(HE4)、骨桥蛋白(OPN)的水平低于静脉给药组;外周血中CD3+、CD4+T淋巴细胞分布比例及CD4+/CD8+比值高于静脉给药组,CD8+T淋巴细胞分布比例低于静脉给药组(P＞0.05).化疗期间,腹腔热灌注组患者的胃肠道反应、骨髓抑制发生率低于静脉给药组(P＜0.05).随访发现,腹腔热灌注组患者的1年生存率高于静脉给药组患者,平均生存时间长于静脉给药组患者(P＜0.05).两组患者的2年生存率差异无统计学意义(P＞0.05).结论:奥沙利铂腹腔热灌注用药可有效提升复发性卵巢癌患者的近期疗效,且在延长其生存时间方面也有一定作用.

Background Recently, several studies observed that locally advanced cervical carcinoma with negative excision repair crross-complementation group one enzyme expression has better outcomes in cisplatin-based chemotherapy or chemoradiotherapy than carcinoma with positive excission repair cross-complementation group one enzyme expression. In this meta-analysis, we quantitatively evaluated the prognostic value of excission repair cross-complementation group one enzyme expression in locally advanced cervical carcinoma patients receiving platinum-based chemotherapy or chemoradiotherapy. Materials A systematic search for relevant studies was conducted in the PubMed, Cochrane Library, EMBASE and Medline databases. Fixed- or random-effects models were used for pooled analysis. The endpoints were overall survival and disease-free survival () reported as ORs and 95% CIs. The effects of excission repair cross-complementation group one enzyme expression on the clinicopathological parameters were measured by the pooled ORs and their 95% CIs. Results Eight studies (612 patients in total) satisfied the inclusion criteria. Negative/low excission repair cross-complementation group one enzyme expression was significantly associated with better overall survival (OR, 1.92; 95%CI, 1.22 to 3.05; P = 0.005) and disease-free survival (OR, 5.77; 95%CI, 1.90 to 17.54; P = 0.002). Additionally, there were significant associations between excission repair cross-complementation group one enzyme expression and lymph node metastasis (OR, 2.57; 95%CI, 1.28 to 5.16; P = 0.008). Conclusions This meta-analysis suggested that pretreatment excission repair cross-complementation group one enzyme expression might be a useful biomarker to predict prognoses for locally advanced cervical carcinoma patients receiving platinum-based chemotherapy or chemoradiotherapy.

目的 探讨食管癌根治术后行三维放疗患者生存的影响因素.方法 回顾分析2005年1月至2009年12月常州市第一人民医院收治的食管癌根治术后行三维放疗的114例患者的临床资料.采用Kaplan-Meier生存分析法和log-rank统计检验各临床病理特征与食管癌根治术后辅助放疗患者预后的相关性.结果 114例患者术后放疗后3、5年总体生存率分别为57％和42％;Kaplan-Meier生存分析法和log-rank统计检验方法分析显示淋巴结转移阳性、淋巴结转移区域数目较多、TNM分期越高、脉管癌栓阳性和Ki-67高表达的食管癌根治术后放疗患者的预后较差,反之则患者预后较好.结论 淋巴结转移、淋巴结转移区域数目、TNM分期、脉管癌栓和Ki-67表达是食管癌术后放疗患者生存的影响因素.

目的 探讨原发性中枢神经系统淋巴瘤(primary central nervous system lymphoma,PCNSL)患者的临床特征、病理情况和预后因素.方法 回顾性分析2011年—2018年诊断为PCNSL的15例患者,患者分别接受了手术、化疗、全脑放疗(WBRT)等综合治疗.结果 15例患者的中位年龄为71岁(范围35～88岁).CD10,Bcl6,MUM1,Bcl2和MYC的蛋白表达分别占0％,57.1％,57.1％,100％和33.3％,有1例生发中心B细胞(GCB)和2例双重表达(MYC+/Bcl2+)淋巴瘤.12例患者为多发性脑病变.分别有7例,4例和3例患者接受了一线WBRT,二线WBRT和手术后巩固WBRT的治疗.中位随访时间为46.0个月,中位生存时间40.0个月,2年生存率为53.3％.与OS相关的因素是WBRT参与的时机(P=0.013).结论 影响PCNSL治疗结果的因素是治疗方案.

Purpose: Positive results have appeared among nonmetastatic breast cancer patients with the use of cognitive behavioral therapy (CBT). However, earlier stage patient results have been mixed. This novelty of this study was the focus on stage I and II breast cancer patients. The objective of the current study was to conduct a meta-analysis of psychosocial functions in early-stage breast cancer survivors to determine its efficacy. Methods: A search of Cochrane Library, EMBASE, MEDLINE, PsycInfo, and PubMed yielded 3237 abstracts, which were independently evaluated by research pairs. Meta-analysis was conducted on 8 studies that included a total of 1053 patients. Psychosocial functions were categorized according to 3 domains: (1) anxiety, (2) depression, and (3) quality of life. Results: Improvement in anxiety was observed in patients treated with CBT relative to controls without CBT (P = .04). Depression and quality of life improvement was not observed in the CBT group within or after 4 months of treatment (P > .05). Conclusions: The results indicated that observed improvements in anxiety in patients with early-stage breast cancer were moderate. The effectiveness of CBT for the improvement of patient outcomes could not be determined, given the methodological and clinical shortcomings of the included trials.

Objective To evaluate the value of peripheral blood neutrophil to lymphocyte ratio (NLR) before radiotherapy in evaluating the efficacy and prognosis of senile patients with esophageal squamous cell carcinoma (ESCC). Methods One hundred and twenty-eight senile ESCC patients treated with radiotherapy alone or concurrent radiotherapy and chemotherapy were retrospectively analyzed. The relationship between the level of NLR in peripheral blood before radiotherapy and the clinicopathological features and prognosis of ESCC patients was analyzed. Cox proportional hazard regression model was used to analyze the factors affecting total survival (OS). Results The receiver operator characteristics (ROC) curve showed that the best cut-off value of NLR before radiotherapy was3. 13. One hundred and twenty-eight patients were divided into low NLR group (n = 75) and high NLR group (n = 53). The level of NLR before radiotherapy was not related to age, sex, TNM stage and treatment modality (P＞0. 05). The effective rate of radiotherapy was 96. 0％ in low NLR group and 69. 8％ in high NLR group. The difference was statistically significant (P＜0. 05). Univariate analysis showed that NLR, N stage and TNM stage were the factors affecting OS in elderly patients with esophageal squamous cell carcinoma.Multivariate analysis showed that NLR and N staging were independent factors affecting OS in senile ESCC patients. Conclusion The high NLR level suggests that the radiotherapy effect and prognosis of elderly patients with esophageal squamous cell carcinoma are poor.

Neoadjuvant chemoradiotherapy (nCRT) has been widely applied to improve the local control rate and survival rate in patients with locally advanced rectal cancer (LARC), yet only part of LARC patients would benefit from nCRT. Therefore, it is imperative to predict the therapeutic outcome of nCRT. Here, we showed that RAD18, an E3 ubiquitin‐linked enzyme, played a fundamental role in predicting the response of LARC patients to nCRT. According to clinical data, patients with low RAD18 expression level in their pre‐nCRT biopsies had a superior response to nCRT compared to those with high RAD18 expression. Inhibition of RAD18 expression in rectal cancer cells pronouncedly attenuated the proliferation and promoted apoptosis after exposing to irradiation or/and 5‐fluorouracil (5‐Fu). Downregulated RAD18 levels increased cell apoptosis by activating caspase‐9‐caspase‐3‐mediated apoptotic pathway, thus resulting in the enhancement of cell radiosensitivity and 5‐Fu susceptibility. Furthermore, a xenograft nude mouse model showed that silencing RAD18 significantly slowed tumor growth after irradiation or/and 5‐Fu in vivo. Collectively, these results implied that RAD18 could be a new biomarker to predict LARC patients who might benefit from nCRT and provide new strategies for clinical treatment of LARC.

目的:探究表观扩散系数(ADC)与宫颈鳞癌危险因素及根治性放化疗后早期疗效之间的关系.方法:32例接受根治性放化疗的宫颈鳞癌患者分别在治疗前、治疗开始后1个月行常规磁共振(MR)及磁共振弥散加权成像(DWI)扫描,并测得治疗前后ADCmean值.治疗结束1个月后根据实体肿瘤疗效评估标准(response evaluation criteria in solid tumors,RECIST)将患者分为反应组和无反应组.计算并两两比较治疗前ADCmean(pre-ADCmean)、治疗开始后1个月ADCmean(mid-ADCmean)、ADCmean的增加(ΔADCmean)及ADCmean增加的比例(ΔADCmean％)与宫颈鳞癌分期、肿块大小、淋巴结转移情况及早期疗效之间的关系.结果:治疗开始后1个月测得的ADCmean明显高于治疗前ADCmean(P＜0.001).pre-ADCmean和ΔADCmean％与淋巴结转移情况相关(P值分别为0.01和0.04).反应组mid-ADCmean、ΔADCmean和ΔADCmean％均明显高于无反应组(P值分别为＜0.001、0.02和＜0.001).结论:ADC可作为预测宫颈鳞癌早期疗效的有效指标.

Background:Radiotherapy (RT) concurrent with cisplatin (CDDP) is the standard regimen used for treatment of locally advanced cervical carcinoma. In this meta-analysis, we compared the weekly and triweekly single CDDP concomitant chemoradiation regimens for treatment of cervical cancer with respect to compliance, recurrence, survival, and acute adverse effects.Materials and methods:A systematic search for relevant studies was conducted in PubMed, Cochrane Library, EMBASE, and Medline databases. Fixed- or random-effects model was used for pooled analysis. The end points were overall survival, recurrence, compliance, and acute adverse effect reported as odds ratios (ORs) and 95% CIs.Results:Six randomized trials and two retrospective studies qualified the inclusion criteria. The regimen of triweekly CDDP alone concurrent with RT showed better compliance (OR, 0.49; 95% CI, 0.29-0.83; P=0.009). No significant difference was observed between the 2 arms with respect to recurrence, survival, and acute adverse effects (all P>0.05). However, triweekly CDDP regimen was associated with significantly lower incidence of local recurrence (OR, 1.83; 95% CI: 1.12-3.01; P=0.02), while weekly CDDP regimen was associated with a lower risk of leucopenia (OR, 0.30; 95% CI: 0.10-0.92; P=0.03).Conclusion:Triweekly single platinum chemotherapy plus concurrent RT was superior to weekly CDDP regimen with respect to local recurrence and treatment compliance in patients with locally advanced cervical carcinoma.