Comparative efficacy and safety of vaginal brachytherapy versus combined pelvic external beam radiotherapy and vaginal brachytherapy in managing intermediate to high-risk endometrial cancer: a systematic review and meta-analysis
Abstract Purpose This review assesses the efficacy and safety of EBRT + VBT versus VBT alone in intermediate- to high-risk endometrial cancer. Methods A systematic review and meta-analysis were conducted using PubMed, EMBASE, ProQuest, Ovid, and Scopus (until February 18, 2025). Studies comparing EB...
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| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
| Published: |
SpringerOpen
2025-06-01
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| Series: | Journal of the Egyptian National Cancer Institute |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s43046-025-00302-1 |
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| Summary: | Abstract Purpose This review assesses the efficacy and safety of EBRT + VBT versus VBT alone in intermediate- to high-risk endometrial cancer. Methods A systematic review and meta-analysis were conducted using PubMed, EMBASE, ProQuest, Ovid, and Scopus (until February 18, 2025). Studies comparing EBRT + VBT to VBT alone were included. The primary outcome was pelvic recurrence rate, while secondary outcomes included distant recurrence, overall survival, and toxicity. Data extraction, risk of bias assessment (RoB-2, ROBINS-I), and meta-analysis (random-effects models in RevMan) were performed. Certainty of evidence was evaluated using GRADE. PROSPERO registration: CRD420250654411. Results Eight studies comprising 2,672 patients met inclusion criteria (1,347 received EBRT + VBT; 1,325 had VBT alone). EBRT + VBT significantly reduced pelvic recurrence (OR 0.14, p = 0.001) but showed no difference in vaginal recurrence (OR 0.25, p = 0.14), distant metastasis (OR 0.78, p = 0.45) or overall survival (HR 0.82, p = 0.29, I2 = 72%). EBRT + VBT was associated with higher gastrointestinal, genitourinary, and hematologic toxicity. Conclusion EBRT + VBT improves pelvic control but does not enhance survival and increases toxicity. VBT alone remains a viable option, highlighting the need for individualized treatment strategies. |
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| ISSN: | 2589-0409 |