Sequential Chemotherapy and Radiotherapy in the Sandwich Method for Advanced Endometrial Cancer: A Meta-Analysis

Endometrial cancer is one of the most common gynecological malignancies and the standard treatment modality has not been established. To assess the efficacy and tolerability of a sandwich method consisted of chemotherapy followed by involved field irradiation and additional chemotherapy for the treatment of advanced endometrial cancer. The Medline, Embase, Cochrane, and China National Knowledge Infrastructure (CNKI) Library were searched to identify the relevant literature published between 1970 and September 2014. A meta-analysis was performed to evaluate progression-free survival (PFS), overall survival (OS), and toxicity. A total of 5 articles were subjected to this meta-analysis. The pooled 3-year PFS and OS of patients with advanced endometrial cancer treated with the “sandwich” method was 68% (95% CI: 0.60–0.77) with no heterogeneity (I(2) = 0.00%, P = 0.77) among the studies and 75% (95% CI: 0.61–0.89) with significant heterogeneity (I(2) = 71.8%, P = 0.01), respectively. Pooled analysis of toxicity was not performed because of the substantial heterogeneity. Sequential chemotherapy and radiotherapy in the sandwich method is both efficacious and well tolerated. Large-scale randomized controlled trials (RCTs) are necessary in the future.