PICO ASN.pptx

7/24/2019 PICO ASN.pptx

1/25

Chemotherapy And

Radiotherapy for AdvancedCervical Cancer

Achmadi Sulistyo Nugroho

PICO


2/25

1st Journal


3/25

A Randomized Trial of Standard versus Partially

Hyperfractionated Radiation with or without Concurrent 5-Fluorouracil in ocally Advanced Cervical Cancer

GYNECOLOGIC ONCOLOGY 69, 137145

O Objcti! " dtrmin #hthr th addition o$concurrnt %&'uorouracil (%&)*+ and,or a changin radiation $ractionation im-ro!s -l!ic controland sur!i!al or dcrass com-lications in

ad!ancd cr!ical cancr. )IGO stags I/,IIA (0%cm+ to IA inclusi!2


4/25

3atrial and 3thods

S

ubjct

4im " January 5667 8 9cmbr 5616

Patint slction intrnal databas

9ata collction rtros-cti!ly collctd

Sam-l si: " 51 -atints

Patint critria rci!d on -r!iouschmothra-y lin $or th tratmnt o$ incurabl

disas

"


5/25

3atrial and 3thodsStratum 1 " thos #ith )IGO stag I/,IIA or stag II/ #ithStratum 5 includd thos #ith )IGO stag II/ disas #ith any lat


6/25

Intr!ntion

A !arity o$ to-otcan

schduls #r -rscribd

62;% mg,m5 -r dayduring % conscuti! days

to 526 mg,m5 -r dayduring < conscuti! days

E!ry 51 days or #=lyto-otcan at gimn slction. dos

adjustmnts and dlays insubs?unt cycls byth assistant -hysician.according to clinical!aluation and -rsntdto@icitis2

istory. -hysical@amination andlaboratory !aluations#r obtaind -rior toach tratmnt cycl2


7/25

Outcom


8/25


9/25


10/25


11/25


12/25


13/25


14/25


15/25

Conclusion4o-otcan. as a singl agnt or in combination. @ihibits only modstacti!ity in a -o-ulation o$ -r!iously tratd -atints #ith cr!icalcancr albit at a cost o$ substantial hmatologic to@icity

4h limitd acti!ity o$ to-otcan schmas in scond& lintratmnt o$ cr!ical cancr and th associatd o!r& all to@icityas sho#n in this rtros-cti! study may not justi$y thir us inthis stting2

Patints #ho -rogrss a$tr Brst&lin tratmnt may b ord-artici-ation in clini& cal trials. othr scond&lin agnts or bstsu--orti! car masurs2


16/25

2nd Jornal

Euro-an Journal o$ Cancr


17/25

Objcti!Primary

th -ro-ortion o$ -atints #ith -rogrssion $r sur!i!al (P)S+$or at last F months and th $r?uncy and s!rity o$ad!rs !nts

Scondary

to stimat th -robability o$ clinical rs-ons. th

distribution o$ o!rall sur!i!al (OS+. th distribution o$P)S. and th im-act o$ -otntial -rognostic $actors on P)Sor OS2


18/25

3atrial and 3thods

3

thods

4im " A-ril 5665 8 No!mbr 566F

4h study rci!d local institutional r!i# boarda--ro!al at -artici-ating institutions. and all -atintsga! in$ormd consnt according to institutional and

$dral guidlins b$or nrollmnt2

Sam-l si: " %6 -atints


19/25

3atrial and 3thods*-&to&dat in$ormation on th dat o$


20/25

!tcome comparison ! comparison "

11 -atints

-rogrssion$r $or at lastF months

% -atints

-artialrs-ons

3dian tim

rs-ons F251months

P)S


21/25


22/25


23/25

Im-licationO There are two alternative neoad#uvant strate$ies to improve

lon$-term outcomes% &ne is a short cycle' dose intensive course

of cisplatin-(ased chemotherapy prior to radiotherapy% The

second is similar chemotherapy $iven prior to sur$ery )with or

without radiotherapy*'


24/25

O sim-ulanO Pmbrian NAC sblum dila=u=ano-rasi mmbri=an man$aat yang lbihbsar dari-ada ji=a dila=u=an o-rasitan-a NAC dulu atau hanya dibri=anradiasi saja2


25/25

"han# yo

PICO ASN.pptx

Documents

Transcript of PICO ASN.pptx