Nicholas Adrianto

Efficacy and Safety of Neoadjuvant Chemotherapy Plus Concurrent Chemoradiotherapy Compared to Concurrent Chemoradiotherapy Alone in Locally Advanced Cervical Cancer: A Systematic Review and Meta-Analysis

This systematic review and meta-analysis assessed the efficacy and safety of neoadjuvant chemotherapy (NACT) followed by concurrent chemoradiotherapy (CCRT) compared to CCRT alone in locally advanced cervical cancer (LACC). We systematically searched PubMed, ScienceDirect, Cochrane Library, EBSCOHost, ProQuest, and grey literature (Google Scholar, OpenGrey, WorldCat) up to April 26, 2024 (PROSPERO: [CRD42024540599]). Seven studies were included (stages IB2-IVA, FIGO 2018), involving 446 participants. Outcomes included complete response (CR), progression-free survival (PFS), overall survival (OS), and adverse effects. Seven studies were included (n = 1,638), with 825 patients receiving NACT+CCRT and 813 receiving CCRT alone. The NACT+CCRT group showed higher CR rates (77% vs. 70.9%), but the difference was not statistically significant (OR 1.23, 95% CI 0.40-3.83). No significant differences were found in PFS (HR 0.94, 95% CI 0.53-1.69) or OS (HR 1.07, 95% CI 0.56-2.03). Adverse effects, including anemia, neutropenia, thrombocytopenia, nausea, vomiting, fatigue, and creatinine elevation, showed no significant differences between the groups. In patients with locally advanced cervical cancer, NACT followed by CCRT is associated with comparable survival outcomes and a similar safety profile to standard CCRT, with a non-significant trend toward improved CR.

Prevalence of depression and anxiety in gestational trophoblastic disease: A systematic review and meta-analysis

Objective The objective of this systematic review and meta-analysis is to determine the prevalence of anxiety and depression among individuals diagnosed with gestational trophoblastic disease (GTD), considering the significant emotional toll associated with miscarriage, surgical procedures, and prolonged β-hCG monitoring. Methods We systematically searched for studies published up to February 2024 that reported on the prevalence of anxiety and depression in GTD. The databases included PubMed, ScienceDirect, Cochrane Library, EBSCOHost, ProQuest, and Google Scholar. Data from the included studies were independently extracted by four researchers and analyzed using MedCalc v19.5.1. This study was registered with PROSPERO (registration number CRD42024525746). Results Our analysis included seven studies involving a total of 462 participants. The findings revealed an overall prevalence of anxiety at 34.9% and depression at 22.2%, indicating a significant psychological impact on patients with GTD. Conclusion The high prevalence of anxiety and depression underscores the necessity for physicians to provide comprehensive psychological support to patients with GTD. Educating patients about their disorder, treatment options, and potential consequences is crucial for managing the psychological aspects of GTD.