Summary of findings 3. Extended‐field chemoradiotherapy compared to pelvic chemoradiotherapy for locally advanced cervical cancer.
| Extended‐field CRT versus pelvic CRT for locally advanced cervical cancer | ||||||
| Participant: women with locally advanced cervical cancer undergoing CRT as a primary treatment Setting: specialised hospital Intervention: extended‐field CRT Comparison: pelvic CRT | ||||||
| Outcomes | Anticipated absolute effects* (95% CI) | Relative effect (95% CI) | No of participants (studies) | Certainty of the evidence (GRADE) | Comments | |
| Risk with pelvic CRT | Risk with extended‐field CRT | |||||
| Overall survival | — | — | HR 0.37 (0.14 to 0.96) | 74 (1 study) |
⊕⊝⊝⊝ Very lowa,b |
As a result of the way HRs are calculated, assumed, and corresponding risks were not estimated. |
| Para‐aortic lymph node recurrence | 139 per 1000 | 26 per 1000 (3 to 214) | RR 0.19 (0.02 to 1.54) | 74 (1 study) | ⊕⊝⊝⊝ Very lowa,b |
— |
| Progression‐free survival | — | — | HR 0.25 (0.07 to 0.87) | 74 (1 study) |
⊕⊝⊝⊝ Very lowa,b |
As a result of the way HRs are calculated, assumed and corresponding risks were not estimated |
| Acute adverse events | 83 per 1000 | 79 per 1000 (17 to 366) | RR 0.95 (0.20 to 4.39) | 74 (1 study) | ⊕⊝⊝⊝ Very lowa,b |
— |
| Late adverse events | 28 per 1000 | 26 per 1000 (2 to 405) | RR 0.95 (0.06 to 14.59) | 74 (1 study) | ⊕⊝⊝⊝ Very lowa,b |
— |
| *The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: confidence interval; CRT: chemoradiotherapy; RR: risk ratio. | ||||||
| GRADE Working Group grades of evidence High‐certainty: we are very confident that the true effect lies close to that of the estimate of the effect. Moderate‐certainty: we are moderately confident in the effect estimate: the true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different. Low‐certainty: our confidence in the effect estimate is limited: the true effect may be substantially different from the estimate of the effect. Very low‐certainty: we have very little confidence in the effect estimate: the true effect is likely to be substantially different from the estimate of effect | ||||||
aDowngraded one level due to serious risk of bias: the included study had a high risk of bias in three key domains assessed. bDowngraded two levels due to serious imprecision: small sample size and few events.