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La falta de respuesta temprana a la quimioterapia neoadyuvante aumentará la recurrencia del cáncer cervical: una

Shiqing Huang^1,2, Runfeng Yang³, Li Yang^1,2

¹Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.

|August 28, 2025

Resumen

La no respuesta temprana a la quimioterapia neoadyuvante (NACT) predice significativamente una peor supervivencia libre de enfermedad (DFS) en pacientes con cáncer de cuello uterino. Este hallazgo pone de relieve la necesidad de estrategias de tratamiento optimizadas para los que no responden.

Área de la Ciencia:

Oncología ginecológica
Oncología médica
Investigación clínica

Sus antecedentes:

El cáncer de cuello uterino representa un desafío significativo para la salud de las mujeres en todo el mundo.
La quimioterapia neoadyuvante (NACT) es una opción de tratamiento emergente, pero sus implicaciones pronósticas, particularmente la falta de respuesta temprana, requieren más aclaraciones.

Objetivo del estudio:

Revisar sistemáticamente y dilucidar la asociación entre la no respuesta temprana al NACT y la supervivencia libre de enfermedad a largo plazo (DFS) en pacientes con cáncer de cuello uterino.

Principales métodos:

Se llevó a cabo una revisión sistemática exhaustiva de acuerdo con las directrices de PRISMA.
Las búsquedas incluyeron PubMed, Embase, Elsevier, Springer, EBSCO y la Biblioteca Cochrane.
Los ratios de riesgo combinados (HR) para DFS se calcularon utilizando el software R, y la heterogeneidad y el sesgo de publicación se evaluaron utilizando métodos estadísticos establecidos.

Principales resultados:

Se incluyeron once estudios que incluyeron a 2064 pacientes (1546 que respondieron y 518 que no respondieron).
La falta de respuesta temprana a NACT se asoció significativamente con una DFS más pobre (HR = 3,29, IC del 95% 2,35- 4,62).
Los análisis de subgrupos por criterios de respuesta (OMS y RECIST) confirmaron esta asociación, sin que se detectara un sesgo de publicación significativo.

Conclusiones:

La falta de respuesta temprana al NACT es un predictor significativo del empeoramiento de la DFS en el cáncer de cuello uterino.
Los hallazgos sugieren la necesidad de estudios a gran escala o prospectivos para validar este valor pronóstico y optimizar las estrategias de tratamiento para los que no responden.
Los ensayos prospectivos futuros son esenciales para validar los hallazgos y establecer criterios para la selección de pacientes en las estrategias basadas en NACT.

Palabras clave:

cáncer de cuello uterino No respuesta temprana supervivencia a largo plazo quimioterapia neoadyuvante (NACT, por sus siglas en inglés)análisis sistemático

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