05(CI 95% 0.85–1.29), as Figure 5. The test for heterogeneity was not statistically significant with p value 068, which indicates that the pooling of the data was valid. In the subgroup analysis there was no difference for overall survival among different clinical stages I, II and III, as demonstrated in Table 4. Figure 5 Local recurrence for all clinical stages in cervix cancer. Grade 3 or 4 Rectal, Bladder or Small Intestine complications Five trials evaluated www.selleckchem.com/products/gw3965.html rectal or bladder complications. For grade 3 or 4 rectal and bladder complication, there was no significant difference between

HDR and LDR, as demonstrated Barasertib in Table 4. Only 3 studies reported the small intestinal complications as one of its outcomes. No significant difference was observed between the treatment arms, considering grade 3 or 4 complication, as showed in Table 4. Discussion Approximately 11,070 women Selleck Ro 61-8048 are diagnosed with cervical

cancer annually in the US, resulting in 3,870 deaths [27]. This represents 0.13 percent of all cancer deaths in women. Despite this, and the promise of newly developed cervical carcinoma vaccines [28], cervical carcinoma is still the third largest cancer killer of women world-wide, causing 274,000 deaths in 2002 [29]. Cervix cancer is a curable cancer, but achieving the best results depends on well-organized and appropriately resourced cancer services. Brachytherapy is an integral part of the cervical carcinoma treatment armamentarium. It is a technically demanding and highly specialized method of radiotherapy delivery. Depending on the equipment used, the capital expenditures and staff costs may be high.

Fractionated HDR brachytherapy in the treatment of uterine cervix cancer has been increasing worldwide, including in the United States [2]. In developing countries such as Brazil, the advantages of outpatient treatment, potential cost savings, radiation protection, patient comfort, reduction of the need for general anesthesia, and less chance of applicators displacement make of this procedure an excellent treatment option [30]. Unfortunately, a well-designed prospective and randomized Phase-III trial with an adequate Exoribonuclease number of patients that would allow comparison of results between LDR and HDR brachytherapy in the treatment of cervix cancer has not yet been published. Thus, we have performed a meta-analysis to improve the statics precision of the outcomes in the clinical trials that compared these two techniques. Meta-analysis of randomized trials allows a more objective appraisal of the evidence, which may lead to the resolution of uncertainty and disagreement. It works as a valuable tool for studying rare and unintended effects of a treatment, by permitting synthesis of data and providing more stable estimates of effect. Our results analyzing five RCTs (2,065 patients) really confirm the use of HDR as an alternative to LDR for all stages of cervical carcinoma.