Recent advances in photodynamic therapy combined with chemotherapy for cervical cancer: a systematic review

Despite the evidence that photodynamic therapy (PDT) associated with chemotherapy presents great potential to overcome the limitations of monotherapy, little is known about the current status of this combination against cervical cancer. This systematic review aimed to address the currently available advances in combining PDT and chemotherapy in different research models and clinical trials of cervical cancer. We conducted a systematic review based on PRISMA Statement and Open Science Framework review protocol using PubMed, Web of Science, Embase, Scopus, LILACS, and Cochrane databases. We selected original articles focusing on ‘Uterine Cervical Neoplasms’ and ‘Photochemotherapy and Chemotherapy’ published in the last 10 years. The risk of bias in the studies was assessed using the CONSORT and SYRCLE tools. Twenty-three original articles were included, focusing on HeLa cells, derived from endocervical adenocarcinoma and on combinations of several chemotherapeutics. Most of the combinations used modern drug delivery systems for improved simultaneous delivery and presented promising results with increased cytotoxicity compared to monotherapy. Despite the scarcity of animal studies and the absence of clinical studies, the combination of chemotherapy with PDT presents a potential option for cervical cancer therapy requiring additional studies. https://doi.org/10.17605/OSF.IO/WPHN5

尽管已有证据表明，光动力疗法（photodynamic therapy, PDT）联合化疗（chemotherapy）在克服单药治疗（monotherapy）的局限性方面具备巨大潜力，但目前学界对该联合疗法用于宫颈癌（cervical cancer）治疗的现状仍知之甚少。本系统综述旨在梳理当前宫颈癌领域中，光动力疗法与化疗联合应用在各类研究模型及临床试验（clinical trials）中的最新进展。本研究依据PRISMA声明与开放科学框架（Open Science Framework）综述方案，检索PubMed、Web of Science、Embase、Scopus、LILACS及Cochrane六大数据库，开展了本项系统综述研究。我们筛选了近十年发表的、以「子宫颈肿瘤（Uterine Cervical Neoplasms）」与「光化学疗法与化疗（Photochemotherapy and Chemotherapy）」为核心主题的原创研究论文。本研究采用CONORT与SYRCLE工具对纳入研究的偏倚风险进行了评估。最终纳入23篇原创研究论文，其研究对象涵盖源自宫颈内膜腺癌的HeLa细胞（HeLa cells），以及多种化疗药物与光动力疗法的联合给药方案。多数联合方案采用了现代化的药物递送系统（drug delivery systems）以实现同步给药，且相较于单药治疗，此类联合方案展现出更强的细胞毒性（cytotoxicity），研究结果颇具前景。尽管目前动物研究较为匮乏，且尚无相关临床试验开展，但化疗联合光动力疗法仍是宫颈癌治疗的潜在可行方案，有待进一步的研究验证。https://doi.org/10.17605/OSF.IO/WPHN5