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首页> 外文期刊>Systematic Reviews >Treatment of pre- and confirmed cervical cancer in HIV-seropositive women from developing countries: a systematic review
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Treatment of pre- and confirmed cervical cancer in HIV-seropositive women from developing countries: a systematic review

机译：来自发展中国家艾滋病毒血清阳性妇女的预先治疗宫颈癌的治疗：系统审查

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Cervical cancer has become a major public health challenge in developing countries with a reported age-standardised incidence rate of about 17.9/100,000/year and lifetime risks approaching 1 in 20 in some settings. Evidence indicates that HIV-seropositive women are 2 to 12 times more likely to develop precancerous lesions that lead to cervical cancer than HIV-negative women. There is a lack of rigorous evidence on which treatment methods are being utilised for HIV-positive women, and this review aims to synthesise available evidence on treatment modalities for both cervical neoplasia and cervical cancer in HIV-seropositive women in developing countries. A systematic review guided by a published protocol was conducted. Online databases including MEDLINE/PubMed, Embase, CINAHL and Emerald (via EBSCOhost), PsycINFO, Cochrane Library, and health databases, which cover developing countries (3ie Systematic Reviews, WHO library and databases, World Bank website), were searched for published articles. Additional articles were found through citation, reference list tracking, and grey literature. Study design, treatment category, geographic country/region, and key outcomes for each included article were documented and summarised. Thirteen research articles from sub-Saharan Africa, Asia, and South America were included. Eight (61.5%) articles focused on the treatment of cervical cancer with the remaining five (38.5%) assessed cervical neoplasia treatment. The available cervical cancer treatments, radiotherapy, chemotherapy, chemoradiation, and surgery are effective for HIV-seropositive patients, and these are the same treatments for HIV-negative patients. Both cryotherapy and LEEP are effective in reducing CIN2+ among HIV-seropositive women, and a choice between the treatments might be based on available resources and expertise. Radiation, chemotherapy, concurrent treatment using radiotherapy and chemotherapy, and surgery have shown the possibility of effectiveness among HIV-seropositive women. Cervical cancer stage, immunosuppressive level including those on HAART, and multisystem toxicities due to treatment are associated with treatment completion, prognostic, and survival outcomes. Treatment of cervical cancer is based on the stage of cancer, and poor outcomes in most developing countries might be due to a lack of optimal treatment regimen. Those infected with HIV were younger and had advanced cervical cancer as compared to those who were HIV-negative. Facilitation and putting HIV-infected people on life-long ART is of importance and has been found to have a positive impact on cervical cancer treatment response. Research on precancerous lesions and cervical cancer management of HIV-seropositive patients focusing on the quality of life of those treated; the effectiveness of the treatment method considering CD4+ count and ART is required.
机译：宫颈癌已成为发展中国家的主要公共卫生挑战，报告的年龄标准化发病率约为17.9 / 100,000 /年，在某些环境中接近了1岁的终身风险和终身风险。证据表明，艾滋病毒血清阳性女性患有比HIV阴性女性患有宫颈癌的癌前病变的可能性2至12倍。缺乏严格的证据证明，用于艾滋病毒阳性妇女的治疗方法，该综述旨在合成有关发展中国家艾滋病毒血清阳性妇女的宫颈瘤形成和宫颈癌治疗方式的可用证据。进行了发表的议定书所指导的系统审查。在线数据库包括Medline / PubMed，Embase，Cinahl和Emerald（通过EBSCOHOST），PSYCINFO，Cochrane图书馆和健康数据库，涵盖发展中国家（3世纪的系统审查，世界银行网站，世界银行网站）被搜索的文章。通过引用，参考列表跟踪和灰色文献发现了其他文章。记录和总结了研究设计，治疗类别，地理国家/地区和每个包括的文章的关键结果。包括来自撒哈拉以南非洲，亚洲和南美洲的十三个研究文章。八（61.5％）的物品集中于治疗宫颈癌，其余五（38.5％）评估的宫颈瘤形成治疗。可用的宫颈癌治疗，放疗，化疗，化学校长和手术对于艾滋病毒血清阳性患者有效，这些患者对HIV阴性患者的治疗方法是相同的。 Cryotherapy和Leep均为减少艾滋病毒血清阳性女性中的CIN2 +，以及治疗之间的选择可能是可用的资源和专业知识。辐射，化疗，使用放疗和化疗的同时治疗，手术表明了艾滋病毒血清阳性女性中有效性的可能性。宫颈癌阶段，免疫抑制水平，包括HAART的水平和由于治疗引起的多系统毒性与治疗完成，预后和生存结果相关。治疗宫颈癌是基于癌症的阶段，大多数发展中国家的差的结果可能是由于缺乏最佳的治疗方案。感染艾滋病毒的人年轻，与患有HIV阴性的人相比，宫颈癌具有晚期。促进和将艾滋病毒感染的人对终身艺术进行了重要性，并且已发现对宫颈癌治疗反应产生积极影响。艾滋病毒血清阳性患者的癌前病变与宫颈癌管理研究，其关注于治疗方法的生活质量;需要考虑CD4 +计数和艺术的治疗方法的有效性。

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