The percentage follow-up ranged from 89% to 100%. None of the studies was interrupted early for benefit. The methodological quality varied by outcome. It was low for mortality and local recurrence in clinical stage I and moderate for other outcomes selleck inhibitor (Figure 2, Figure 3). Figure 2 and Figure 3 also provide the absolute reductions in the risks of different outcomes for a number of illustrative baseline risks, including medium baseline risks. Overall

mortality Five studies reported overall mortality as one of the outcomes. Altogether, the analyses included 5 trials with 2,065 patients. The overall mortality rates were not decreased for LDR arm (340/997 = 34.1%) compared to HDR arms (375/1068 = 35.1%). The overall odds ratio (OR = 0.94, CI 95% -0.78, 1.13)

suggests that there is no Bafilomycin A1 order difference between LDR arms and HDR arms in terms of overall mortality rate with p value 0.52, as demonstrated in Figure 4. The test for heterogeneity was not statistically significant with p value 0.98, which indicates that the pooling of the data was valid. In the subgroup analysis there was no difference Selleck CDK inhibitor for overall survival among different clinical stages I, II and III, as demonstrated in Table 4. Figure 4 Overal mortality for all clinical stages in cervix cancer. Table 4 LDR versus HDR for overall mortality, local recurrence and late complications Overall mortality Stage Number of studies Total

patients Patients/events HDR Patients/events LDR OR CI95% P value I 2 134 19/67 13/67 0.68 0.36–1.29 0.23 Axenfeld syndrome II 4 500 75/257 62/243 0.84 0.56–1.24 0.38 III 5 1079 238/572 228/507 1.22 0.95–1.56 0.11 Local recurrence Stage Number of studies Total patients Patients/events HDR Patients/events LDR OR CI95% P value I 2 134 7/67 3/67 2.31 0.61–8.71 0.22 II 4 500 45/257 34/243 1.17 0.74–1.85 0.51 III 5 1079 143/572 138/507 0.94 0.70–1.27 0.70 Grade 3 or 4 rectal complication   Number of studies Total patients Patients/events HDR Patients/events LDR OR CI95% P value   5 2065 27/1068 27/997 0.9 0.52–1.56 0.7 Grade 3 or 4 bladder complication   Number of studies Total patients Patients/events HDR Patients/events LDR OR CI95% P value   5 2065 17/1068 16/997 0.98 0.49–1.96 0.95 Grade 3 or 4 small intestine complication   Number of studies Total patients Patients/events HDR Patients/events LDR OR CI95% P value   3 783 13/432 3/351 3.15 0.9–10.37 0.06 Local recurrence Five trials reported on local control.