Which is better for gastric cancer patients, perioperative or adjuvant chemotherapy: a meta-analysis

BMC Cancer

Research Article

Jing-xu Sun¹  Yu-chong Yang¹  Bin Ma¹  Xiao-wan Chen¹  Zhen-ning Wang¹  Peng Gao¹  Yong-xi Song¹  Jun-hua Zhao¹ 

[1] Department of Surgical Oncology and General Surgery, the First Hospital of China Medical University, 110001, Shenyang, People’s Republic of China;

关键词: Gastric cancer;    Perioperative chemotherapy;    Adjuvant chemotherapy;    Overall survival;    Combination chemotherapy;   

DOI  :  10.1186/s12885-016-2667-5

 received in 2016-05-25, accepted in 2016-08-02,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundThe preferred chemotherapy method for gastric cancer continues to be matter of debate. We performed a meta-analysis to comparing prognosis and safety between perioperative chemotherapy and adjuvant chemotherapy to identify the better chemotherapy option for gastric cancer.MethodsWe searched the PubMed, EMBASE, Cochrane Library, and Ovid databases for eligible studies until February 2016. The main endpoints were prognostic value (hazard ratio [HR] for overall survival [OS] and 1-, 2-, 3-, and 5-year survival rate), response rate of chemotherapy, radical resection rate, post-operative complication rate, and adverse effects of chemotherapy.ResultsFive randomized controlled trials and six clinical controlled trials involving 1,240 patients were eligible for analysis. Compared with the adjuvant chemotherapy group, the perioperative chemotherapy group had significantly better prognosis (HR, 0.74; 95 % CI, 0.61 to 0.89; P < 0.01). The difference between the two groups remained significant in the studies that used combination chemotherapy as the neoadjuvant chemotherapy regimen (HR, 0.59; 95 % CI, 0.46 to 0.76; P < 0.01) but were not significant in the studies that used fluoropyrimidine monotherapy (HR, 0.93; 95 % CI, 0.56 to 1.55; P = 0.84). Furthermore, the two groups showed no significant differences in the post-operative complication rates (relative risk, 0.98; 95 % CI, 0.63 to 1.51; P = 0.91) or adverse effects of chemotherapy (P > 0.05 for all adverse effects).ConclusionPerioperative chemotherapy showed improved survival compared to adjuvant chemotherapy for gastric cancer. In addition, combination chemotherapy resulted in better survival compared to monotherapy in the neoadjuvant chemotherapy regimens.

【 授权许可】

CC BY   
© The Author(s). 2016