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《Chongqing Medicine》 2017-05
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Meta-analysis of S-1 versus fluorouracil chemotherapy in Chinese patients with advanced gastric cancer

Chen Xiaodong;He Fuqian;Chen Mi;Department of Gastrointestinal Surgery,Sichuan Cancer Hospital·Institute,Sichuan Cancer Control and Prevention Center;School of Medicine,University of Electronic Science and Technology of China;Department of Geriatrics,the Affiliated West China Hospital Sichuan University;  
Objective The aim of this study is to compare the efficacy and safety of S-1-based chemotherapy versus 5-fluorouracil-(5-FU-)based chemotherapy in Chinese patients with advanced gastric cancer(AGC).Methods Multicenter randomized controlled trials(mcRCTs),comparing S-1-based chemotherapy with 5-FU-based chemotherapy in Chinese patients with AGC,were searched in 3online databases CNKI,Wanfang Data and PubMed.Two reviewers independently screened studies according to the inclusion and exclusion criteria,assessed quality of the included studies and extracted the data.Meta-analysis was performed using RevMan 5.2.Results Four mcRCTs were included in the analysis.Meta-analysis showed that S-1could improve objective response rate[(OR=1.90,95%CI(1.36-2.65),P0.01]and disease control rate[(OR=2.08,95%CI(1.43,3.03),P0.01]compared with 5-FU,however,there was no significant difference in overall survival between the two groups[HR=0.76(0.39-1.50),P=0.82].With regard to safety,S-1significantly increased the incidence of leukopenia[grade 1-4:OR=2.40(1.41,4.07),P0.01;grade 3-4:OR=3.09(1.94,4.93),P0.01],neutropenia[grade 1-4:OR=2.23(1.60-3.10),P0.01;grade 3-4:OR=2.90(1.40-6.02),P0.01],thrombocytopenia[grade 1-4:OR=2.40(1.56-3.69),P0.01,anemia(grade 3-4:OR=1.78(1.11-2.87),P=0.02]and diarrhea[grade 3-4:OR=2.51(1.13-5.58),P=0.02];whereas,although the incidences of other gastrointestinal adverse events were relatively low in S-1group,only the difference of grade 1-4nausea was significant[OR=0.59(0.42-0.81),P0.01].Conclusion For Chinese patients with AGC,S-1can significantly improve the objective response rate and disease control rate,whereas increase the incidence of hematological toxicities.
【Fund】: 四川省科技计划项目(2014FZ0089);; 四川省卫生厅科研课题(130226)
【CateGory Index】: R735.2
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