Chemotherapy for patients with gastric cancer after complete resection: A network meta-analysis |
| |
Authors: | Ya-Wu Zhang Yu-Long Zhang Hui Pan Feng-Xian Wei You-Cheng Zhang Yuan Shao Wei Han Hai-Peng Liu Zhe-Yuan Wang Sun-Hu Yang |
| |
Affiliation: | Ya-Wu Zhang, Yu-Long Zhang, Hui Pan, Feng-Xian Wei, You-Cheng Zhang, Yuan Shao, Wei Han, Hai-Peng Liu, Zhe-Yuan Wang, Sun-Hu Yang, Department of General Surgery, Lanzhou University Second Hospital, Lanzhou 730030, Gansu Province, China |
| |
Abstract: | AIM: To conduct a network meta-analysis to evaluate the effectiveness of different chemotherapy regimens for patients with gastric cancer.METHODS: PubMed (1966-2011.12), the Cochrane Library (2011 Issue 2) and EMBASE (1974-2011.12) were searched with the terms “gastric cancer” and “chemotherapy”, as well as the medical subject headings. References from relevant articles and conferences were also included. Patients who had previous gastric surgery, radiation before or after surgery or chemotherapy before surgery were excluded. In this study, only randomized controlled trials (RCTs) were considered, and the end-point was the overall mortality. Direct comparisons were performed using traditional meta-analysis whereas indirect comparisons were performed using network meta-analysis.RESULTS: In total, 31 RCTs with 7120 patients were included. Five chemotherapy regimens, fluorouracil (FU) + BCNU, FU + methyl-CCNU (mCCNU), FU + cisplatin, FU + anthracyclines and FU + mitomycin c (MMC) + cytarabine (Ara-c), were found to be less beneficial in terms of overall mortality. In contrast, four chemotherapy regimens were effective for the patients after surgery, including FU + MMC + adriamycin (FMA), FU + MMC (FM), Tegafur and MMC, There was no significant difference in terms of overall mortality among these regimens. The evidence for the FM regimen and MMC regimen was poor. Additionally, the FMA regimen, which includes a variety of chemotherapy drugs and causes many side effects, was not better than the Tegafur regimen.CONCLUSION: Although the four chemotherapy regimens were effective in patients with gastric cancer after surgery and the overall mortality revealed no significant difference among them in the network meta-analysis, thorough analysis of the results recommends Tegafur as the first-line adjuvant chemotherapy regimen for patients after complete resection. |
| |
Keywords: | Gastric cancer Chemotherapy Randomized controlled trials Indirect treatment comparison Network meta-analysis |
本文献已被 CNKI 等数据库收录! |
| 点击此处可从《World journal of gastroenterology : WJG》浏览原始摘要信息 |
|