Limits...
The efficacy and toxicity of paclitaxel plus S-1 compared with paclitaxel plus 5-FU for advanced gastric cancer: a PRISMA systematic review and meta-analysis of randomized controlled trials.

Liu H, Chen X, Sun J, Gao P, Song Y, Zhang N, Lu X, Xu H, Wang Z - Medicine (Baltimore) (2014)

Bottom Line: The standard treatment for patients with advanced gastric cancer (AGC) is still a matter of debate.There was a significant decrease in nausea (RR = 0.60, 95% CI = 0.43-0.82, P = 0.001) and vomiting (RR = 0.55, 95% CI = 0.33-0.91, P = 0.02) in patients treated with PTX plus S-1.PTX plus S-1 was associated with almost equivalent safety and a lower progressive disease rate compared with PTX plus 5-FU.PTX plus S-1 is a good alternative strategy for patients who cannot tolerate a continuous intravenous infusion.

View Article: PubMed Central - PubMed

Affiliation: From the Department of Surgical Oncology and General Surgery, First Hospital of China Medical University (HL, XC, JS, PG, YS, XL, HX, ZW) and Department of Pathophysiology, School of Basic Medical of China Medical University (NZ), Shenyang, China.

ABSTRACT
The standard treatment for patients with advanced gastric cancer (AGC) is still a matter of debate. The chemotherapy regimen of paclitaxel (PTX) combined with S-1 has been used to treat AGC or metastatic gastric cancer.We conducted a meta-analysis to compare oral S-1 and infusional 5-fluorouracil (5-FU) to determine which agent was more efficacious and less toxic in combination with PTX. A systematic review with a meta-analysis was performed. PubMed, EmBase, the Cochrane Central Register of Controlled Trials, and the China National Knowledge Infrastructure databases were searched to select randomized controlled trials (RCTs) comparing PTX plus S-1 and PTX plus 5-FU in patients with AGC.Three RCTs were eligible and 352 patients were analyzed. PTX plus S-1 increased the disease control rate (risk ratio [RR] = 1.14, 95% confidence interval [CI] = 1.00-1.30, P = 0.04) and reduced the progressive disease rate (RR = 0.62, 95% CI] = 0.39-0.98, P = 0.04) compared with PTX plus 5-FU. There was a significant decrease in nausea (RR = 0.60, 95% CI = 0.43-0.82, P = 0.001) and vomiting (RR = 0.55, 95% CI = 0.33-0.91, P = 0.02) in patients treated with PTX plus S-1.PTX plus S-1 was associated with almost equivalent safety and a lower progressive disease rate compared with PTX plus 5-FU. PTX plus S-1 is a good alternative strategy for patients who cannot tolerate a continuous intravenous infusion.

Show MeSH

Related in: MedlinePlus

Flow chart of trial selection process. RCTrandomized controlled trial
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4616381&req=5

Figure 1: Flow chart of trial selection process. RCTrandomized controlled trial

Mentions: The literature search and selection procedure are shown in Figure 1. Three RCTs20–22 were eligible for analysis and 352 patients with nonresectable, palliative-resected, recurrent, or metastatic GC were included: 182 patients in PTX plus S-1 group and 170 patients in PTX plus 5-FU group (Table 1). The sample size of individual RCTs ranged from 44 to 229. There were no significant differences in the baselines between the PTX plus S-1 and control groups in these studies, as reported.


The efficacy and toxicity of paclitaxel plus S-1 compared with paclitaxel plus 5-FU for advanced gastric cancer: a PRISMA systematic review and meta-analysis of randomized controlled trials.

Liu H, Chen X, Sun J, Gao P, Song Y, Zhang N, Lu X, Xu H, Wang Z - Medicine (Baltimore) (2014)

Flow chart of trial selection process. RCTrandomized controlled trial
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4616381&req=5

Figure 1: Flow chart of trial selection process. RCTrandomized controlled trial
Mentions: The literature search and selection procedure are shown in Figure 1. Three RCTs20–22 were eligible for analysis and 352 patients with nonresectable, palliative-resected, recurrent, or metastatic GC were included: 182 patients in PTX plus S-1 group and 170 patients in PTX plus 5-FU group (Table 1). The sample size of individual RCTs ranged from 44 to 229. There were no significant differences in the baselines between the PTX plus S-1 and control groups in these studies, as reported.

Bottom Line: The standard treatment for patients with advanced gastric cancer (AGC) is still a matter of debate.There was a significant decrease in nausea (RR = 0.60, 95% CI = 0.43-0.82, P = 0.001) and vomiting (RR = 0.55, 95% CI = 0.33-0.91, P = 0.02) in patients treated with PTX plus S-1.PTX plus S-1 was associated with almost equivalent safety and a lower progressive disease rate compared with PTX plus 5-FU.PTX plus S-1 is a good alternative strategy for patients who cannot tolerate a continuous intravenous infusion.

View Article: PubMed Central - PubMed

Affiliation: From the Department of Surgical Oncology and General Surgery, First Hospital of China Medical University (HL, XC, JS, PG, YS, XL, HX, ZW) and Department of Pathophysiology, School of Basic Medical of China Medical University (NZ), Shenyang, China.

ABSTRACT
The standard treatment for patients with advanced gastric cancer (AGC) is still a matter of debate. The chemotherapy regimen of paclitaxel (PTX) combined with S-1 has been used to treat AGC or metastatic gastric cancer.We conducted a meta-analysis to compare oral S-1 and infusional 5-fluorouracil (5-FU) to determine which agent was more efficacious and less toxic in combination with PTX. A systematic review with a meta-analysis was performed. PubMed, EmBase, the Cochrane Central Register of Controlled Trials, and the China National Knowledge Infrastructure databases were searched to select randomized controlled trials (RCTs) comparing PTX plus S-1 and PTX plus 5-FU in patients with AGC.Three RCTs were eligible and 352 patients were analyzed. PTX plus S-1 increased the disease control rate (risk ratio [RR] = 1.14, 95% confidence interval [CI] = 1.00-1.30, P = 0.04) and reduced the progressive disease rate (RR = 0.62, 95% CI] = 0.39-0.98, P = 0.04) compared with PTX plus 5-FU. There was a significant decrease in nausea (RR = 0.60, 95% CI = 0.43-0.82, P = 0.001) and vomiting (RR = 0.55, 95% CI = 0.33-0.91, P = 0.02) in patients treated with PTX plus S-1.PTX plus S-1 was associated with almost equivalent safety and a lower progressive disease rate compared with PTX plus 5-FU. PTX plus S-1 is a good alternative strategy for patients who cannot tolerate a continuous intravenous infusion.

Show MeSH
Related in: MedlinePlus