Efficacy and safety of neoadjuvant chemotherapy containing tegafur gimeracil oteracil potassium combined with surgery in the treatment of advanced gastric cancer: a meta-analysis_Chinese Journal of Evidence-Based Medicine

Authors：

ZHAN Hao , LONG Bo , WANG Zhenjiang , DU Hengrui , ZHOU Huinian ,  JIAO Zuoyi

First Department of General Surgery, Second Hospital of Lanzhou University, Lanzhou, 730030, P.R.China;

Corresponding?author：

JIAO Zuoyi, Email: jiaozx@lzu.edu.cn

Keywords：

Advanced gastric cancer; Tegafur gimeracil oteracil potassium; Neoadjuvant chemotherapy; Meta-analysis; R₀ resection rate; Survival rate; Randomized controlled trial

DOI：

10.7507/1672-2531.201702044

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

ObjectiveTo systematically review the efficacy and safety of neoadjuvant chemotherapy containing tegafur gimeracil oteracil potassium (S-1) combined with surgery in the treatment of advanced gastric cancer.MethodsWe searched EMbase, PubMed, The Cochrane Library, Web of Science, CBM, CNKI and WanFang Data from inception to February 2017, to collect randomized controlled trials (RCTs) about neoadjuvant chemotherapy containing S-1 combined with surgery in the treatment of advanced gastric cancer. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Meta-analysis was performed by using RevMan 5.3 software.ResultsA total of 11 RCTs involving 971 advanced gastric cancer patients were included. The results of meta-analysis showed that the neoadjuvant chemotherapy containing S-1 combined with surgery group was superior to the control group in R₀ resection rate (OR=2.75, 95%CI 1.91 to 3.95, P<0.000 01), 2 year survival rate (OR=1.72, 95%CI 1.01 to 2.93, P=0.05) and 3 year survival rate (OR=1.64, 95%CI 1.12 to 2.41, P=0.01), while there were no statistical differences in response rate (OR=1.33, 95%CI 0.70 to 2.51, P=0.39), 1 year survival rate (OR=1.50, 95%CI 0.64 to 3.53, P=0.35) and the incidence of postoperative complications (OR=1.00, 95%CI 0.66 to 1.51, P=0.98).ConclusionNeoadjuvant chemotherapy containing S-1 combined with surgery can improve the R₀ resection rate, 2-year survival rate and 3-year survival rate without increase postoperative complications rate. Due to limited quality and quantity of the included studies, more high-quality studies are needed to verify the above conclusion.

Citation： ZHAN Hao, LONG Bo, WANG Zhenjiang, DU Hengrui, ZHOU Huinian, JIAO Zuoyi. Efficacy and safety of neoadjuvant chemotherapy containing tegafur gimeracil oteracil potassium combined with surgery in the treatment of advanced gastric cancer: a meta-analysis. Chinese Journal of Evidence-Based Medicine, 2017, 17(7): 820-828. doi: 10.7507/1672-2531.201702044 Copy

1.	陳萬青, 鄭榮壽, 張思維, 等. 2013 年中國惡性腫瘤發病和死亡分析. 中國腫瘤, 2017, 26(1): 1-7.
2.	鄭朝旭, 鄭榮壽, 張思維, 等. 中國 2010 年胃癌發病與死亡分析. 中國腫瘤, 2014, 23(10): 795-800.
3.	Ajani JA, D'Amico TA, Almhanna K, et al. Gastric cancer, version 3.2016, NCCN clinical practice guidelines in oncology. J Natl Compr Canc Netw, 2016, 14(10): 1286-1312.
4.	Japanese Gastric Cancer Association. Japanese gastric cancer treatment guidelines 2014 (ver. 4). Gastric Cancer, 2017, 20(1): 1-19.
5.	Ter Veer E, Mohammad NH, Lodder P, et al. The efficacy and safety of S-1-based regimens in the first-line treatment of advanced gastric cancer: a systematic review and meta-analysis. Gastric Cancer, 2016, 19(3): 696-712.
6.	Yang J, Zhou Y, Min K, et al. S-1-based vs. non-S-1-based chemotherapy in advanced gastric cancer: a meta-analysis. World J Gastroenterol, 2014, 20(33): 11886-11893.
7.	Li DH, Pan ZK, Ye F, et al. S-1-based versus 5-FU-based chemotherapy as first-line treatment in advanced gastric cancer: a meta-analysis of randomized controlled trials. Tumour Biol, 2014, 35(8): 8201-8208.
8.	陳穎, 楊大明, 邵俊, 等. 替吉奧單藥新輔助化療對進展期胃癌的影響. 中國醫藥導刊, 2012, 14(1): 43-44.
9.	杜新超, 李勇. 替吉奧聯合奧沙利鉑新輔助化療對賁門癌手術患者的療效觀察. 河北醫科大學學報, 2015, 36(1): 69-71.
10.	黃健. SOX 方案圍手術期化療對局部進展期胃癌近期療效的影響. 石家莊: 河北醫科大學, 2014.
11.	李定云, 張濤, 凌亞非, 等. 替吉奧聯合奧沙利鉑新輔助化療治療進展期胃癌療效觀察. 現代醫藥衛生, 2014, 30(10): 1538-1540.
12.	劉林, 楊新輝, 王海江, 等. 多西他賽聯合奧沙利鉑及替吉奧治療進展期胃癌的療效及對圍手術期影響. 中國腫瘤臨床, 2013, 40(13): 788-791.
13.	吳凱, 馮許剛, 戴曉玲. 術前 SOX 方案新輔助化療對局部進展期胃癌手術效果的影響. 海南醫學, 2016, 27(19): 3167-3169.
14.	謝振山, 張謝夫, 劉光輝, 等. 應用多西他賽聯合 S-1 新輔助化療方案治療可切除的進展期胃癌的療效. 世界華人消化雜志, 2014, 22(34): 5334-5338.
15.	Yoshikawa T, Morita S, Tanabe K, et al. Survival results of a randomised two-by-two factorial phase II trial comparing neoadjuvant chemotherapy with two and four courses of S-1 plus cisplatin (SC) and paclitaxel plus cisplatin (PC) followed by D2 gastrectomy for resectable advanced gastric cancer. Eur J Cancer. 2016, 62: 103-111.
16.	趙俊峰. 多西他賽聯合替吉奧新輔助化療治療進展期胃癌的療效分析. 醫藥前沿, 2016, 6(27): 127-128.
17.	張培良, 張煥珍. SOX 方案新輔助化療在進展期胃癌中的臨床應用. 中國當代醫藥, 2011, 18(29): 78-79.
18.	趙運成, 劉和平, 王桂琦. 替吉奧聯合奧沙利鉑新輔助化療治療胃癌療效觀察. 現代中西醫結合雜志, 2016, 25(9): 991-993.
19.	Shirasaka T. Development history and concept of an oral anticancer agent S-1 (TS-1): its clinical usefulness and future vistas. Jpn J Clin Oncol, 2009, 39(1): 2-15.
20.	Wilke H, Preusser P, Fink U, et al. Preoperative chemotherapy in locally advanced and nonresectable gastric cancer: a phase II study with etoposide, doxorubicin, and cisplatin. J Clin Oncol, 1989, 7(9): 1318-1326.
21.	Zhao JH, Gao P, Song YX, et al. Which is better for gastric cancer patients, perioperative or adjuvant chemotherapy: a meta-analysis. BMC Cancer, 2016, 16: 631.
22.	Yang Y, Yin X, Sheng L, et al. Perioperative chemotherapy more of a benefit for overall survival than adjuvant chemotherapy for operable gastric cancer: an updated meta-analysis. Sci Rep, 2015, 5: 12850.
23.	Xiong BH, Cheng Y, Ma L, et al. An updated meta-analysis of randomized controlled trial assessing the effect of neoadjuvant chemotherapy in advanced gastric cancer. Cancer Invest, 2014, 32(6): 272-284.
24.	Okabe H, Hata H, Ueda S, et al. A phase II study of neoadjuvant chemotherapy with S-1 and cisplatin for stage III gastric cancer: KUGC03. J Surg Oncol, 2016, 113(1): 36-41.
25.	Migita K, Nashimoto A, Yabusaki H, et al. Efficacy of neoadjuvant chemotherapy with docetaxel, cisplatin and S-1 for resectable locally advanced gastric cancer. Int J Clin Oncol, 2016, 21(1): 102-109.
26.	Kemmochi A, Inagawa S, Akashi Y, et al. A case of advanced gastric cancer with a complete response to S-1 neoadjuvant chemotherapy in an elderly patient. Gan To Kagaku Ryoho, 2016, 43(1): 115-119.
27.	Mori S, Kishimoto H, Tauchi K, et al. Histological complete response in advanced gastric cancer after 2 weeks of S-1 administration as neoadjuvant chemotherapy. Gastric Cancer, 2006, 9(2): 136-139.
28.	Sasako M, Sakuramoto S, Katai H, et al. Five-year outcomes of a randomized phase III trial comparing adjuvant chemotherapy with S-1 versus surgery alone in stage II or III gastric cancer. J Clin Oncol, 2011, 29(29): 4387-4393.

1. 陳萬青, 鄭榮壽, 張思維, 等. 2013 年中國惡性腫瘤發病和死亡分析. 中國腫瘤, 2017, 26(1): 1-7.
2. 鄭朝旭, 鄭榮壽, 張思維, 等. 中國 2010 年胃癌發病與死亡分析. 中國腫瘤, 2014, 23(10): 795-800.
3. Ajani JA, D'Amico TA, Almhanna K, et al. Gastric cancer, version 3.2016, NCCN clinical practice guidelines in oncology. J Natl Compr Canc Netw, 2016, 14(10): 1286-1312.
4. Japanese Gastric Cancer Association. Japanese gastric cancer treatment guidelines 2014 (ver. 4). Gastric Cancer, 2017, 20(1): 1-19.
5. Ter Veer E, Mohammad NH, Lodder P, et al. The efficacy and safety of S-1-based regimens in the first-line treatment of advanced gastric cancer: a systematic review and meta-analysis. Gastric Cancer, 2016, 19(3): 696-712.
6. Yang J, Zhou Y, Min K, et al. S-1-based vs. non-S-1-based chemotherapy in advanced gastric cancer: a meta-analysis. World J Gastroenterol, 2014, 20(33): 11886-11893.
7. Li DH, Pan ZK, Ye F, et al. S-1-based versus 5-FU-based chemotherapy as first-line treatment in advanced gastric cancer: a meta-analysis of randomized controlled trials. Tumour Biol, 2014, 35(8): 8201-8208.
8. 陳穎, 楊大明, 邵俊, 等. 替吉奧單藥新輔助化療對進展期胃癌的影響. 中國醫藥導刊, 2012, 14(1): 43-44.
9. 杜新超, 李勇. 替吉奧聯合奧沙利鉑新輔助化療對賁門癌手術患者的療效觀察. 河北醫科大學學報, 2015, 36(1): 69-71.
10. 黃健. SOX 方案圍手術期化療對局部進展期胃癌近期療效的影響. 石家莊: 河北醫科大學, 2014.
11. 李定云, 張濤, 凌亞非, 等. 替吉奧聯合奧沙利鉑新輔助化療治療進展期胃癌療效觀察. 現代醫藥衛生, 2014, 30(10): 1538-1540.
12. 劉林, 楊新輝, 王海江, 等. 多西他賽聯合奧沙利鉑及替吉奧治療進展期胃癌的療效及對圍手術期影響. 中國腫瘤臨床, 2013, 40(13): 788-791.
13. 吳凱, 馮許剛, 戴曉玲. 術前 SOX 方案新輔助化療對局部進展期胃癌手術效果的影響. 海南醫學, 2016, 27(19): 3167-3169.
14. 謝振山, 張謝夫, 劉光輝, 等. 應用多西他賽聯合 S-1 新輔助化療方案治療可切除的進展期胃癌的療效. 世界華人消化雜志, 2014, 22(34): 5334-5338.
15. Yoshikawa T, Morita S, Tanabe K, et al. Survival results of a randomised two-by-two factorial phase II trial comparing neoadjuvant chemotherapy with two and four courses of S-1 plus cisplatin (SC) and paclitaxel plus cisplatin (PC) followed by D2 gastrectomy for resectable advanced gastric cancer. Eur J Cancer. 2016, 62: 103-111.
16. 趙俊峰. 多西他賽聯合替吉奧新輔助化療治療進展期胃癌的療效分析. 醫藥前沿, 2016, 6(27): 127-128.
17. 張培良, 張煥珍. SOX 方案新輔助化療在進展期胃癌中的臨床應用. 中國當代醫藥, 2011, 18(29): 78-79.
18. 趙運成, 劉和平, 王桂琦. 替吉奧聯合奧沙利鉑新輔助化療治療胃癌療效觀察. 現代中西醫結合雜志, 2016, 25(9): 991-993.
19. Shirasaka T. Development history and concept of an oral anticancer agent S-1 (TS-1): its clinical usefulness and future vistas. Jpn J Clin Oncol, 2009, 39(1): 2-15.
20. Wilke H, Preusser P, Fink U, et al. Preoperative chemotherapy in locally advanced and nonresectable gastric cancer: a phase II study with etoposide, doxorubicin, and cisplatin. J Clin Oncol, 1989, 7(9): 1318-1326.
21. Zhao JH, Gao P, Song YX, et al. Which is better for gastric cancer patients, perioperative or adjuvant chemotherapy: a meta-analysis. BMC Cancer, 2016, 16: 631.
22. Yang Y, Yin X, Sheng L, et al. Perioperative chemotherapy more of a benefit for overall survival than adjuvant chemotherapy for operable gastric cancer: an updated meta-analysis. Sci Rep, 2015, 5: 12850.
23. Xiong BH, Cheng Y, Ma L, et al. An updated meta-analysis of randomized controlled trial assessing the effect of neoadjuvant chemotherapy in advanced gastric cancer. Cancer Invest, 2014, 32(6): 272-284.
24. Okabe H, Hata H, Ueda S, et al. A phase II study of neoadjuvant chemotherapy with S-1 and cisplatin for stage III gastric cancer: KUGC03. J Surg Oncol, 2016, 113(1): 36-41.
25. Migita K, Nashimoto A, Yabusaki H, et al. Efficacy of neoadjuvant chemotherapy with docetaxel, cisplatin and S-1 for resectable locally advanced gastric cancer. Int J Clin Oncol, 2016, 21(1): 102-109.
26. Kemmochi A, Inagawa S, Akashi Y, et al. A case of advanced gastric cancer with a complete response to S-1 neoadjuvant chemotherapy in an elderly patient. Gan To Kagaku Ryoho, 2016, 43(1): 115-119.
27. Mori S, Kishimoto H, Tauchi K, et al. Histological complete response in advanced gastric cancer after 2 weeks of S-1 administration as neoadjuvant chemotherapy. Gastric Cancer, 2006, 9(2): 136-139.
28. Sasako M, Sakuramoto S, Katai H, et al. Five-year outcomes of a randomized phase III trial comparing adjuvant chemotherapy with S-1 versus surgery alone in stage II or III gastric cancer. J Clin Oncol, 2011, 29(29): 4387-4393.

Chinese Journal of Evidence-Based Medicine

Efficacy and safety of neoadjuvant chemotherapy containing tegafur gimeracil oteracil potassium combined with surgery in the treatment of advanced gastric cancer: a meta-analysis

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content