He An-Bing, Peng Xiu-Lan, Song Jia, Zhang Ji-Xing, Dong Wei-Guo, Luo Ren-Feng, Tang Yan
An-Bing He, Xiu-Lan Peng, Yan Tang, Department of Oncology, the Fifth Hospital of Wuhan, Wuhan 430050, Hubei Province, China.
World J Gastroenterol. 2015 Apr 14;21(14):4358-64. doi: 10.3748/wjg.v21.i14.4358.
To rationally evaluate the effect of S-1 vs capecitabine for the treatment of gastric cancer.
MEDLINE, EMBASE, Cochrane Controlled Trials Register, Google Scholar, and China Journal Full Text Database were accessed to collect clinical randomized controlled trials regarding the effect of S-1 vs capecitabine for the treatment of gastric cancer patients. Statistical analysis was performed by meta-analysis. Four randomized controlled trials met the inclusion criteria.
Compared with capecitabine regimens, the 1-year survival rate in gastric cancer patients was 0.80 (95%CI: 0.52-1.21, P = 0.29). The overall response rate of S-1 vs capecitabine was 0.94 (95%CI: 0.59-1.51, P = 0.93). Compared with capecitabine regimens, the most frequent hematologic toxicities were neutropenia (OR = 0.99, 95%CI: 0.65-1.49, P = 0.94) and thrombocytopenia (OR = 0.72, 95%CI: 0.31-1.67, P = 0.44). The most frequent non-hematologic toxicities included nausea (OR = 0.85, 95%CI: 0.56-1.28, P = 0.43) and hand-foot syndrome (OR = 0.16, 95%CI: 0.10-0.27, P < 0.00001).
The existing studies suggest that S-1 is not more effective than capecitabine in the treatment of gastric cancer patients, but does exhibit less toxicity with regard to hand-foot syndrome.
合理评估S-1与卡培他滨治疗胃癌的效果。
检索MEDLINE、EMBASE、Cochrane对照试验注册库、谷歌学术和中国期刊全文数据库,收集关于S-1与卡培他滨治疗胃癌患者效果的临床随机对照试验。采用Meta分析进行统计分析。四项随机对照试验符合纳入标准。
与卡培他滨方案相比,胃癌患者的1年生存率为0.80(95%CI:0.52-1.21,P = 0.29)。S-1与卡培他滨的总缓解率为0.94(95%CI:0.59-1.51,P = 0.93)。与卡培他滨方案相比,最常见的血液学毒性是中性粒细胞减少(OR = 0.99,95%CI:0.65-1.49,P = 0.94)和血小板减少(OR = 0.72,95%CI:0.31-1.67,P = 0.44)。最常见的非血液学毒性包括恶心(OR = 0.85,95%CI:0.56-1.28,P = 0.43)和手足综合征(OR = 0.16,95%CI:0.10-0.27,P < 0.00001)。
现有研究表明,S-1在治疗胃癌患者方面并不比卡培他滨更有效,但在手-足综合征方面毒性较小。