Medical Oncology Unit, University of Siena, Viale Bracci 11, 53100 Siena, Italy.
Section of Pharmacology and University Center DIFF-Drug Innovation Forward Future, Department of Molecular and Translational Medicine, University of Brescia, Viale Europa 11, 25124 Brescia, Italy; Unit of Molecular Therapy and Pharmacogenomic, AO Azienda Istituti Ospitalieri di Cremona, Viale Concordia 1, 26100 Cremona, Italy.
Crit Rev Oncol Hematol. 2016 Jun;102:82-8. doi: 10.1016/j.critrevonc.2016.04.001. Epub 2016 Apr 8.
Docetaxel or Epirubicin-based regimens are both approved for the treatment of metastatic gastric cancer. We perform a systemic review with metanalysis to evaluate the efficacy and toxicities of docetaxel-based chemotherapy compared with epirubicin-containing regimens. A metaanalysis of randomized studies in accordance with the preference guidelines for reported items in systematic reviews and meta-analyses is performed in which the databases of PubMed, the Cochrane Library, and the ASCO University Meeting were searched for relevant publications. The primary outcome was efficacy, the secondary toxicities. A total of 553 cases were included in the meta-analysis; 278 received epirubicin-based treatment and 313 received docetaxel. The pooled risk ratio to achieve an objective response and a disease control rate were 1.08 (95% CI 0.85-1.37; P=0.52) and 0.90 (95% CI 0.75-1.08; P=0.27) respectively. EPI arm showed a decrease in the risk of neutropenia, anemia, fatigue, asthenia and diarrhea, paraesthesia; docetaxel arm showed a decrease in the risk of leucopenia, thrombocytopenia, anorexia, nausea, nausea-vomiting, stomatitis and neutropenic fever. The results of our study suggest a similar activity of docetaxel and epirubicin-based chemotherapeutic regimens in metastatic gastric cancer. Other parameters as, comorbidity, concomitant diseases and prior therapies should be taken into account to address the clinician's choice in selecting the best therapeutical approach for any single patient.
多西他赛或表柔比星为基础的方案均被批准用于治疗转移性胃癌。我们进行了一项系统评价和荟萃分析，以评估多西他赛为基础的化疗与表柔比星联合方案相比的疗效和毒性。按照系统评价和荟萃分析报告项目的偏好指南，对符合条件的随机研究进行荟萃分析，检索 PubMed、Cochrane 图书馆和 ASCO 大学会议的数据库以查找相关文献。主要结局是疗效，次要结局是毒性。共有 553 例病例纳入荟萃分析，其中 278 例接受表柔比星为基础的治疗，313 例接受多西他赛治疗。达到客观缓解和疾病控制率的合并风险比分别为 1.08（95%CI 0.85-1.37；P=0.52）和 0.90（95%CI 0.75-1.08；P=0.27）。EPI 组的中性粒细胞减少、贫血、疲劳、乏力和腹泻、感觉异常的风险降低；多西他赛组的白细胞减少、血小板减少、厌食、恶心、恶心-呕吐、口腔炎和中性粒细胞减少性发热的风险降低。我们的研究结果表明，多西他赛和表柔比星为基础的化疗方案在转移性胃癌中的活性相似。其他参数，如合并症、伴随疾病和既往治疗，应在选择最佳治疗方法时考虑到，以满足临床医生为每个患者做出的选择。
