Li Bo, Chen Lian, Luo Hong-Liang, Yi Feng-Ming, Wei Yi-Ping, Zhang Wen-Xiong
Department of Thoracic Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi Province, China.
Jiangxi Medical College, Nanchang University, Nanchang 330006, Jiangxi Province, China.
World J Clin Cases. 2019 Mar 6;7(5):600-615. doi: 10.12998/wjcc.v7.i5.600.
As the first-line regimens for the treatment of advanced gastric cancer, both docetaxel, cisplatin, and 5-fluorouracil (DCF) and epirubicin, cisplatin, and 5-fluorouracil (ECF) regimens are commonly used in clinical practice, but there is still controversy about which is better.
To compare the efficacy and safety of DCF and ECF regimens by conducting this meta-analysis.
Computer searches in PubMed, EMBASE, Ovid MEDLINE, Science Direct, Web of Science, The Cochrane Library and Scopus were performed to find the clinical studies of all comparisons between DCF and ECF regimens. We used progression-free survival (PFS), overall survival (OS), objective response rate (ORR), disease control rate (DCR), and adverse effects (AEs) as endpoints for analysis.
Our meta-analysis included seven qualified studies involving a total of 598 patients. The pooled hazard ratios between the DCF and ECF groups were comparable in PFS (95%CI: 0.58-1.46, = 0.73), OS (95%CI: 0.65-1.10, = 0.21), and total AEs (95%CI: 0.93-1.29, = 0.30). The DCF group was significantly better than the ECF group in terms of ORR (95%CI: 1.13-1.75, = 0.002) and DCR (95%CI: 1.03-1.41, = 0.02). However, the incidence rate of grade 3-4 AEs was also greater in the DCF group than in the ECF group (95%CI: 1.16-1.88, = 0.002), especially for neutropenia and febrile neutropenia.
With better ORR and DCR values, the DCF regimen seems to be more suitable for advanced gastric cancer than the ECF regimen. However, the higher rate of AEs in the DCF group still needs to be noticed.
多西他赛、顺铂和5-氟尿嘧啶（DCF）方案以及表柔比星、顺铂和5-氟尿嘧啶（ECF）方案作为晚期胃癌的一线治疗方案，在临床实践中均常用，但哪种方案更好仍存在争议。
通过进行这项荟萃分析比较DCF和ECF方案的疗效和安全性。
在PubMed、EMBASE、Ovid MEDLINE、Science Direct、Web of Science、Cochrane图书馆和Scopus中进行计算机检索，以查找DCF和ECF方案之间所有比较的临床研究。我们将无进展生存期（PFS）、总生存期（OS）、客观缓解率（ORR）、疾病控制率（DCR）和不良反应（AEs）作为分析终点。
我们的荟萃分析纳入了7项合格研究，共涉及598例患者。DCF组和ECF组之间在PFS（95%CI：0.58 - 1.46，P = 0.73）、OS（95%CI：0.65 - 1.10，P = 0.21）和总AEs（95%CI：0.93 - 1.29，P = 0.30）方面的合并风险比具有可比性。在ORR（95%CI：1.13 - 1.75，P = 0.002）和DCR（95%CI：1.03 - 1.41，P = 0.02）方面，DCF组显著优于ECF组。然而，DCF组3 - 4级AEs的发生率也高于ECF组（95%CI：1.16 - 1.88，P = 0.002），尤其是中性粒细胞减少和发热性中性粒细胞减少。
DCF方案的ORR和DCR值更好，似乎比ECF方案更适合晚期胃癌。然而，仍需注意DCF组较高的AEs发生率。
