Wu Zhongliang, Zhang Xingfa, Zhang Chongxiang, Lin Yi
Department of Gastrointestinal Surgery, The Third Affiliated Hospital of Guizhou Medical University, Duyun, Guizhou Province, China.
Evid Based Complement Alternat Med. 2023 Jun 27;2023:4946642. doi: 10.1155/2023/4946642. eCollection 2023.
To investigate the effect of capecitabine versus 5-fluorouracil in advanced gastric cancer patients.
We searched PubMed, Cochrane Library, Embase, and other databases from database establishment to June 2022, containing randomized controlled trials (RCT) on capecitabine and 5-fluorouracil in advanced gastric cancer patients. A meta-analysis was conducted to evaluate the effect of capecitabine versus 5-fluorouracil on overall response rate, neutropenia, thrombocytopenia, stomatitis, hand-foot syndrome, nausea and vomiting, alopecia, and diarrhea.
Eight RCTs with a total of 1998 patients with advanced gastric cancer were finally included, including 982 with capecitabine and 1016 with 5-fluorouracil. Compared with 5-fluorouracil, capecitabine use was significantly associated with an improved overall response rate in patients (RR 1.13, 95% CI 1.02-1.25, =0.02). Compared with 5-fluorouracil, treatment with capecitabine was significantly associated with decreased neutropenia events (RR 0.78, 95% CI 0.62-0.99, = 86%, =0.04), and a decreased risk of stomatitis (RR 0.73, 95% CI 0.64-0.84, = 40%, < 0.0001) in patients with advanced gastric cancer. In terms of hand-foot syndrome, capecitabine was associated with increased hand-foot syndrome events than 5-fluorouracil (RR 2.00, 95% CI 1.21-3.31, =0.007). In terms of thrombocytopenia, nausea and vomiting, alopecia, and diarrhea, the effect of capecitabine and 5-fluorouracil were similar ( > 0.05).
Compared with 5-fluorouracil, capecitabine treatment improves the overall response rate and reduces the risk of neutropenia and stomatitis in advanced gastric cancer patients. It should be noted that capecitabine treatment may also increase the occurrence of hand-foot syndrome. Capecitabine is similar to 5-fluorouracil in causing thrombocytopenia, nausea and vomiting, alopecia, and diarrhea.
探讨卡培他滨与5-氟尿嘧啶对晚期胃癌患者的疗效。
检索了从数据库建立至2022年6月的PubMed、Cochrane图书馆、Embase及其他数据库，纳入关于卡培他滨和5-氟尿嘧啶用于晚期胃癌患者的随机对照试验（RCT）。进行荟萃分析以评估卡培他滨与5-氟尿嘧啶在总缓解率、中性粒细胞减少、血小板减少、口腔炎、手足综合征、恶心呕吐、脱发和腹泻方面的疗效。
最终纳入8项RCT，共1998例晚期胃癌患者，其中982例使用卡培他滨，1016例使用5-氟尿嘧啶。与5-氟尿嘧啶相比，使用卡培他滨的患者总缓解率显著提高（RR 1.13，95%CI 1.02-1.25，P=0.02）。与5-氟尿嘧啶相比，卡培他滨治疗显著降低晚期胃癌患者中性粒细胞减少事件的发生率（RR 0.78，95%CI 0.62-0.99，I²=86%，P=0.04），以及口腔炎风险（RR 0.73，95%CI 0.64-0.84，I²=40%，P<0.0001）。在手足综合征方面，卡培他滨导致的手足综合征事件比5-氟尿嘧啶更多（RR 2.00，95%CI 1.21-3.31，P=0.007）。在血小板减少、恶心呕吐、脱发和腹泻方面，卡培他滨和5-氟尿嘧啶的疗效相似（P>0.05）。
与5-氟尿嘧啶相比，卡培他滨治疗可提高晚期胃癌患者的总缓解率，并降低中性粒细胞减少和口腔炎的风险。需要注意的是，卡培他滨治疗也可能增加手足综合征的发生。卡培他滨在导致血小板减少、恶心呕吐、脱发和腹泻方面与5-氟尿嘧啶相似。
