可切除胃癌患者的围手术期化疗与辅助化疗：系统评价与荟萃分析。
Perioperative chemotherapy versus adjuvant chemotherapy in patients with resectable gastric cancer: A systematic review with meta-analysis.
机构信息
Department of Oncology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China.
Clinical Trial Institution, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China.
出版信息
Crit Rev Oncol Hematol. 2024 Jun;198:104082. doi: 10.1016/j.critrevonc.2023.104082. Epub 2023 Aug 1.
PURPOSE
The study aimed to investigate the prognosis and safety of perioperative chemotherapy (PC) compared with adjuvant chemotherapy (AC).
METHODS
We systematically searched and assessed studies in PubMed, Embase, and the Cochrane Library from inception to 1st September 2022.
RESULTS
Eighteen studies were eligible for the analysis, including 4686 patients in total. Our study found that patients with resectable gastric cancer undergoing PC had favorable prognosis on OS (HR 0.77; 95% CI 0.69-0.87) and DFS (HR 0.76; 95% CI 0.69-0.84) than those who undergoing AC. Addition of neoadjuvant chemotherapy (NAC) to AC provided higher R0 resection rate but did not increase the risk of postoperative complication rate and most of the adverse event rates.
CONCLUSION
Our study demonstrated that PC shows better OS and DFS in Asians with resectable gastric cancer compared with AC. PC should be preferred because of its favorable prognosis and similar safety.
目的
本研究旨在探讨与辅助化疗（AC）相比，围手术期化疗（PC）的预后和安全性。
方法
我们系统地检索了 PubMed、Embase 和 Cochrane Library 自成立至 2022 年 9 月 1 日的研究，并对其进行了评估。
结果
共有 18 项研究符合分析标准，总共纳入了 4686 名患者。我们的研究发现，接受 PC 的可切除胃癌患者在 OS（HR 0.77；95%CI 0.69-0.87）和 DFS（HR 0.76；95%CI 0.69-0.84）方面的预后更好。与 AC 相比，将新辅助化疗（NAC）加入 AC 可提高 R0 切除率，但不会增加术后并发症发生率和大多数不良事件发生率。
结论
本研究表明，与 AC 相比，PC 可改善可切除胃癌亚洲患者的 OS 和 DFS。由于 PC 的预后良好且安全性相似，因此应优先选择 PC。
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