Lv Hui-Fen, Qin Li-Feng, Ran Rui-Zhi, Jiang Xue-Ping, Zhao Fang-Yu, Li Bo
Hubei Provincial Key Laboratory of Occurrence and Intervention of Rheumatic Diseases, Hubei Minzu University, Enshi, China.
Department of Pharmacology, Health Science Center, Hubei Minzu University, Enshi, China.
Front Pharmacol. 2024 Jan 8;14:1242548. doi: 10.3389/fphar.2023.1242548. eCollection 2023.
To systematically evaluate the safety and efficacy of docetaxel plus S-1-based therapy in gastric cancer treatment. PubMed, Embase, The Cochrane Library, and Web of Science electronic databases were searched for randomized controlled trials on docetaxel plus S-1-based therapy in the treatment of gastric cancer from the establishment of the database to 1 September 2022. Relevant studies were included per pre-defined eligibility criteria, and two researchers independently screened and assessed the included literature using Review Manager v5. Outcome measures and statistics related with efficacy and safety profiles were extracted from the included studies, and Stata v15.1 was used for pooled analysis. Objective response rate (odds ratio = 2.34, 95% CI = [1.32, 4.13], = 0.003), relapse-free survival (HR = 0.68, 95% CI = [0.58, 0.79], < 0.001), progression-free survival (HR = 0.81, 95% CI = [0.68, 0.96], = 0.016), and overall survival (HR = 0.86, 95% CI = [0.79, 0.95], = 0.002) of docetaxel plus S-1-based therapy (DS-based therapy) in gastric cancer treatment were better than those of the non-DS-based therapy. However, DS-based therapy was associated with increased risk of certain adverse drug effects, such as alopecia, leukopenia, and oral mucositis. Further studies are warranted to validate the efficacy superiority of DS-based non-DS-based regimens as per our trial sequential analysis findings. DS-based therapy significantly improves patients' clinical outcomes in gastric cancer, albeit at the cost of increased toxicity. Further RCTs are needed to confirm the efficacy superiority of DS-based regimens.
系统评价多西他赛联合S-1方案治疗胃癌的安全性和有效性。检索PubMed、Embase、Cochrane图书馆和Web of Science电子数据库，查找从数据库建立至2022年9月1日关于多西他赛联合S-1方案治疗胃癌的随机对照试验。根据预先定义的纳入标准纳入相关研究，两名研究人员使用Review Manager v5独立筛选和评估纳入文献。从纳入研究中提取与疗效和安全性相关的结局指标及统计数据，使用Stata v15.1进行汇总分析。多西他赛联合S-1方案（DS方案）治疗胃癌的客观缓解率（优势比=2.34，95%可信区间=[1.32, 4.13]，P=0.003）、无复发生存期（风险比=0.68，95%可信区间=[0.58, 0.79]，P<0.001）、无进展生存期（风险比=0.81，95%可信区间=[0.68, 0.96]，P=0.016）和总生存期（风险比=0.86，95%可信区间=[0.79, 0.95]，P=0.002）均优于非DS方案。然而，DS方案与某些药物不良反应风险增加相关，如脱发、白细胞减少和口腔黏膜炎。根据我们的试验序贯分析结果，有必要进一步研究以验证DS方案相对于非DS方案的疗效优势。DS方案虽以增加毒性为代价，但能显著改善胃癌患者的临床结局。需要进一步的随机对照试验来证实DS方案的疗效优势。
