School of Medico-Legal Studies, National Forensic Sciences University, Sector 9, Gandhinagar, Gujarat, 382007, India.
School of Forensic Science, National Forensic Sciences University, Sector 9, Gandhinagar, Gujarat, 382007, India.
J Gastrointest Cancer. 2024 Dec;55(4):1485-1497. doi: 10.1007/s12029-024-01103-w. Epub 2024 Aug 20.
Metronomic capecitabine has been found to be useful in several types of cancers such as pancreatic cancer, breast cancer, gastrointestinal cancers, nasopharyngeal carcinoma, and metastatic colorectal cancer. This unique systematic literature review and meta-analysis was undertaken to assess the effectiveness and safety of metronomic capecitabine as a treatment regimen for hepatocellular carcinoma.
A systematic search of major databases was performed. Eight studies that dealt with the use of metronomic capecitabine for hepatocellular carcinoma (HCC) were selected, seven were non-randomized control trials (n-RCTs), and one was a randomized control trial (RCT). Meta-analysis of these studies was performed using Review Manager v5.3 and STATA 15.1 software. The pooled prevalence of overall survival (OS), progression-free survival (PFS), overall response rate (ORR), grade 1-2 adverse events (grade 1-2 AEs), grade 3-4 adverse events (grade 3-4 AEs) was determined, including publication bias and sensitivity analysis.
Eight studies met the inclusion criteria, combining the pooled data of 476 patients from safety and efficacy studies. The pooled prevalence of disease control rate (DCR) and overall response rate (ORR) achieved with metronomic capecitabine was 36% (95% CI 32-41) and 7% (95% CI 5-9) respectively. The median progression-free survival (PFS) and median overall survival (OS) were 3.57 months (95% CI 3.29-3.85) and 11.75 months (95% CI 10.56-12.95) respectively. The incidence of grade 3-4 adverse events (grade 3-4 AEs) and grade 1-2 adverse events (grade 1-2 AEs) was 38% (95% CI 32-44) and 73% (95% CI 67-79) respectively.
This meta-analysis highlights metronomic capecitabine as a potential treatment for hepatocellular carcinoma (HCC) in the advanced stage. However, effective management of capecitabine's side effects is essential.
节拍式卡培他滨已被证明在多种癌症中具有疗效，如胰腺癌、乳腺癌、胃肠道癌、鼻咽癌和转移性结直肠癌。本项独特的系统文献回顾和荟萃分析旨在评估节拍式卡培他滨作为肝细胞癌治疗方案的有效性和安全性。
对主要数据库进行了系统检索。选择了 8 项涉及节拍式卡培他滨治疗肝细胞癌（HCC）的研究，其中 7 项为非随机对照试验（n-RCT），1 项为随机对照试验（RCT）。使用 Review Manager v5.3 和 STATA 15.1 软件对这些研究进行荟萃分析。确定了总生存（OS）、无进展生存（PFS）、总缓解率（ORR）、1-2 级不良事件（1-2 级 AE）、3-4 级不良事件（3-4 级 AE）的总体发生率，包括发表偏倚和敏感性分析。
纳入了 8 项研究，对来自安全性和疗效研究的 476 例患者的数据进行了汇总。节拍式卡培他滨治疗的疾病控制率（DCR）和总缓解率（ORR）的汇总发生率分别为 36%（95% CI 32-41）和 7%（95% CI 5-9）。中位无进展生存期（PFS）和中位总生存期（OS）分别为 3.57 个月（95% CI 3.29-3.85）和 11.75 个月（95% CI 10.56-12.95）。3-4 级不良事件（3-4 级 AE）和 1-2 级不良事件（1-2 级 AE）的发生率分别为 38%（95% CI 32-44）和 73%（95% CI 67-79）。
这项荟萃分析强调了节拍式卡培他滨作为晚期肝细胞癌的一种潜在治疗方法。然而，有效管理卡培他滨的副作用至关重要。
