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Abstract
ObjectiveA network meta-analysis was performed to compare the short-term efficacy of different chemotherapy regimens in the treatment of advanced gastric cancer.MethodsRandomized controlled trials of different chemotherapy regimens for advanced gastric cancer were included in this study. Network meta-analysis combined direct evidence and indirect evidence to evaluate the odds ratio and draw surface under the cumulative ranking curves of different chemotherapy regimens in advanced gastric cancer.ResultsThe results of surface under the cumulative ranking curves showed that S-1 and capecitabine regimens were better than fluorouracil. As for multi-drug combination regimens, the disease control rate of cisplatin + capecitabine, docetaxel + cisplatin + fluorouracil and etoposide + cisplatin + capecitabine regimens were relatively better, while fluorouracil + adriamycin + mitomycin regimen was relatively poorer when compared with cisplatin + fluorouracil regimen. Additionally, the overall response ratio of cisplatin + capecitabine, paclitaxel + fluorouracil, docetaxel + cisplatin + fluorouracil and etoposide + cisplatin + fluorouracil regimens were relatively better, while the disease control rate of fluorouracil + adriamycin + mitomycin regimen was relatively poorer when compared with cisplatin + fluorouracil regimen. Furthermore, the results of cluster analysis demonstrated that cisplatin + capecitabine, etoposide + cisplatin + capecitabine, S-1 + paclitaxel and S-1 + irinotecan chemotherapy regimens had better disease control rate and overall response ratio for advanced gastric cancer patients.ConclusionThis network meta-analysis clearly showed that multi-drug combination chemotherapy regimens based on capecitabine and S-1 might be the best chemotherapy regimen for advanced gastric cancer.
Highlights
Gastric cancer (GC) is the 4th most common malignant disease and the 2nd most frequent cause of cancer-related deaths around the world [1]
The results of surface under the cumulative ranking curves showed that S-1 and capecitabine regimens were better than fluorouracil
As for multidrug combination regimens, the disease control rate of cisplatin + capecitabine, docetaxel + cisplatin + fluorouracil and etoposide + cisplatin + capecitabine regimens were relatively better, while fluorouracil + adriamycin + mitomycin regimen was relatively poorer when compared with cisplatin + fluorouracil regimen
Summary
Gastric cancer (GC) is the 4th most common malignant disease and the 2nd most frequent cause of cancer-related deaths around the world [1]. GC is a multifactorial disease caused by environmental and lifestyle factors, other recognized risk factors include smoking, obesity, dietary factors, radiation, Helicobacter pylori infection, pernicious anemia and partial gastrectomy, etc. Detection is possible with screening, but most GC patients are diagnosed at www.impactjournals.com/oncotarget an inoperable advanced stage which requiring palliative chemotherapy [5]. Despite the advances achieved over the recent decades, the prognosis of patients with advanced GC (AGC) remains poor [7]. New chemotherapy regimens are desperately needed for the benefit of improving the dismal prognosis of AGC
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