Efficacy and safety of neoadjuvant chemotherapy containing tegafur gimeracil oteracil potassium combined with surgery in the treatment of advanced gastric cancer: a meta-analysis_Chinese Journal of Evidence-Based Medicine

Authors：

ZHAN Hao , LONG Bo , WANG Zhenjiang , DU Hengrui , ZHOU Huinian ,  JIAO Zuoyi

First Department of General Surgery, Second Hospital of Lanzhou University, Lanzhou, 730030, P.R.China;

Corresponding author：

JIAO Zuoyi, Email: jiaozx@lzu.edu.cn

Keywords：

Advanced gastric cancer; Tegafur gimeracil oteracil potassium; Neoadjuvant chemotherapy; Meta-analysis; R₀ resection rate; Survival rate; Randomized controlled trial

DOI：

10.7507/1672-2531.201702044

Video：

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ObjectiveTo systematically review the efficacy and safety of neoadjuvant chemotherapy containing tegafur gimeracil oteracil potassium (S-1) combined with surgery in the treatment of advanced gastric cancer.MethodsWe searched EMbase, PubMed, The Cochrane Library, Web of Science, CBM, CNKI and WanFang Data from inception to February 2017, to collect randomized controlled trials (RCTs) about neoadjuvant chemotherapy containing S-1 combined with surgery in the treatment of advanced gastric cancer. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Meta-analysis was performed by using RevMan 5.3 software.ResultsA total of 11 RCTs involving 971 advanced gastric cancer patients were included. The results of meta-analysis showed that the neoadjuvant chemotherapy containing S-1 combined with surgery group was superior to the control group in R₀ resection rate (OR=2.75, 95%CI 1.91 to 3.95, P<0.000 01), 2 year survival rate (OR=1.72, 95%CI 1.01 to 2.93, P=0.05) and 3 year survival rate (OR=1.64, 95%CI 1.12 to 2.41, P=0.01), while there were no statistical differences in response rate (OR=1.33, 95%CI 0.70 to 2.51, P=0.39), 1 year survival rate (OR=1.50, 95%CI 0.64 to 3.53, P=0.35) and the incidence of postoperative complications (OR=1.00, 95%CI 0.66 to 1.51, P=0.98).ConclusionNeoadjuvant chemotherapy containing S-1 combined with surgery can improve the R₀ resection rate, 2-year survival rate and 3-year survival rate without increase postoperative complications rate. Due to limited quality and quantity of the included studies, more high-quality studies are needed to verify the above conclusion.

Citation： ZHAN Hao, LONG Bo, WANG Zhenjiang, DU Hengrui, ZHOU Huinian, JIAO Zuoyi. Efficacy and safety of neoadjuvant chemotherapy containing tegafur gimeracil oteracil potassium combined with surgery in the treatment of advanced gastric cancer: a meta-analysis. Chinese Journal of Evidence-Based Medicine, 2017, 17(7): 820-828. doi: 10.7507/1672-2531.201702044 Copy

1.	陈万青, 郑荣寿, 张思维, 等. 2013 年中国恶性肿瘤发病和死亡分析. 中国肿瘤, 2017, 26(1): 1-7.
2.	郑朝旭, 郑荣寿, 张思维, 等. 中国 2010 年胃癌发病与死亡分析. 中国肿瘤, 2014, 23(10): 795-800.
3.	Ajani JA, D'Amico TA, Almhanna K, et al. Gastric cancer, version 3.2016, NCCN clinical practice guidelines in oncology. J Natl Compr Canc Netw, 2016, 14(10): 1286-1312.
4.	Japanese Gastric Cancer Association. Japanese gastric cancer treatment guidelines 2014 (ver. 4). Gastric Cancer, 2017, 20(1): 1-19.
5.	Ter Veer E, Mohammad NH, Lodder P, et al. The efficacy and safety of S-1-based regimens in the first-line treatment of advanced gastric cancer: a systematic review and meta-analysis. Gastric Cancer, 2016, 19(3): 696-712.
6.	Yang J, Zhou Y, Min K, et al. S-1-based vs. non-S-1-based chemotherapy in advanced gastric cancer: a meta-analysis. World J Gastroenterol, 2014, 20(33): 11886-11893.
7.	Li DH, Pan ZK, Ye F, et al. S-1-based versus 5-FU-based chemotherapy as first-line treatment in advanced gastric cancer: a meta-analysis of randomized controlled trials. Tumour Biol, 2014, 35(8): 8201-8208.
8.	陈颖, 杨大明, 邵俊, 等. 替吉奥单药新辅助化疗对进展期胃癌的影响. 中国医药导刊, 2012, 14(1): 43-44.
9.	杜新超, 李勇. 替吉奥联合奥沙利铂新辅助化疗对贲门癌手术患者的疗效观察. 河北医科大学学报, 2015, 36(1): 69-71.
10.	黄健. SOX 方案围手术期化疗对局部进展期胃癌近期疗效的影响. 石家庄: 河北医科大学, 2014.
11.	李定云, 张涛, 凌亚非, 等. 替吉奥联合奥沙利铂新辅助化疗治疗进展期胃癌疗效观察. 现代医药卫生, 2014, 30(10): 1538-1540.
12.	刘林, 杨新辉, 王海江, 等. 多西他赛联合奥沙利铂及替吉奥治疗进展期胃癌的疗效及对围手术期影响. 中国肿瘤临床, 2013, 40(13): 788-791.
13.	吴凯, 冯许刚, 戴晓玲. 术前 SOX 方案新辅助化疗对局部进展期胃癌手术效果的影响. 海南医学, 2016, 27(19): 3167-3169.
14.	谢振山, 张谢夫, 刘光辉, 等. 应用多西他赛联合 S-1 新辅助化疗方案治疗可切除的进展期胃癌的疗效. 世界华人消化杂志, 2014, 22(34): 5334-5338.
15.	Yoshikawa T, Morita S, Tanabe K, et al. Survival results of a randomised two-by-two factorial phase II trial comparing neoadjuvant chemotherapy with two and four courses of S-1 plus cisplatin (SC) and paclitaxel plus cisplatin (PC) followed by D2 gastrectomy for resectable advanced gastric cancer. Eur J Cancer. 2016, 62: 103-111.
16.	赵俊峰. 多西他赛联合替吉奥新辅助化疗治疗进展期胃癌的疗效分析. 医药前沿, 2016, 6(27): 127-128.
17.	张培良, 张焕珍. SOX 方案新辅助化疗在进展期胃癌中的临床应用. 中国当代医药, 2011, 18(29): 78-79.
18.	赵运成, 刘和平, 王桂琦. 替吉奥联合奥沙利铂新辅助化疗治疗胃癌疗效观察. 现代中西医结合杂志, 2016, 25(9): 991-993.
19.	Shirasaka T. Development history and concept of an oral anticancer agent S-1 (TS-1): its clinical usefulness and future vistas. Jpn J Clin Oncol, 2009, 39(1): 2-15.
20.	Wilke H, Preusser P, Fink U, et al. Preoperative chemotherapy in locally advanced and nonresectable gastric cancer: a phase II study with etoposide, doxorubicin, and cisplatin. J Clin Oncol, 1989, 7(9): 1318-1326.
21.	Zhao JH, Gao P, Song YX, et al. Which is better for gastric cancer patients, perioperative or adjuvant chemotherapy: a meta-analysis. BMC Cancer, 2016, 16: 631.
22.	Yang Y, Yin X, Sheng L, et al. Perioperative chemotherapy more of a benefit for overall survival than adjuvant chemotherapy for operable gastric cancer: an updated meta-analysis. Sci Rep, 2015, 5: 12850.
23.	Xiong BH, Cheng Y, Ma L, et al. An updated meta-analysis of randomized controlled trial assessing the effect of neoadjuvant chemotherapy in advanced gastric cancer. Cancer Invest, 2014, 32(6): 272-284.
24.	Okabe H, Hata H, Ueda S, et al. A phase II study of neoadjuvant chemotherapy with S-1 and cisplatin for stage III gastric cancer: KUGC03. J Surg Oncol, 2016, 113(1): 36-41.
25.	Migita K, Nashimoto A, Yabusaki H, et al. Efficacy of neoadjuvant chemotherapy with docetaxel, cisplatin and S-1 for resectable locally advanced gastric cancer. Int J Clin Oncol, 2016, 21(1): 102-109.
26.	Kemmochi A, Inagawa S, Akashi Y, et al. A case of advanced gastric cancer with a complete response to S-1 neoadjuvant chemotherapy in an elderly patient. Gan To Kagaku Ryoho, 2016, 43(1): 115-119.
27.	Mori S, Kishimoto H, Tauchi K, et al. Histological complete response in advanced gastric cancer after 2 weeks of S-1 administration as neoadjuvant chemotherapy. Gastric Cancer, 2006, 9(2): 136-139.
28.	Sasako M, Sakuramoto S, Katai H, et al. Five-year outcomes of a randomized phase III trial comparing adjuvant chemotherapy with S-1 versus surgery alone in stage II or III gastric cancer. J Clin Oncol, 2011, 29(29): 4387-4393.

1. 陈万青, 郑荣寿, 张思维, 等. 2013 年中国恶性肿瘤发病和死亡分析. 中国肿瘤, 2017, 26(1): 1-7.
2. 郑朝旭, 郑荣寿, 张思维, 等. 中国 2010 年胃癌发病与死亡分析. 中国肿瘤, 2014, 23(10): 795-800.
3. Ajani JA, D'Amico TA, Almhanna K, et al. Gastric cancer, version 3.2016, NCCN clinical practice guidelines in oncology. J Natl Compr Canc Netw, 2016, 14(10): 1286-1312.
4. Japanese Gastric Cancer Association. Japanese gastric cancer treatment guidelines 2014 (ver. 4). Gastric Cancer, 2017, 20(1): 1-19.
5. Ter Veer E, Mohammad NH, Lodder P, et al. The efficacy and safety of S-1-based regimens in the first-line treatment of advanced gastric cancer: a systematic review and meta-analysis. Gastric Cancer, 2016, 19(3): 696-712.
6. Yang J, Zhou Y, Min K, et al. S-1-based vs. non-S-1-based chemotherapy in advanced gastric cancer: a meta-analysis. World J Gastroenterol, 2014, 20(33): 11886-11893.
7. Li DH, Pan ZK, Ye F, et al. S-1-based versus 5-FU-based chemotherapy as first-line treatment in advanced gastric cancer: a meta-analysis of randomized controlled trials. Tumour Biol, 2014, 35(8): 8201-8208.
8. 陈颖, 杨大明, 邵俊, 等. 替吉奥单药新辅助化疗对进展期胃癌的影响. 中国医药导刊, 2012, 14(1): 43-44.
9. 杜新超, 李勇. 替吉奥联合奥沙利铂新辅助化疗对贲门癌手术患者的疗效观察. 河北医科大学学报, 2015, 36(1): 69-71.
10. 黄健. SOX 方案围手术期化疗对局部进展期胃癌近期疗效的影响. 石家庄: 河北医科大学, 2014.
11. 李定云, 张涛, 凌亚非, 等. 替吉奥联合奥沙利铂新辅助化疗治疗进展期胃癌疗效观察. 现代医药卫生, 2014, 30(10): 1538-1540.
12. 刘林, 杨新辉, 王海江, 等. 多西他赛联合奥沙利铂及替吉奥治疗进展期胃癌的疗效及对围手术期影响. 中国肿瘤临床, 2013, 40(13): 788-791.
13. 吴凯, 冯许刚, 戴晓玲. 术前 SOX 方案新辅助化疗对局部进展期胃癌手术效果的影响. 海南医学, 2016, 27(19): 3167-3169.
14. 谢振山, 张谢夫, 刘光辉, 等. 应用多西他赛联合 S-1 新辅助化疗方案治疗可切除的进展期胃癌的疗效. 世界华人消化杂志, 2014, 22(34): 5334-5338.
15. Yoshikawa T, Morita S, Tanabe K, et al. Survival results of a randomised two-by-two factorial phase II trial comparing neoadjuvant chemotherapy with two and four courses of S-1 plus cisplatin (SC) and paclitaxel plus cisplatin (PC) followed by D2 gastrectomy for resectable advanced gastric cancer. Eur J Cancer. 2016, 62: 103-111.
16. 赵俊峰. 多西他赛联合替吉奥新辅助化疗治疗进展期胃癌的疗效分析. 医药前沿, 2016, 6(27): 127-128.
17. 张培良, 张焕珍. SOX 方案新辅助化疗在进展期胃癌中的临床应用. 中国当代医药, 2011, 18(29): 78-79.
18. 赵运成, 刘和平, 王桂琦. 替吉奥联合奥沙利铂新辅助化疗治疗胃癌疗效观察. 现代中西医结合杂志, 2016, 25(9): 991-993.
19. Shirasaka T. Development history and concept of an oral anticancer agent S-1 (TS-1): its clinical usefulness and future vistas. Jpn J Clin Oncol, 2009, 39(1): 2-15.
20. Wilke H, Preusser P, Fink U, et al. Preoperative chemotherapy in locally advanced and nonresectable gastric cancer: a phase II study with etoposide, doxorubicin, and cisplatin. J Clin Oncol, 1989, 7(9): 1318-1326.
21. Zhao JH, Gao P, Song YX, et al. Which is better for gastric cancer patients, perioperative or adjuvant chemotherapy: a meta-analysis. BMC Cancer, 2016, 16: 631.
22. Yang Y, Yin X, Sheng L, et al. Perioperative chemotherapy more of a benefit for overall survival than adjuvant chemotherapy for operable gastric cancer: an updated meta-analysis. Sci Rep, 2015, 5: 12850.
23. Xiong BH, Cheng Y, Ma L, et al. An updated meta-analysis of randomized controlled trial assessing the effect of neoadjuvant chemotherapy in advanced gastric cancer. Cancer Invest, 2014, 32(6): 272-284.
24. Okabe H, Hata H, Ueda S, et al. A phase II study of neoadjuvant chemotherapy with S-1 and cisplatin for stage III gastric cancer: KUGC03. J Surg Oncol, 2016, 113(1): 36-41.
25. Migita K, Nashimoto A, Yabusaki H, et al. Efficacy of neoadjuvant chemotherapy with docetaxel, cisplatin and S-1 for resectable locally advanced gastric cancer. Int J Clin Oncol, 2016, 21(1): 102-109.
26. Kemmochi A, Inagawa S, Akashi Y, et al. A case of advanced gastric cancer with a complete response to S-1 neoadjuvant chemotherapy in an elderly patient. Gan To Kagaku Ryoho, 2016, 43(1): 115-119.
27. Mori S, Kishimoto H, Tauchi K, et al. Histological complete response in advanced gastric cancer after 2 weeks of S-1 administration as neoadjuvant chemotherapy. Gastric Cancer, 2006, 9(2): 136-139.
28. Sasako M, Sakuramoto S, Katai H, et al. Five-year outcomes of a randomized phase III trial comparing adjuvant chemotherapy with S-1 versus surgery alone in stage II or III gastric cancer. J Clin Oncol, 2011, 29(29): 4387-4393.

Chinese Journal of Evidence-Based Medicine

Efficacy and safety of neoadjuvant chemotherapy containing tegafur gimeracil oteracil potassium combined with surgery in the treatment of advanced gastric cancer: a meta-analysis

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