Adjuvant chemoradiotherapy versus chemotherapy for gastric cancer: A meta-analysis of randomized controlled trials

Objective The aim of this study was to evaluate the efficacy and safety of adjuvant chemoradiotherapy (CRT) versus chemotherapy (CT) for patients with gastric cancer. Methods Electronic databases including PUBMED, EMBASE, and Cochrane Library were retrieved for original studies from their inception...

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Published in:Journal of surgical oncology 2015-03, Vol.111 (3), p.277-284
Main Authors: Dai, Qiang, Jiang, Lei, Lin, Rui-Jiang, Wei, Kong-kong, Gan, Liang-Liang, Deng, Cheng-Hui, Guan, Quan-Lin
Format: Article
Language:English
Subjects:
chemoradiotherapy
Chemoradiotherapy, Adjuvant
Chemotherapy, Adjuvant
gastric cancer
Humans
meta-analysis
Prognosis
Randomized Controlled Trials as Topic
Stomach Neoplasms - therapy
surgery
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Summary:Objective The aim of this study was to evaluate the efficacy and safety of adjuvant chemoradiotherapy (CRT) versus chemotherapy (CT) for patients with gastric cancer. Methods Electronic databases including PUBMED, EMBASE, and Cochrane Library were retrieved for original studies from their inception to April 2014. Two reviewers independently evaluated the quality of the included studies and extracted the data. All Statistical analyses were performed using RevMan Version 5.2 software. Results Six randomized controlled trials involving 1,171 patients were included. The meta‐analysis showed that there were statistical significances between chemoradiotherapy group and chemotherapy group in 5‐year disease free survival rate (OR = 1.56, 95% CI: 1.09–2.24), local‐regional recurrence rate (OR = 0.46, 95% CI: 0.32–0.67) and neutropenia (OR = 1.47, 95% CI: 1.11–1.96). While treatment efficacy did not differ significantly by the 5‐year overall survival rate (OR = 1.32, 95% CI: 0.92–1.88), 3‐year disease free survival rate (OR = 1.28, 95% CI: 0.92–1.80), and new metastases (OR = 0.76, 95% CI: 0.57–1.03). Toxicities were not significantly different between two groups for nausea/vomiting, diarrhea, anemia, and thrombocytopenia. Conclusions For patients with gastric cancer, adjuvant chemoradiotherapy could significantly improve 5‐year disease free survival rate and reduce local‐regional recurrence rate compared with chemotherapy and, can be well accepted and tolerated. J. Surg. Oncol. 2015 111:277–284. © 2014 Wiley Periodicals, Inc.
ISSN:0022-4790
1096-9098
DOI:10.1002/jso.23795