Meta-analysis on effect of postoperative adjuvant chemotherapy for advanced gastric cancer / 重庆医学

ABSTRACT

Objective To systematically analyze the effect of adjuvant chemotherapy after radical operation in advanced gastric cancer .Methods The related literatures published at home and abroad were retrieved from the electronic databases including CNKI ,PubMed ,Elsevier ,Springer ,Oxford from January 2003 to December 2013 ,then 11 articles of the randomized controlled trial (RCT) of the comparison between the postoperative adjuvant chemotherapy and simple operation were collected .The effect merging and the quantitative systematic evaluation in the aspects of the total survival ,disease free survival and relapse free survival were per-formed with RevMan5 .2 provided by the Cochrane collaboration network .Results 11 articles of RCT were included with 4 points and more by the Jadad scale ,involving 4 433 patients ,among them 2 203 patients with operation plus postoperative chemotherapy and 2 230 patients with surgery alone .The results analysis indicated that the postoperative adjuvant chemotherapy made the pa-tients to obtain the apparent benefit during survival period ,the significant difference had statistical significance .OSHR= 0 .80 , 95% CI(0 .73 ,0 .88) ,P<0 .01 ;DFSHR=0 .78 ,95% CI(0 .63 ,0 .97) ,P=0 .02 ;RFSHR=0 .67 ,95% CI(0 .53 ,0 .85) ,P=0 .001 . Conclusion The postoperative adjuvant chemotherapy can make the patients with radical operation to obtain the apparent benefit during the survival period .The adjuvant chemotherapy of oral capecitabine plus oxaliplatin or oral Tegafur Gimeracil Oteracil Potas-sium after D2 radical operation may be the best scheme at present .