Meta analysis on neoadjavunt chemotherapy in the treatment of advanced gastric carcinoma / 中国医师进修杂志

ABSTRACT

Objective To review the effect of neoadjavunt chemotherapy on advanced gastric carcinoma.Methods The CNKI,CBM,VIP and PubMed online databases of clinical study about neoadjavunt chemotherapy in treatment of advanced gastric carcinoma were searched,according to inclusion and exclusion criteria for pooling of essay and Jadad scale was used.Revman software (version 4.2) was used to undertake Meta analysis for evaluating the overall effectiveness.Results Sixteen compared clinical study,1937 patients in total had been included.The results showed that neoadjuvant chemotherapy group was higher than conventional surgery group on radical resection rate and survival rate (OR =1.900,95％ CI1.30-2.77,P ＜ 0.01 for radical resection rate,OR =1.83,95％ CI 1.43-2.33,P ＜ 0.01 for survival rate)and neoadjuvant chemotherapy group was lower than conventonal surgery group on palliation resection rate (OR =0.54,95％ CI 0.33-0.88,P=0.01).But there was no significant difference on pathological stage betwee two groups (OR =1.03,95％ CI 0.62-1.73,P =0.90).Conclusions Existing clinical evidence suggest that neoadjuvant chemotherapy can improve the rate of radical resection and survival.But selection bias due to the existence of including studies and the possibility of measurement bias can affect the outcome of argument strength.So looking forward to more high-quality,randomized and double-blind controlled trial to provide higher quality evidence to guide the rationalization of clinical medicine is work in clinical search.