Efficacy and safety of docetaxel or epirubicin based chemotherapy regimens in the treatment of advanced gastric cancer: a meta-analysis_Chinese Journal of Evidence-Based Medicine

Authors：

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

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

Corresponding?author：

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

Keywords：

Advanced gastric cancer; Docetaxel; Epirubicin; Meta-analysis; Systematic review; Randomized controlled trial

DOI：

10.7507/1672-2531.201703081

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objectives To systematically review the efficacy and safety of docetaxel or epirubicin based regimens in the treatment of advanced gastric cancer. Methods We searched EMbase, PubMed, The Cochrane Library, Web of Science, CBM, CNKI and WanFang Data from inception to March 2017, to collect randomized controlled trials (RCTs) on docetaxel or epirubicin based regimens 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. Results A total of 12 RCTs involving 984 advanced gastric cancer patients were included. The results of meta-analysis showed that docetaxel based regimens were superior to epirubicin based regimens in ORR (RR=1.21, 95%CI 1.02 to 1.43, P=0.03), DCR (RR=1.13, 95%CI 1.01 to 1.26, P=0.03), 1-year survival rate (RR=1.26, 95%CI 1.01 to 1.56, P=0.04) and 2-year survival rate (RR=3.03, 95%CI 1.59 to 5.75, P=0.000 7), while there was no statistical difference between two groups in the incidence of grade Ⅲ to Ⅳ adverse events. The results of sensitivity analysis showed that docetaxel based regimens were superior to epirubicin based regimens in 2-year survival rate (RR=2.56, 95%CI 1.06 to 6.19, P=0.04), but there were no statistical differences in ORR (RR=1.13, 95%CI 0.88 to 1.45, P=0.34), DCR (RR=1.02, 95%CI 0.85 to 1.21, P=0.84) and 1-year survival rate (RR=1.29, 95%CI 0.92 to 1.80, P=0.14). The results of sensitivity analysis indicated that the overall outcomes might be affected by the risk bias of included studies. The comparision between docetaxel based regimens and epirubicin based regimens was consistent with the overall outcomes in the incidence of grade Ⅲ to Ⅳ adverse events. Conclusions Compared with epirubicin based regimens, docetaxel based regimens may have more clinical benefits for advanced gastric cancer patients. Due to limited quality and quantity of the included studies, more high quality studies are required to verify above conclusions.

Citation： ZHAN Hao, LONG Bo, DU Hengrui, WANG Zhenjiang, ZHOU Huinian, JIAO Zuoyi. Efficacy and safety of docetaxel or epirubicin based chemotherapy regimens in the treatment of advanced gastric cancer: a meta-analysis. Chinese Journal of Evidence-Based Medicine, 2017, 17(12): 1419-1427. doi: 10.7507/1672-2531.201703081 Copy

1.	陳萬青, 鄭榮壽, 張思維, 等. 2013 年中國惡性腫瘤發病和死亡分析. 中國腫瘤, 2017, 26(1): 1-7.
2.	Marano L, Polom K, Patriti A, et al. Surgical management of advanced gastric cancer: an evolving issue. Eur J Surg Oncol, 2016, 42(1): 18.
3.	季加孚. 我國胃癌防治研究三十年回顧. 中國腫瘤臨床, 2013, 40(22): 1345-1351.
4.	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.
5.	韓曉娜, 曲顏麗, 唐勇, 等. 晚期胃癌 DCF 方案與 ECF 方案治療的 Meta 分析. 腫瘤防治研究, 2014, 41(10): 1102-1106.
6.	Petrioli R, Roviello G, Zanotti L, et al. Epirubicin-based compared with docetaxel-based chemotherapy for advanced gastric carcinoma: A systematic review and meta-analysis. Crit Rev Oncol Hematol, 2016, 102: 82-88.
7.	Ochenduszko S, Puskulluoglu M, Konopka K, et al. Comparison of efficacy and safety of first-line palliative chemotherapy with EOX and mDCF regimens in patients with locally advanced inoperable or metastatic HER2-negative gastric or gastroesophageal junction adenocarcinoma: a randomized phase 3 trial. Med Oncol, 2015, 32(10): 242.
8.	Roth AD, Fazio N, Stupp R, et al. Docetaxel, cisplatin, and fluorouracil; docetaxel and cisplatin; and epirubicin, cisplatin, and fluorouracil as systemic treatment for advanced gastric carcinoma: a randomized phase II trial of the Swiss Group for Clinical Cancer Research. J Clin Oncol, 2007, 25(22): 3217.
9.	Sadighi S, Mohagheghi MA, Montazeri A, et al. Quality of life in patients with advanced gastric cancer: a randomized trial comparing docetaxel, cisplatin, 5-FU (TCF) with epirubicin, cisplatin, 5-FU (ECF). BMC Cancer, 2006, 6(1): 1-6.
10.	Thusspatience PC, Kretzschmar A, Repp M, et al. Docetaxel and continuous-infusion fluorouracil versus epirubicin, cisplatin, and fluorouracil for advanced gastric adenocarcinoma: a randomized phase II study. J Clin Oncol, 2005, 23(3): 494-501.
11.	曹波, 姬樂, 樊華. EOX 和 mDCF 方案一線治療晚期或轉移性 HER2 陰性胃癌的療效對比分析. 臨床和實驗醫學雜志, 2016, 15(17): 1679-1682.
12.	戴鵬. ECF與DF方案治療晚期胃癌效果比較. 山西職工醫學院學報, 2012, 22(1): 14-16.
13.	高輝, 丁鑫, 魏東, 等. 多西他賽對比表柔比星聯合順鉑、亞葉酸鈣和氟尿嘧啶一線治療進展期胃癌的隨機對照研究. 臨床腫瘤學雜志, 2010, 15(6): 529-533.
14.	洪專, 馮繼鋒, 陳嘉, 等. LFTP 序貫每周方案與 ECF 方案治療晚期胃癌的比較研究. 臨床腫瘤學雜志, 2007, 12(12): 933-935.
15.	李文, 季德林, 林華明. 多西他賽聯合順鉑、5-Fu 及亞葉酸鈣治療晚期胃癌. 腫瘤防治研究, 2008, 35(8): 590-592.
16.	梁冰, 韓娜, 楊家梅. DCF 和 ECF 方案治療進展期胃癌的療效觀察. 中國腫瘤臨床與康復, 2010, 17(1): 59-61.
17.	劉軍. DCF 方案與 ECF 方案治療進展期胃癌的臨床研究. 中國醫師進修雜志, 2013, 36(17): 17-19.
18.	楊蘊, 徐燕, 李玉芳, 等. 多西紫杉醇聯合順鉑、氟尿嘧啶治療晚期胃癌的臨床研究. 中國腫瘤外科雜志, 2011, 3(5): 294-297.
19.	Wagner AD, Grothe W, Haerting J, et al. Chemotherapy in advanced gastric cancer: a systematic review and meta-analysis based on aggregate data. J Clin Oncol, 2006, 24(24): 2903-2909.
20.	Webb A, Cunningham D, Scarffe JH, et al. Randomized trial comparing epirubicin, cisplatin, and fluorouracil versus fluorouracil, doxorubicin, and methotrexate in advanced esophagogastric cancer. J Clin Oncol, 1997, 15(1): 261.
21.	Van CE, Moiseyenko VM, Tjulandin S, et al. Phase III study of docetaxel and cisplatin plus fluorouracil compared with cisplatin and fluorouracil as first-line therapy for advanced gastric cancer: a report of the V325 Study Group. J Clin Oncol, 2006, 24(31): 4991.
22.	Yao Z, Guo H, Yuan Y, et al. Retrospective analysis of docetaxel, oxaliplatin plus fluorouracil compared with epirubicin, cisplatin and fluorouracil as first-line therapy for advanced gastric cancer. J Chemother, 2014, 26(2): 117.
23.	Teker F, Yilmaz B, Kemal Y, et al. Efficacy and safety of docetaxel or epirubicin, combined with cisplatin and fluorouracil (DCF and ECF), regimens as first line chemotherapy for advanced gastric cancer: a retrospective analysis from Turkey. Asian Pac J Cancer Prev, 2014, 15(16):6727-6732.
24.	Kilickap S, Yalcin S, Ates O, et al. The first line systemic chemotherapy in metastatic gastric carcinoma: A comparison of docetaxel, cisplatin and fluorouracil (DCF) versus cisplatin and fluorouracil (CF); versus epirubicin, cisplatin and fluorouracil (ECF) regimens in clinical setting. Hepatogastroenterology, 2011, 58(105): 208.
25.	劉寧, 陸建偉, 丁選勝. 晚期胃癌化療三藥聯合方案對比兩藥聯合方案有效性及安全性 meta 分析. 中國醫院藥學雜志, 2012, 32(18):1467-1472.
26.	Smyth EC, Verheij M, Allum W, et al. Gastric cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol, 2016, 27(suppl 5): v38-v49.
27.	中華人民共和國衛生部醫政司. 胃癌診療規范(2011 年版). 中國醫學前沿雜志電子版, 2012, 4(5): 62-71.
28.	Bojic M, Pluschnig U, Zacherl J, et al. Docetaxel, cisplatin and 5-fluorouracil plus granulocyte colony-stimulating factor prophylaxis in patients with metastatic adenocarcinoma of the stomach and gastroesophageal junction: experience at the Medical University of Vienna. Anticancer Res, 2011, 31(6): 2379-2382.
29.	徐俊麗, 和水祥, 張明麗, 等. 胸腺法新注射液聯合化療對老年胃癌伴肝轉移患者的療效觀察. 疑難病雜志, 2016, 15(7): 694-697.
30.	邵晶, 劉敬楊, 徐睿玲, 等. 注射液胸腺法新(日達仙)輔助希羅達聯合奧沙利鉑(XELOX 方案)治療晚期胃癌的臨床療效觀察. 現代生物醫學進展, 2016, 16(23): 4468-4471.
31.	李龍, 展昊, 龍勃, 等. 鹽酸帕洛諾司瓊注射液預防中重度化療所致惡心嘔吐療效和安全性的 Meta 分析. 中國普外基礎與臨床雜志, 2017, 24(1): 48-58.
32.	中國研究型醫院學會消化道腫瘤專業委員會, 中國醫師協會外科醫師分會多學科綜合治療專業委員會. 胃癌多學科綜合治療協作組診療模式專家共識. 中國實用外科雜志, 2017, 37(1): 37-38.

1. 陳萬青, 鄭榮壽, 張思維, 等. 2013 年中國惡性腫瘤發病和死亡分析. 中國腫瘤, 2017, 26(1): 1-7.
2. Marano L, Polom K, Patriti A, et al. Surgical management of advanced gastric cancer: an evolving issue. Eur J Surg Oncol, 2016, 42(1): 18.
3. 季加孚. 我國胃癌防治研究三十年回顧. 中國腫瘤臨床, 2013, 40(22): 1345-1351.
4. 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.
5. 韓曉娜, 曲顏麗, 唐勇, 等. 晚期胃癌 DCF 方案與 ECF 方案治療的 Meta 分析. 腫瘤防治研究, 2014, 41(10): 1102-1106.
6. Petrioli R, Roviello G, Zanotti L, et al. Epirubicin-based compared with docetaxel-based chemotherapy for advanced gastric carcinoma: A systematic review and meta-analysis. Crit Rev Oncol Hematol, 2016, 102: 82-88.
7. Ochenduszko S, Puskulluoglu M, Konopka K, et al. Comparison of efficacy and safety of first-line palliative chemotherapy with EOX and mDCF regimens in patients with locally advanced inoperable or metastatic HER2-negative gastric or gastroesophageal junction adenocarcinoma: a randomized phase 3 trial. Med Oncol, 2015, 32(10): 242.
8. Roth AD, Fazio N, Stupp R, et al. Docetaxel, cisplatin, and fluorouracil; docetaxel and cisplatin; and epirubicin, cisplatin, and fluorouracil as systemic treatment for advanced gastric carcinoma: a randomized phase II trial of the Swiss Group for Clinical Cancer Research. J Clin Oncol, 2007, 25(22): 3217.
9. Sadighi S, Mohagheghi MA, Montazeri A, et al. Quality of life in patients with advanced gastric cancer: a randomized trial comparing docetaxel, cisplatin, 5-FU (TCF) with epirubicin, cisplatin, 5-FU (ECF). BMC Cancer, 2006, 6(1): 1-6.
10. Thusspatience PC, Kretzschmar A, Repp M, et al. Docetaxel and continuous-infusion fluorouracil versus epirubicin, cisplatin, and fluorouracil for advanced gastric adenocarcinoma: a randomized phase II study. J Clin Oncol, 2005, 23(3): 494-501.
11. 曹波, 姬樂, 樊華. EOX 和 mDCF 方案一線治療晚期或轉移性 HER2 陰性胃癌的療效對比分析. 臨床和實驗醫學雜志, 2016, 15(17): 1679-1682.
12. 戴鵬. ECF與DF方案治療晚期胃癌效果比較. 山西職工醫學院學報, 2012, 22(1): 14-16.
13. 高輝, 丁鑫, 魏東, 等. 多西他賽對比表柔比星聯合順鉑、亞葉酸鈣和氟尿嘧啶一線治療進展期胃癌的隨機對照研究. 臨床腫瘤學雜志, 2010, 15(6): 529-533.
14. 洪專, 馮繼鋒, 陳嘉, 等. LFTP 序貫每周方案與 ECF 方案治療晚期胃癌的比較研究. 臨床腫瘤學雜志, 2007, 12(12): 933-935.
15. 李文, 季德林, 林華明. 多西他賽聯合順鉑、5-Fu 及亞葉酸鈣治療晚期胃癌. 腫瘤防治研究, 2008, 35(8): 590-592.
16. 梁冰, 韓娜, 楊家梅. DCF 和 ECF 方案治療進展期胃癌的療效觀察. 中國腫瘤臨床與康復, 2010, 17(1): 59-61.
17. 劉軍. DCF 方案與 ECF 方案治療進展期胃癌的臨床研究. 中國醫師進修雜志, 2013, 36(17): 17-19.
18. 楊蘊, 徐燕, 李玉芳, 等. 多西紫杉醇聯合順鉑、氟尿嘧啶治療晚期胃癌的臨床研究. 中國腫瘤外科雜志, 2011, 3(5): 294-297.
19. Wagner AD, Grothe W, Haerting J, et al. Chemotherapy in advanced gastric cancer: a systematic review and meta-analysis based on aggregate data. J Clin Oncol, 2006, 24(24): 2903-2909.
20. Webb A, Cunningham D, Scarffe JH, et al. Randomized trial comparing epirubicin, cisplatin, and fluorouracil versus fluorouracil, doxorubicin, and methotrexate in advanced esophagogastric cancer. J Clin Oncol, 1997, 15(1): 261.
21. Van CE, Moiseyenko VM, Tjulandin S, et al. Phase III study of docetaxel and cisplatin plus fluorouracil compared with cisplatin and fluorouracil as first-line therapy for advanced gastric cancer: a report of the V325 Study Group. J Clin Oncol, 2006, 24(31): 4991.
22. Yao Z, Guo H, Yuan Y, et al. Retrospective analysis of docetaxel, oxaliplatin plus fluorouracil compared with epirubicin, cisplatin and fluorouracil as first-line therapy for advanced gastric cancer. J Chemother, 2014, 26(2): 117.
23. Teker F, Yilmaz B, Kemal Y, et al. Efficacy and safety of docetaxel or epirubicin, combined with cisplatin and fluorouracil (DCF and ECF), regimens as first line chemotherapy for advanced gastric cancer: a retrospective analysis from Turkey. Asian Pac J Cancer Prev, 2014, 15(16):6727-6732.
24. Kilickap S, Yalcin S, Ates O, et al. The first line systemic chemotherapy in metastatic gastric carcinoma: A comparison of docetaxel, cisplatin and fluorouracil (DCF) versus cisplatin and fluorouracil (CF); versus epirubicin, cisplatin and fluorouracil (ECF) regimens in clinical setting. Hepatogastroenterology, 2011, 58(105): 208.
25. 劉寧, 陸建偉, 丁選勝. 晚期胃癌化療三藥聯合方案對比兩藥聯合方案有效性及安全性 meta 分析. 中國醫院藥學雜志, 2012, 32(18):1467-1472.
26. Smyth EC, Verheij M, Allum W, et al. Gastric cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol, 2016, 27(suppl 5): v38-v49.
27. 中華人民共和國衛生部醫政司. 胃癌診療規范(2011 年版). 中國醫學前沿雜志電子版, 2012, 4(5): 62-71.
28. Bojic M, Pluschnig U, Zacherl J, et al. Docetaxel, cisplatin and 5-fluorouracil plus granulocyte colony-stimulating factor prophylaxis in patients with metastatic adenocarcinoma of the stomach and gastroesophageal junction: experience at the Medical University of Vienna. Anticancer Res, 2011, 31(6): 2379-2382.
29. 徐俊麗, 和水祥, 張明麗, 等. 胸腺法新注射液聯合化療對老年胃癌伴肝轉移患者的療效觀察. 疑難病雜志, 2016, 15(7): 694-697.
30. 邵晶, 劉敬楊, 徐睿玲, 等. 注射液胸腺法新(日達仙)輔助希羅達聯合奧沙利鉑(XELOX 方案)治療晚期胃癌的臨床療效觀察. 現代生物醫學進展, 2016, 16(23): 4468-4471.
31. 李龍, 展昊, 龍勃, 等. 鹽酸帕洛諾司瓊注射液預防中重度化療所致惡心嘔吐療效和安全性的 Meta 分析. 中國普外基礎與臨床雜志, 2017, 24(1): 48-58.
32. 中國研究型醫院學會消化道腫瘤專業委員會, 中國醫師協會外科醫師分會多學科綜合治療專業委員會. 胃癌多學科綜合治療協作組診療模式專家共識. 中國實用外科雜志, 2017, 37(1): 37-38.

Chinese Journal of Evidence-Based Medicine

Efficacy and safety of docetaxel or epirubicin based chemotherapy regimens in the treatment of advanced gastric cancer: a meta-analysis

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content