Adjuvant Chemotherapy for Advanced Gastric Cancer in Elderly and Non-elderly Patients: Meta-Analysis of Randomized Controlled Trials

被引：17
作者：
Chang, Seong-Hwan [1 ]
Kim, Soo-Nyung [2 ]
Choi, Hye Jung [3 ]
Park, Misuk [4 ]
Kim, Rock Bum [5 ]
Go, Se-Il [3 ]
Lee, Won Sup [3 ]
机构：
[1] Konkuk Univ, Sch Med, Dept Surg, Seoul, South Korea
[2] Konkuk Univ, Sch Med, Dept Obstet & Gynecol, Seoul, South Korea
[3] Gyeongsang Natl Univ, Sch Med, Inst Hlth Sci, Dept Internal Med, Jinju, South Korea
[4] Gyeongsang Natl Univ, Sch Med, Inst Hlth Sci, Med Lib, Jinju, South Korea
[5] Gyeongsang Natl Univ, Sch Med, Inst Hlth Sci, Dept Prevent Med & Environm Hlth, Jinju, South Korea
来源：
CANCER RESEARCH AND TREATMENT | 2017年 / 49卷 / 01期
关键词：
Adjuvant chemotherapy; Aged; Stomach neoplasms; Meta-analysis; PHASE-III TRIAL; COLON-CANCER; OPEN-LABEL; STAGE-II; 5-FLUOROURACIL; OXALIPLATIN; LEUCOVORIN; CISPLATIN; SURVIVAL; SURGERY;
D O I：
10.4143/crt.2016.054
中图分类号：
R73 [肿瘤学];
学科分类号：
100214 ;
摘要：
Purpose This study evaluated the benefits of adjuvant chemotherapy on elderly patients with advanced gastric cancer (AGC) using meta-analysis of well-designed randomized controlled clinical studies. Materials and Methods PubMed, Embase, and Cochrane were searched to retrieve clinical studies evaluating the benefits of adjuvant chemotherapy in the elderly with AGC. Hazards ratios (HRs) with 95% confidence intervals (Cis) were pooled across studies using a fixed-effects model. Results Two studies were included in this meta-analysis to estimate HR for the overall survival (OS), and relapse-free survival (RFS) between adjuvant chemotherapy and surgery in elderly and non-elderly patients. HR for OS in the elderly and non-elderly was 0.745 (95% CI, 0.552 to 1.006, p=0.055) and 0.636 (95% CI, 0.522 to 0.776; p < 0.001), respectively, which showed no heterogeneity regarding HR between the two groups (p(interaction)=0.389). HR for RFS in the elderly and non-elderly was 0.613 (95% CI, 0.466 to 0.806; p < 0.001) and 0.633 (95% CI, 0.533 to 0.753; p < 0.001), respectively (p(interaction)=0.846). Conclusion Meta-analysis suggests that the benefit of adjuvant chemotherapy to the elderly is not big enough to reach statistical significance while the HR for OS is less than 1 (0.745) and no heterogeneity are observed regarding the HR between the elderly and non-elderly patients.
引用
收藏
页码：263 / 273
页数：11
相关论文
共 28 条
[1]   Microsatellite instability in sporadic gastric cancer: its prognostic role and guidance for 5-FU based chemotherapy after R0 resection [J].
An, Ji Yeong ;
Kim, Hyunki ;
Cheong, Jae-Ho ;
Hyung, Woo Jin ;
Kim, Hoguen ;
Noh, Sung Hoon .
INTERNATIONAL JOURNAL OF CANCER, 2012, 131 (02) :505-511
[2]  
Arai Tomio, 2004, Gastric Cancer, V7, P154
[3]   Adjuvant capecitabine and oxaliplatin for gastric cancer after D2 gastrectomy (CLASSIC): a phase 3 open-label, randomised controlled trial [J].
Bang, Yung-Jue ;
Kim, Young-Woo ;
Yang, Han-Kwang ;
Chung, Hyun Cheol ;
Park, Young-Kyu ;
Lee, Kyung Hee ;
Lee, Keun-Wook ;
Kim, Yong Ho ;
Noh, Sang-Ik ;
Cho, Jae Yong ;
Mok, Young Jae ;
Kim, Yeul Hong ;
Ji, Jiafu ;
Yeh, Ta-Sen ;
Button, Peter ;
Sirzen, Florin ;
Noh, Sung Hoon .
LANCET, 2012, 379 (9813) :315-321
[4]   Comprehensive molecular characterization of gastric adenocarcinoma [J].
Bass, Adam J. ;
Thorsson, Vesteinn ;
Shmulevich, Ilya ;
Reynolds, Sheila M. ;
Miller, Michael ;
Bernard, Brady ;
Hinoue, Toshinori ;
Laird, Peter W. ;
Curtis, Christina ;
Shen, Hui ;
Weisenberger, Daniel J. ;
Schultz, Nikolaus ;
Shen, Ronglai ;
Weinhold, Nils ;
Keiser, David P. ;
Bowlby, Reanne ;
Sipahimalani, Payal ;
Cherniack, Andrew D. ;
Getz, Gad ;
Liu, Yingchun ;
Noble, Michael S. ;
Pedamallu, Chandra ;
Sougnez, Carrie ;
Taylor-Weiner, Amaro ;
Akbani, Rehan ;
Lee, Ju-Seog ;
Liu, Wenbin ;
Mills, Gordon B. ;
Yang, Da ;
Zhang, Wei ;
Pantazi, Angeliki ;
Parfenov, Michael ;
Gulley, Margaret ;
Piazuelo, M. Blanca ;
Schneider, Barbara G. ;
Kim, Jihun ;
Boussioutas, Alex ;
Sheth, Margi ;
Demchok, John A. ;
Rabkin, Charles S. ;
Willis, Joseph E. ;
Ng, Sam ;
Garman, Katherine ;
Beer, David G. ;
Pennathur, Arjun ;
Raphael, Benjamin J. ;
Wu, Hsin-Ta ;
Odze, Robert ;
Kim, Hark K. ;
Bowen, Jay .
NATURE, 2014, 513 (7517) :202-209
[5]   Adjuvant chemotherapy with 5-fluorouracil and cisplatin compared with surgery alone for gastric cancer:: 7-year results of the FFCD randomized phase III trial (8801) [J].
Bouché, O ;
Ychou, M ;
Burtin, P ;
Bedenne, L ;
Ducreux, M ;
Lebreton, G ;
Baulieux, J ;
Nordlinger, B ;
Martin, C ;
Seitz, JF ;
Tigaud, JM ;
Echinard, E ;
Stremsdoerfer, N ;
Milan, C ;
Rougier, P .
ANNALS OF ONCOLOGY, 2005, 16 (09) :1488-1497
[6]   Use of 5-fluorouracil and survival in patients with microsatellite-unstable colorectal cancer [J].
Carethers, JM ;
Smith, EJ ;
Behling, CA ;
Nguyen, L ;
Tajima, A ;
Doctolero, RT ;
Cabrera, BL ;
Goel, M ;
Arnold, CA ;
Miyai, K ;
Boland, CR .
GASTROENTEROLOGY, 2004, 126 (02) :394-401
[7]   Adjuvant treatment of high-risk, radically resected gastric cancer patients with 5-fluorouracil, leucovorin, cisplatin, and epidoxorubicin in a randomized controlled trial [J].
Cascinu, Stefano ;
Labianca, Roberto ;
Barone, Carlo ;
Santoro, Armando ;
Carnaghi, Carlo ;
Cassano, Alessandra ;
Beretta, Giordano D. ;
Catalano, Vincenzo ;
Bertetto, Oscar ;
Barni, Sandro ;
Frontini, Luciano ;
Aitini, Enrico ;
Rota, Silvia ;
Torri, Valter ;
Floriani, Irene .
JOURNAL OF THE NATIONAL CANCER INSTITUTE, 2007, 99 (08) :601-607
[8]  
Choi Ju Young, 2011, Korean J Gastroenterol, V58, P9
[9]   Adjuvant chemotherapy with epirubicin, leucovorin, 5-fluorouracil and etoposide regimen in resected gastric cancer patients: a randomized phase III trial by the Gruppo Oncologico Italia Meridionale (GOIM 9602 Study) [J].
De Vita, F. ;
Giuliani, F. ;
Orditura, M. ;
Maiello, E. ;
Galizia, G. ;
Di Martino, N. ;
Montemurro, F. ;
Carteni, G. ;
Manzione, L. ;
Romito, S. ;
Gebbia, V. ;
Ciardiello, F. ;
Catalano, G. ;
Colucci, G. .
ANNALS OF ONCOLOGY, 2007, 18 (08) :1354-1358
[10]  
EDELMAN DS, 1987, AM SURGEON, V53, P170
123