| Objective: To evaluate the effectiveness and safety of neoadjuvant chemotherapy containing docetaxel in the treatment of advanced gastric cancer by Meta-analysis.Methods: The relevant literature was collected by searching several national and international databases,such as China Biology Medicine(CBM),China National Knowledge Infrastructure(CNKI),Wanfang Data,VIP Database for Chinese Technical Periodicals,PubMed,Embase and Cochrane Library.According to the inclusion and exclusion criteria,the eligible randomized controlled trials(RCTs)on the neoadjuvant chemotherapy containing docetaxel in the treatment of advanced gastric cancer were selected.After data extraction and the quality assessment,Meta-analysis was performed by using RevMan 5.3 software.Results: A total of 14 RCTs was included involving 1106 patients.Results of Meta-analysis for overall group showed that in the comparison of study group(undergoing neoadjuvant chemotherapy containing docetaxel combined with surgery)with control group(undergoing immediate surgery or neoadjuvant chemotherapy without docetaxel combined with surgery),the surgical resection rate(OR = 1.69,95% CI = 1.04~2.77,P = 0.04),R0 resection rate(OR = 2.40,95% CI: 1.68~3.43,P < 0.00001),overall response rate(OR = 1.92,95% CI = 1.13~3.25,P = 0.02),2-year survival rate(OR = 2.35,95% CI = 1.18~4.67,P = 0.01)and 3-year survival rate(OR = 1.75,95% CI = 1.09~2.81,P = 0.02)were significantly increased,while no statistical difference was noted in incidence of postoperative complications(OR = 1.00,95% CI = 0.66~1.50,P = 0.98)and 1-year survival rate(OR = 1.38,95% CI = 0.56~3.38,P = 0.49).Results of subgroup analysis showed that the surgical resection rate and R0 resection rate had no statistical difference between patients undergoing preoperative neoadjuvant chemotherapy containing docetaxel and those undergoing preoperative neoadjuvant chemotherapy without docetaxel(P > 0.05).Conclusions: Neoadjuvant chemotherapy containing docetaxel can improve the surgical resection rate,R0 resection rate,overall response rate and long-term survival rate(2-year survival rate and 3-year survival rate)without increase of complications,so it has better efficacy and safety. |
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