Adjuvant Chemoradiotherapy Versus Chemotherapy For Gastric Cancer: A Meta-Analysis Of Randomized Controlled Trials

Objective: The aim of this study was to evaluate the efficacy and safety of adjuvant chemoradiotherapy(CRT) versus chemotherapy(CT) for patients with gastric cancer.Methods: A Meta-analysis of randomized controlled trials of adjuvant chemoradiotherapy(CRT) versus chemotherapy for patients with gastric cancer was performed according to the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-analyses(PRISMA) statement. The following electronic databases were searched from their inception to April 2014: PUBMED, EMBASE and Cochrane Library. All Statistical analyses were done using REVIEW MANAGER v5.2 software.Results: Six randomized controlled trials involving 1171 patients were included. The Meta-analysis showed that there were statistical significances between chemoradiotherapy group and chemotherapy group in 5-year disease free survival rate(OR=1.56, 95%CI: 1.09~2.24), local-regional recurrence rate(OR=0.46, 95%CI: 0.32~0.67) and neutropenia(OR=1.47, 95%CI: 1.11~1.96). While treatment efficacy did not differ significantly by the 5-year overall survival rate(OR=1.32, 95%CI: 0.92~1.88), 3-Year disease free survival rate(OR=1.28, 95%CI: 0.92~1.80), and new Metastases(OR=0.76, 95%CI: 0.57~1.03). Toxicity profiles were not significantly different between two groups for nausea/vomiting, diarrhea, anemia and thrombocytopenia.Conclusions: For patients with gastric cancer, adjuvant chemoradiotherapy could significantly improve 5-year disease free survival rate and reduce local-regional recurrence rate compared with chemotherapy and well be accepted and tolerated.