The Chemotherapy Of S-1 Combined With Paclitaxel For Advanced Gastric Cancer. A Systematic Review Of Published Studies

Aim: To assess the clinical efficacy and safety of S-1 combined with paclitaxel(PTX) for advanced gastric cancer(AGC) by performing a systematic review of the published studies.Methods: All published controlled trials of S-1 combined with PTX for AGC were searched. We searched the databases included the Cochrane Library, Medline/Pubmed, EMBASE, Web of Science, CNKI, VIP and Wanfang Database from 2000 to 2015. The censor date was up to December 2015. The first endpoint was the overall survival(OS). Other endpoints were the progression-free survival(PFS), objective response rate(ORR) and disease control rate(DCR). Safety analyses were also performed. All calculations and statistical tests were performed using Revman5.3 and Stata12.0 software.Results: A total of 1407 patients with AGC enrolled in 7 trials were divided into study group(n = 711) and control group(n = 696). S-1 combined with PTX significantly improved the OS [HR = 0.78, 95% CI: 0.60-0.97, P = 0.000],PFS [HR = 0.70, 95% CI: 0.55-0.85, P = 0.000], ORR [RR = 1.30, 95% CI: 1.05-1.60, P = 0.017] and DCR [RR = 1.15, 95% CI: 1.04-1.27, P = 0.008] of patients with AGC. The grade 3 ~ 4 adverse events were anemia [RR = 1.71, 95% CI: 1.04-2.79, P = 0.03], neutropenia [RR = 1.65, 95% CI: 1.32-2.06, P < 0.0001] and anorexia [RR = 1.66, 95% CI: 1.05-2.64, P = 0.03]. The incidence of fever, fatigue, nausea, vomiting, diarrhea, stomatitis and nerve toxicity between the two groups had no statistical difference.Conclusion: S-1 combined with PTX may be a good choice for patients with AGC at least in Asia, because of good efficacy and rather better safety.