A Meta-analysis Of The Efficacy And Safety Of S-1 Combined With Oxaliplatin For Metastatic Colorectal Cancer

Objective:To investigate the efficacy and safety of S-1 combined with oxaliplatin as first-line treatment for metastatic colorectal cancer(mCRC).Methods:A wide search of randomized clinical trials(RCT)using S-1 combined with oxaliplatin as a first-line therapy for mCRC patients was performed in the Cochrane Library,PubMed,EMBASE,MEDLINE,CNKI and WanFang databases.All of the studies were assessed on the basis of the guidance of the Cochrane Collaboration's tool for assessing risk of bias of RCTs,and then statistical analyses were performed using RevMan 5.3 software.Results:5 RCT trials were involved,totally 1382 patients.Meta analysis indicated that the progression-free survival(HR=0.90,95%CI:0.80-1.02,P=0.10),overall survival(HR=1.14,95%CI:0.98-1.31,P=0.08),objective response rate(RR=1.12,95%CI:0.87-1.43,P=0.38),disease control rate(RR=1.04,95%CI:0.98-1.10,P=0.24),showed no statistical significance between S-1 combined with oxaliplatin and oxaliplatin combined with 5-FU or capecitabine.For safety,S-1 combined with oxaliplatin could decrease incidence of grade 3-4 leukopenia,but increased the incidence of grade 3-4 stomatitis,anorexia,diarrhea.There were no statistical difference between the two regimen in the incidence of neutropenia,anemia,thrombocytopenia,nausea,vomiting and fatigue.Conclusion:S-1 combined with oxaliplatin in the first-line treatment for mCRC seem to have similar efficacy that with different toxicity.The S-1 may offer an alternative to 5-FU.