Postoperative Chemoradiotherapy Versus Chemotherapy For Advanced Gastric Cancer With D2 Lymph Node Dissection: A Meta-analysis

Objective:This article systematically reviewed the efficacy and safety of chemoradiotherapy for advanced gastric cancer with D2 lymph node dissection,in order to determine the clinical values of it.Methods:Clinical studies that compared clinical outcomes of chemoradiotherapy and chem otherapy for advanced gastric cancer with D2 lymph node dissection were searched from Pubmed,The Cochrane Library,CNKI,Wan Fang,VIP and CBMdisc.The studies were filtrates according to pre-established criteria,then,we evaluated the qualities of included studies a nd extracted the information from the them.Results:10 studies including 710 cases were included.Our meta-analysis showed th-at chemoradiotherapy can bring a significant better 1,2,3-year survival rate(RR=1.20;95%CI:1.09-1.32;RR=1.48;95%CI:1.28-1.72;RR=1.60;95%CI:1.30-1.95),1,2,3-year disease-free survival rate(RR=1.21;95%CI:1.01-1.45;RR=1.31;95%CI:1.01-1.71;RR=1.48;95%CI:1.09-2.00),1,2,3-year recurrence rate(RR=0.38;95%CI:0.19-0.74;RR=0.47;95%CI:0.28-0.77;RR=0.41;95%CI:0.24-0.73),distant metastasis rate(RR=0.58,95%CI:0.38-0.87;P=0.009),but there was no significant diffrence in the 5-year survival rate and 5-year disease-free survival rate between 2 groups.The incidence rate of neutr-openia was higher in the chem oradiotherapy group(P=0.02),and there was no sign-ificant diffrence in the incidenc e rate of other toxic effects classified as grade 3 or higher(P>0.05).Conclusion:Compared with chemotherapy,the chemoradiotherapy can improve the short-term curative effect,reduce the recurrence rate and distant metastasis rate for advanced gastric cancer with D2 lymph node dissection,and the toxicity was acceptable.