Paclitaxel combined with platinum (PTX) versus fluorouracil combined with cisplatin (PF) in the treatment of unresectable esophageal cancer: a systematic review and meta-analysis of the efficacy and toxicity of two different regimens
机构:[1]Department of Radiation Oncology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China河北医科大学第四医院[2]Department of Medical Oncology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China临床科室肿瘤内科河北医科大学第四医院[3]Department of Epidemiology and Health Statistics, Hebei Medical University, Shijiazhuang, China
Background: Chemotherapy plays an important role in definitive chemoradiotherapy strategies. However, the most optimal concurrent chemotherapy scheme is still controversial. This study aimed to systematically evaluate the efficacy and toxicity of paclitaxel/docetaxel combined with platinum (PTX) and fluorouracil combined with cisplatin (PF) in the concurrent chemoradiotherapy (CCRT) of unresectable esophageal cancer. Methods: The PubMed, China National Knowledge Infrastructure (CNKI), Google Scholar and Embase databases were searched by combining subject words and free words through December 31, 2021. The inclusion criteria were pathologically confirmed esophageal cancer studies using CCRT, where the chemotherapy regimen only compared PTX and PF. Quality evaluation and data extraction of studies that met the inclusion criteria were carried out independently. Stata 11.1 software was used to perform the meta analysis. The begger analysis and egger analysis were used to assess publication bias, and the robustness of the pooled results further assessed by the Trim and Fill analysis. Results: After screening, 13 randomized controlled trials (RCTs) were included. A total of 962 cases were enrolled, including 480(49.9%) in the PTX group and 482 (50.1%) in the PF group. The gastrointestinal reaction to the PF regimen was the most serious (RR=0.54, 95% CI: 0.36-0.80, P=0.003). The complete remission (CR) rate, objective response rate (ORR), and disease control rate (DCR) of the PTX group were higher than those of the PF group (RR =1.35, 95% CI: 1.03-1.76, P=0.030; RR =1.12, 95% CI: 1.03-1.22, P=0.006; RR =1.05, 95% CI: 1.01-1.09, P=0.022). In terms of the overall survival (OS) rate, the 2-year survival rates of the PTX group were higher than those of the PF group (P=0.005). There was no significant difference in the 1-, 3-, and 5-year survival rates between the two regimens (P=0.064, 0.144, and 0.341, respectively). There may be publication bias for ORR and DCR, and the results are reversed after applying the Trim and Fill method, so the combined results are not robust. Conclusions: PTX may be the preferred regimen for CCRT of esophageal squamous cell carcinoma, with better short-term therapeutic effect and 2-year OS rate and lower gastrointestinal toxicity.
第一作者机构:[1]Department of Radiation Oncology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
通讯作者:
通讯机构:[1]Department of Radiation Oncology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China[3]Department of Epidemiology and Health Statistics, Hebei Medical University, Shijiazhuang, China[*1]Department of Radiation Oncology, The Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China[*2]Department of Epidemiology and Health Statistics, Hebei Medical University, Shijiazhuang 050017, China
推荐引用方式(GB/T 7714):
Xu Li'ang,Chen Xiaoxi,Wang Lan,et al.Paclitaxel combined with platinum (PTX) versus fluorouracil combined with cisplatin (PF) in the treatment of unresectable esophageal cancer: a systematic review and meta-analysis of the efficacy and toxicity of two different regimens[J].JOURNAL OF GASTROINTESTINAL ONCOLOGY.2023,14(2):1037-1051.doi:10.21037/jgo-23-33.
APA:
Xu, Li'ang,Chen, Xiaoxi,Wang, Lan,Han, Jing,Wang, Qi...&Han, Chun.(2023).Paclitaxel combined with platinum (PTX) versus fluorouracil combined with cisplatin (PF) in the treatment of unresectable esophageal cancer: a systematic review and meta-analysis of the efficacy and toxicity of two different regimens.JOURNAL OF GASTROINTESTINAL ONCOLOGY,14,(2)
MLA:
Xu, Li'ang,et al."Paclitaxel combined with platinum (PTX) versus fluorouracil combined with cisplatin (PF) in the treatment of unresectable esophageal cancer: a systematic review and meta-analysis of the efficacy and toxicity of two different regimens".JOURNAL OF GASTROINTESTINAL ONCOLOGY 14..2(2023):1037-1051