Title: Intravenous chemotherapy for resected gastric cancer: meta-analysis of randomized controlled trials
Abstract: AIM:To assess the safety and efficacy of different intravenous chemotherapeutic regimens in patients with gastric carcinomas who had undergone gastrectomy. METHODS:A meta-analysis of all the relevant randomized controlled trials (RCTs) was performed.Language was restricted to Chinese and English.RCTs were identified from Medline and Embase (1980-2001/4), and Chinese Biomedicine Database (1990-2001/1).Literature references were checked at the same time.We included randomized and quasi-randomized trials comparing the efficacy of intravenous chemotherapy after gastrectomy with that of surgery alone in patients with confirmed gastric carcinomas who had undergone gastrectomy.Selection criteria were: randomized or quasi-randomized trials with following-up results; Trials could be double-blind, single-blind or not blind; Chemotherapy groups were given intravenous chemotherapy after gastrectomy without neo-adjuvant chemotherapy, intraperitoneal hyperthermic perfusion, radiotherapy or chemoimmunotherapy; Controlled group included those receiving gastrectomy alone.The following data were extracted: the number of survival and death by the end of the follow-up; the different agents and doses of the intravenous chemotherapy; the baseline of the chemotherapy group and the controlled arm; the serious adverse events; the statistical consideration; cost-effectiveness analysis.The statistical analysis was performed by RevMan4.1 software which was provided by the Cochrane Collaboration.A P value of <0.05 was considered statistically significant.Metaanalysis was done with random effects model.Heterogeneity was checked by chi-square test.Sensitivity analysis was performed by excluding the trials in which Jadad-scale was only 1 score.The result was expressed with odds ratio (OR) for the categorical variable.RESULTS: Fourteen trials involving 4543 patients were included.Meta-analysis was done with random effects model.