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Postoperative chemo‐radiotherapy versus chemotherapy for resected gastric cancer: A systematic review and meta‐analysis
Author(s) -
Soon Yu Yang,
Leong Cheng Nang,
Tey Jeremy Chee Seong,
Tham Ivan Weng Keong,
Lu Jiade Jay
Publication year - 2014
Publication title -
journal of medical imaging and radiation oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.31
H-Index - 43
eISSN - 1754-9485
pISSN - 1754-9477
DOI - 10.1111/1754-9485.12190
Subject(s) - medicine , meta analysis , hazard ratio , radiation therapy , randomized controlled trial , confidence interval , cancer , chemotherapy , surgery , oncology
This study conducted a systematic review and meta‐analysis (direct and indirect) of published randomised controlled trials ( RCT s) to compare the effects of postoperative chemo‐radiotherapy ( ChRT ) with chemotherapy ( Ch ) on overall and disease‐free survival ( DFS ) for patients with resectable gastric cancer. Methods We searched MEDLINE and CENTRAL from the date of inception and annual meeting proceedings of A merican S ociety of C linical O ncology and A merican S ociety for R adiation O ncology from 1999 to N ovember 2012 for RCTs comparing postoperative ChRT with Ch , postoperative ChRT with surgery alone and postoperative Ch with surgery alone. The primary outcome was overall survival ( OS ); secondary outcomes included DFS and toxicity. Hazard ratios ( HR s), confidence intervals ( CI s) and P values ( P ) were estimated with fixed effects models using Revman 5.1. Results We found six trials comparing postoperative ChRT with Ch ( n = 1171). Meta‐analysis of direct comparison trials showed that postoperative ChRT significantly improved both OS ( HR 0.80, 95% CI 0.65–0.98, P = 0.03) and DFS ( HR 0.76, 95% CI 0.63–0.91, P = 0.003) when compared with Ch . There were no significant differences in toxicity between the two groups. Conclusions This study suggests a survival benefit of postoperative ChRT over Ch in patients with resected gastric cancer.