Short-term efficacy of different chemotherapy regimens in the treatment of advanced gastric cancer: a network meta-analysis

// Mi-Ma Duo-Ji 1 , Ba-Sang Ci-Ren 1 , Zi-Wen Long 2, 3 , Xiao-Hua Zhang 1 and Dong-Lin Luo 1 1 Department of Medicine, Shigatse People’s Hospital, Shigatse 857000, P.R. China 2 Department of Gastric Cancer and Soft-Tissue Sarcoma Sugery, Fudan University Shanghai Cancer Center, Shanghai 200032, P.R. China 3 Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, P.R. China Correspondence to: Zi-Wen Long, email: longziwensh@126.com Keywords: gastric cancer, fluorouracil, capecitabine, S-1, chemotherapy Received: July 11, 2016      Accepted: November 14, 2016      Published: January 14, 2017 ABSTRACT Objective : A network meta-analysis was performed to compare the short-term efficacy of different chemotherapy regimens in the treatment of advanced gastric cancer. Methods : Randomized controlled trials of different chemotherapy regimens for advanced gastric cancer were included in this study. Network meta-analysis combined direct evidence and indirect evidence to evaluate the odds ratio and draw surface under the cumulative ranking curves of different chemotherapy regimens in advanced gastric cancer. Results : The results of surface under the cumulative ranking curves showed that S-1 and capecitabine regimens were better than fluorouracil. As for multi-drug combination regimens, the disease control rate of cisplatin + capecitabine, docetaxel + cisplatin + fluorouracil and etoposide + cisplatin + capecitabine regimens were relatively better, while fluorouracil + adriamycin + mitomycin regimen was relatively poorer when compared with cisplatin + fluorouracil regimen. Additionally, the overall response ratio of cisplatin + capecitabine, paclitaxel + fluorouracil, docetaxel + cisplatin + fluorouracil and etoposide + cisplatin + fluorouracil regimens were relatively better, while the disease control rate of fluorouracil + adriamycin + mitomycin regimen was relatively poorer when compared with cisplatin + fluorouracil regimen. Furthermore, the results of cluster analysis demonstrated that cisplatin + capecitabine, etoposide + cisplatin + capecitabine, S-1 + paclitaxel and S-1 + irinotecan chemotherapy regimens had better disease control rate and overall response ratio for advanced gastric cancer patients. Conclusion : This network meta-analysis clearly showed that multi-drug combination chemotherapy regimens based on capecitabine and S-1 might be the best chemotherapy regimen for advanced gastric cancer.