A Systematic Review of Capecitabine Plus Oxaliplatin Compared with5-fluorouracil Plus Oxaliplatin in Metastatic Colorectal Cancer
|School||Chongqing Medical University|
|Keywords||capecitabine oxaliplatin metastatic colorectal cancer Meta analysis|
Objective To evaluate the curative effect and adverse reaction ofcapecitabine plus oxaliplatin compared with5-fluorouracil plus oxaliplatinin patients with metastatic colorectal cancer.Methods We searched Cochrane Central register of Controlled Trials(CENTRAL), PubMed, EMBASE, Wanfang Data and VIP informationdatabase from January2000to April2011. We included randomisedcontrolled trials (RCTs) comparing capecitabine plus oxaliplatin versus5-fluorouracil plus oxaliplatin. Two reviewers independently retrieved RCTsaccording to the inclusion and exclusion criteria, assessed themethodological quality of included trials and extracted data. Meta analysiswas performed by Review Manager5.0and the main outcome measureincluded complete response rate (CR), partial response rate (PR), overallresponse rate (ORR) and adverse reaction．Results Nine RCTs published were identified. A total number of3713patients was treated,1758in the capecitabine plus oxaliplatin arm and1955 in the5-fluorouracil plus oxaliplatin arm. Curative effect outcome includedCR (OR=0.79，95%CI（0.48~1.30），p=0.36), PR (OR=0.82，95%CI（0.67~1.01），p=0.06) and ORR (OR=0.85，95%C（I0.71~1.02），p=0.08) showedthe same curative effect between capecitabine plus oxaliplatin arm and5-fluorouracil plus oxaliplatin, and the median overall survival time andprogression-free survival (PFS) had no statistically differences. Hand-footsyndrome was more frequently observed in capecitabine plus oxaliplatin arm(OR=3.13，95%CI（1.80~5.44），p<0.0001) while peripheral neurotoxity,stomatitis and thrombocytopenia were reversed. Nausea, diarrhea,neutropenia, fever and fatigue were had no statistically significantdifferences between two arms.Conclusion Capecitabine plus oxaliplatin had the same curative effectwith5-fluorouracil plus oxaliplatin and was more safety than5-fluorouracilplus oxaliplatin in patients with metastatic colorectal cancer.