Gemcitabine Plus S-1Versus Gemcitabine Alone In The Treatment Of Advanced Pancreatic Cancer: A Meta-analysis

ObjectiveTo compare the gemcitabine(GEM) plus S-1and gemcitabine alone inthe treatment of advanced pancreatic cancer(PC).MethodsArticles were searched in Pubmed, Cochrane library, Embase, CNKI,and CBM up to August1st,2013. Only randomized controlled trails(RCTs)for GEM+S-1and GEM alone in advanced PC were included. Tworeviewers retrieved and collected data respectively. Data were selectedbasing on inclusion and exclusion criteria. The meta-analysis was base onsurvival advantage (include overall survival and progress free survival),object response rate, disease control rate and adverse reaction.ResultsA total of3trials with772cases were included. Meta-analysisdemonstrated that GEM plus S-1significantly improved the progress freesurvival (HR:0.64,95%CI:0.54-0.75,P<0.00001) and overall survival (HR:0.81,95%CI:0.68-0.96,P=0.01), improved object response rate(RD:0.16,95%CI:0.10-0.21,P<0.00001) and disease control rate(RD:0.10,95%CI:0.03-0.17, P=0.009) also. However, the incidence ofWHO3/4grade adverse reaction was increased significantly in theGEM+S-1group. Neutropenia, thrombocytopenia, and gastrointestinalreaction were increased by18%(P=0.02),18%(P=0.008) and8%(P <0.00001) respectively.ConclusionGEM combined with S-1can improve the chemotherapy effect withGEM alone. The adverse reactions also increase significantly, but the overallsurvival is benefit.