| Objective: The aim of this study was to evaluate the efficacy and safety of bevacizumab combined with chemotherapy for patients with advanced gastric cancer.Methods: Two researchers searched PubMed, Embase, Cochrane Library, Chinese Journal Full-text Database, VIP Chinese Science & Technology Journal Database and Wanfang database, and collected domestic and abroad published research literature about bevacizumab combined with chemotherapy in treatment of advanced gastric cancer. Two reviewers independently screened studies according to the inclusion and exclusion criteria, extracted data and assessed quality of the included studies. Then Meta-analysis was conducted using RevMan 5.3 software.Results: Five randomized control trials involving 1202 patients were included. The Meta-analysis showed that there were statistical significances between bevacizumab combined with chemotherapy group and chemotherapy alone group in complete remission [odds ratio(OR)=2.17, 95% confidence interval(CI):1.07-4.38, P=0.03], partial remission(OR=1.53, 95%CI: 1.19-1.97, P=0.001) and response rate(OR=2.03, 95%CI: 1.25-3.28, P=0.004). While there was no statistical difference in one-year survival rate(OR=1.25, 95%CI: 0.99-1.58, P=0.06). In terms of adverse reactions, there were statistical significances between bevacizumab combined with chemotherapy group and chemotherapy alone group in the incidence of hypertension(OR=7.29, 95%CI: 2.71-19.64, P<0.0001) and gastrointestinal perforation(OR=7.07, 95%CI: 1.27-39.33, P=0.03), and toxicities were not significantly different between two groups for myelosuppression, gastrointestinal reactions, impaired liver function, arterio-venous thromboembolism and hemorrhage.Conclusions: Bevacizumab combined with chemotherapy in the treatment of patients with advanced gastric cancer can improve the response rate, but the scheme may increase the incidence of hypertension and gastrointestinal perforation. |
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