Curative Effect Of Neoadjuvant Chemotherapy With XELOX For People With Advanced Gastric Cancer:a Meta-analysis

Objective:To systematically evaluate the curative effect of neoadjuvant chemotherapy with XELOX for people with advanced gastric cancer.Methods: Searched the national and international databases such as Medline 、Cochrane library、CNKI、Embase、CBM、VIP、CJFD 、CBMdisc.Retrieve all articles from January 1989 to October 2016,which compared the efficacy of neoadjuvant chemotherapy with XELOX and simple surgery in patients with advanced gastric cancer.The quality of the articles were evaluated by the corresponding methods.Inclusion of high quality articles that met the inclusion criteria.The collected data were analyzed with Review Manager5.2 for Meta analysis.Results: This study included 11 clinical trials,including 8 RCTs,and 3 retrospective studies.A total of 870 patients were enrolled in this study,446 cases in test group(neoadjuvant chemotherapy with XELOX),424 cases in the control group(simple surgery).The results of Meta analysis show:Compared with simple surgery group,neoadjuvant chemotherapy with XELOX group had higher overall rate of surgery(OR=8.28,95%CI:3.58-19.15,P < 0.00001)、 higher radical resection rate(OR=3.75,95%CI:2.67-5.28,P < 0.00001)、 higher 1 year survival rate(OR=2.97,95%CI:1.55-5.02,P=0.0006 < 0.05)、 higher 2 year survival rate(OR=2.78,95%CI:1.36-5.68,P=0.005 < 0.05)and higher 3 year survival rate(OR=2.57,95%CI:1.28-5.17,P=0.008<0.05).Conclusion:1.Compared with the patients treated with simple operation,the total operation rate and radical resection rate of the patients who received neoadjuvant chemotherapy with XELOX were higher,the difference was statistically significant.2.Compared with the patients treated with simple operation,the 1 year survival rate of patients who received neoadjuvant chemotherapy with XELOX was higher,the difference was statistically significant.Neoadjuvant chemotherapy with XELOX scheme is recommended in clinical practice.3.Due to the limited number of articles included in this paper,the sample size is small,the lack of multi area,large sample randomized controlled clinical trials,and reports of postoperative survival rate is less,so the results may be biased.In the future,there will be more rigorous design of large sample,high quality randomized controlled study to verify.