Efficacy and safety of oxaliplatin-based regimen versus cisplatin-based regimen in the treatment of gastric cancer: a meta-analysis of randomized controlled trials.

BACKGROUND: Cisplatin played an important role in the treatment of gastric cancer (GC). Oxaliplatin has been shown to be at least as effective as cisplatin for GC, with less toxicity and a better tolerability profile. We performed a meta-analysis to compare the efficacy and safety of oxaliplatin-based regimen versus cisplatin-based regimen in the treatment of GC.

METHODS: Databases of CNKI, CBM, VIP, Wanfang, PubMed, Embase, Cochrane Library were searched for eligible literatures from their establishments to November 2018. Randomized controlled trials that compared the efficacy and safety of oxaliplatin-based regimen with that of cisplatin-based regimen in the treatment of GC were included. Statistical analyses were calculated using RevMan 5.3 software.

RESULTS: Seven randomized controlled trials including 2297 patients were included. Compared with cisplatin-based regimen intervention in GC, oxaliplatin-based regimen treatment was able to significantly improve the partial response rate (OR = 1.26, 95% CI 1.07-1.49; p = 0.007), disease progression rate (OR = 0.41, 95% CI 0.25-0.66; p = 0.0002) and 1-year survival (OR = 1.25, 95% CI 1.00-1.56; p = 0.05). The toxicities of hematopoietic system were significantly higher in cisplatin-based regimen group (OR = 0.6, 95% CI 0.46-0.79; p = 0.0002), while oxaliplatin-based regimen group had higher neurosensory toxicity (OR = 2.21, 95% CI 1.52-3.21; p < 0.0001), In addition, gastrointestinal toxicity was similar between the two groups (OR = 1.01, 95% CI 0.5-2.01; p = 0.27).

CONCLUSIONS: Compared with cisplatin-based regimen, oxaliplatin-based regimen treatment has an obvious advantage in patients with GC with acceptable tolerance.