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World J Gastroenterol. Dec 14, 2014; 20(46): 17648-17655
Published online Dec 14, 2014. doi: 10.3748/wjg.v20.i46.17648
Published online Dec 14, 2014. doi: 10.3748/wjg.v20.i46.17648
Table 1 Patient demographics and characteristics of the included studies
Study | Groups | Chemo regimens | RT regimens | No. of patients | Male | Age (yr) | MS (M) | Follow-up (M) | Clinical stage |
Chauffert et al[16] | GEM-CRT | 5-FU infusion, 300 mg /m2 per day, days 1-5 for 6 wk; cisplatin, 20 mg /m2 per day, days 1-5 during wk 1 and 5. Then, GEM 1000 mg/m2 weekly, 3/4 wk | Induction: 60 Gy, 2 Gy/fraction | 59 | 31 | 60 (41-79) | 8.6 | 31 | Locally advanced unresectable PC |
GEM alone | GEM 1000 mg/m2 weekly for 7 wk. Then, GEM 1000 mg/m2 weekly, 3/4 wk | None | 60 | 34 | 62 (38-80) | 13 | 33 | Locally advanced PC | |
Loehrer et al[18] | GEM+RT | 600 mg/m2 per week for wk 1 to 5, then 4 wk later, 1000 mg/m2 for 3 of 4 wk | Starting on day 1, 1.8 Gy/Fx for a total of 50.4 Gy | 34 | 19 | 66 (46.9-83.5) | 11.1 | NG | |
GEM alone | 1000 mg/m2 per week for wk 1 to 6, followed by 1 wk rest, then for 3 of 4 wk | None | 37 | 18 | 69 (49.7-83.7) | 9.2 | NG | ||
Van Laethem et al[19] | GEM-CRT | 2 cycles of GEM (1000 mg/m2 on days 1, 8, 15, followed by 1 wk rest-a cycle), then GEM 300 mg/m2 once per wk for 5 to 6 wk | 50.4 Gy in 28 fractions, 1.8 Gy per fraction for 5 to 6 wk | 45 | 24 | 61 (44-75) | 24.3 | 30.7 | Curatively resected PC |
GEM alone | 4 cycles of GEM (1000 mg/m2 on days 1, 8, 15, followed by 1 wk rest-a cycle) | None | 45 | 27 | 58 (32-77) | 24.4 | 33.3 | ||
Wang et al[17] | GEM-RT | 2 cycles of GEM (1000 mg/m2 on radiation 1, 8, 15, 21-d a cycle) | 50.4 Gy in 28 fractions on Monday through Friday over 5.5 wk | 35 | 17 | 61 (44-71) | 13 | 8-24 | Locally advanced PC |
GEM alone | 4-6 cycles of GEM (1000 mg/m2 on days 1, 8, and 15, 28 d a cycle) | None | 21 | 13 | 61 (39-71) | 8 | 8-24 |
Table 2 Quality assessment of the studies included
Table 3 Meta-analysis of adverse events
Outcome | Studies | Participants | Statistical method | Effect size | 95%CI | P | I2(%) |
Anemia | 3 | 240 | RR, Fixed | 5.32 | (2.23-12.66) | 0.0002 | 0 |
Leukocytopenia | 3 | 240 | RR, Random | 2.31 | (1.08-4.97) | 0.03 | 49 |
Neutropenia | 3 | 240 | RR, Random | 1.37 | (0.60-3.16) | 0.46 | 78 |
Thrombocytopenia | 3 | 240 | RR, Fixed | 2.34 | (1.04-5.29) | 0.04 | 0 |
Anorexia | 2 | 154 | RR, Fixed | 5.74 | (1.05-31.39) | 0.04 | 0 |
Diarrhea | 3 | 240 | RR, Fixed | 2.58 | (0.51-13.01) | 0.25 | 0 |
Nausea/vomiting | 3 | 240 | RR, Fixed | 3.58 | (1.32-9.69) | 0.01 | 0 |
SGPT abnormality | 2 | 154 | RR, Fixed | 0.99 | (0.34-2.88) | 0.98 | 0 |
Asthenia/Fatigue | 2 | 154 | RR, Fixed | 3.54 | (1.23-10.18) | 0.02 | 29 |
Weight Loss | 2 | 154 | RR, Fixed | 4.02 | (0.46-35.04) | 0.21 | 0 |
- Citation: Zhang X, Huang HJ, Feng D, Yang DJ, Wang CM, Cai QP. Is concomitant radiotherapy necessary with gemcitabine-based chemotherapy in pancreatic cancer? World J Gastroenterol 2014; 20(46): 17648-17655
- URL: https://www.wjgnet.com/1007-9327/full/v20/i46/17648.htm
- DOI: https://dx.doi.org/10.3748/wjg.v20.i46.17648