Adjuvant Chemotherapy for Advanced Gastric Cancer in Elderly and Non-elderly Patients: Meta-Analysis of Randomized Controlled Trials
Cancer Research and Treatment 2017³â 49±Ç 1È£ p.263 ~ p.273
À强ȯ(Chang Seong-Hwan) - Konkuk University School of Medicine Department of Surgery
±è¼ö³ç(Kim Soo-Nyung) - Konkuk University School of Medicine Department of Obstetrics and Gynecology
ÃÖÇýÁ¤(Choi Hye-Jung) - Gyeongsang National University School of Medicine Department of Internal Medicine
¹Ú¹Ì¼÷(Park Mi-Suk) - Gyeongsang National University School of Medicine Institute of Health Science
±è·Ï¹ü(Kim Rock-Bum) - Gyeongsang National University School of Medicine Department of Preventive Medicine and Environmental Health
°í¼¼ÀÏ(Go Se-Il) - Gyeongsang National University School of Medicine Department of Internal Medicine
ÀÌ¿ø¼·(Lee Won-Sup) - Gyeongsang National University School of Medicine Department of Internal Medicine
Abstract
Purpose: This study evaluated the benefits of adjuvant chemotherapy on elderly patients with advanced gastric cancer (AGC) using meta-analysis of well-designed randomized controlled clinical studies.
Materials and Methods: PubMed, Embase, and Cochrane were searched to retrieve clinical studies evaluating the benefits of adjuvant chemotherapy in the elderly with AGC. Hazards ratios (HRs) with 95% confidence intervals (CIs) were pooled across studies using a fixed-effects model.
Results: Two studies were included in this meta-analysis to estimate HR for the overall survival (OS), and relapse-free survival (RFS) between adjuvant chemotherapy and surgery in elderly and non-elderly patients. HR for OS in the elderly and non-elderly was 0.745 (95% CI, 0.552 to 1.006, p=0.055) and 0.636 (95% CI, 0.522 to 0.776; p < 0.001), respectively, which showed no heterogeneity regarding HR between the two groups (pinteraction=0.389). HR for RFS in the elderly and non-elderly was 0.613 (95% CI, 0.466 to 0.806; p < 0.001) and 0.633 (95% CI, 0.533 to 0.753; p < 0.001), respectively (pinteraction=0.846).
Conclusion: Meta-analysis suggests that the benefit of adjuvant chemotherapy to the elderly is not big enough to reach statistical significance while the HR for OS is less than 1 (0.745) and no heterogeneity are observed regarding the HR between the elderly and non-elderly patients.
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Adjuvant chemotherapy, Aged, Stomach neoplasms, Meta-analysis
KMID :
0939920170490010263
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The benefit of adjuvant chemotherapy to the elderly is still statistically insignificant, even though there was no statistically significant heterogeneity regarding HR between the elderly and non-elderly patients.