Efficacy of adjuvant chemotherapy using tegafur-based regimen for curatively resected gastric cancer: update of a meta-analysis
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A consensus regarding standard adjuvant chemotherapy for curatively resected gastric cancer has not been obtained between Japan and the Western world. In order to evaluate the effect of a tegafur-based regimen (the most frequently used regimen in Japan) compared with a surgery-alone control, a meta-analysis was performed, investigating four clinical trials. After meticulous examination of each trial, trials with improper noncentralized randomization were excluded from the analysis. A total of 1197 patients were enrolled in the four relevant trials determined to be eligible for the meta-analysis (Nakajima 1984; Japan Clinical Oncology Group [JCOG] 8801, JCOG 9206-2, and National Surgical Adjuvant Study of Gastric Cancer [NSASGC], in which a tegafur-based regimen was used for chemotherapy and central randomization was performed. The endpoint was overall survival, and a common hazard ratio was estimated. The 5-year overall survival rates differed among the trials because of differences in the background disease status. But there was no heterogeneity (P = 0.235) of treatment effect. The estimated common hazard ratio was 0.75, with a 95% confidence interval of 0.58–0.98. The treatment effect of the tegafur-based agent was shown to be statistically significant (P = 0.037) compared with surgery-alone therapy (n = 1179). From the results of the above meta-analysis, it is suggested that chemotherapy with a tegafur-based agent after surgery can improve the survival of patients with curatively resected gastric cancer. The Global Advanced/Adjuvant Stomach Tumor Research through International Collaboration (GASTRIC) group is conducting two individual patient data meta-analyses, testing post-operative adjuvant chemotherapy for resect-able gastric cancer and chemotherapy for advanced gastric cancer. It is expected to determine and quantify the role of adjuvant chemotherapy in detail from the GASTRIC.
Key wordsAdjuvant chemotherapy Gastric cancer Meta-analysis
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- 1.Ferlay J, Bray F, Pisani P, et al. GLOBOCAN 2002 (2004) Cancer incidence, mortality and prevalence worldwide. IARC CancerBase No. 5. Version 2.0. IARC, LyonGoogle Scholar
- 6.Saka M, Sasako M, Katai H, et al. (2000) Current status and problem of adjuvant chemotherapy for curatively resected gastric cancer (in Japanese). Jpn J Cancer Chemother 27:2033–2042Google Scholar
- 7.Sasaki T (2004) In regard to gastric cancer treatment guidelines — a revised edition (in Japanese). Jpn J Cancer Chemother 21:1947–1951Google Scholar
- 10.Ohta K (2000) Present status of treatment for stomach cancer in Japan (from the questionnaire) (in Japanese). J Ther 82:1782–1783Google Scholar
- 14.Honda I, Watanabe S, Fujita Y (1997) Preoperative adjuvant chemotherapy with oral anticancer agents for stomach cancer (in Japanese). Jpn J Cancer Chemother 24:1109–1117Google Scholar
- 15.Tsugita M, Takasaki K, Yagawa A, et al. (1992) An evaluation of perioperative and continuous infusion of tegafur as surgical adjuvant chemotherapy of resected gastric cancer (in Japanese). Jpn J Cancer Chemother 19:333–337Google Scholar
- 17.Yoshino H, Fujita M, Hirata K, et al. (2000) Interim report on JFMTC Study no.21 on effectiveness of UFT as an adjuvant therapy for semi-advanced cancer of the stomach (in Japanese). Jpn J Cancer Chemother 27:263–270Google Scholar
- 18.Miyashiro I, Furukawa H, Sasako M, et al. (2005) No survival benefit with adjuvant chemotherapy for serosa-positive gastric cancer: randomized trial of adjuvant chemotherapy with cisplatin followed by oral fluorouracil (UFT) in serosa-positive gastric cancer: Japan Clinical Oncology Group 9206-2. 2005 Gastrointestinal Cancers Symposium Proceedings Miami, Jan 27–29: abstract no.4Google Scholar
- 19.Kinoshita T, Nakajima T, Ohashi Y, et al. (2005) Adjuvant chemotherapy with uracil-tegafur (UFT) for serosa negative advanced gastric cancer: results of a randomized trial by National Surgical Adjuvant Study Of Gastric Cancer. Proc Am Soc Clin Oncol 23:313sGoogle Scholar
- 24.Sakamoto J, Paoletti X, on behalf of the Global Adv/Adj Stomach Tumor Research through International Collaboration (GASTRIC). (2008) Meta-analyses of randomized trials assessing the interest of postoperative adjuvant chemotherapy in gastric cancer. Proc Am Soc Clin Oncol 26:4543sGoogle Scholar
- 25.Rougier P, Oba K, on behalf of the Global Adv/Adj Stomach Tumor Research through International Collaboration (GASTRIC). (2008) Meta-analyses of randomized trials assessing the interest chemotherapy in advanced gastric cancer. Proc Am Soc Clin Oncol 26:4563sGoogle Scholar