Kuang ZY, Sun QH, Cao LC, Ma XY, Wang JX, Liu KX, Li J. Efficacy and safety of perioperative therapy for locally resectable gastric cancer: A network meta-analysis of randomized clinical trials. World J Gastrointest Oncol 2024; 16(3): 1046-1058 [PMID: 38577462 DOI: 10.4251/wjgo.v16.i3.1046]
Corresponding Author of This Article
Jie Li, MD, PhD, Chief Doctor, Doctor, Oncology Department, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, No. 5 North Line Pavilion, Xicheng District, Beijing 100053, China. qfm2020jieli@yeah.net
Research Domain of This Article
Oncology
Article-Type of This Article
Meta-Analysis
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Oncol. Mar 15, 2024; 16(3): 1046-1058 Published online Mar 15, 2024. doi: 10.4251/wjgo.v16.i3.1046
Efficacy and safety of perioperative therapy for locally resectable gastric cancer: A network meta-analysis of randomized clinical trials
Zi-Yu Kuang, Qian-Hui Sun, Lu-Chang Cao, Xin-Yi Ma, Jia-Xi Wang, Ke-Xin Liu, Jie Li
Zi-Yu Kuang, Graduate College, Beijing University of Traditional Chinese Medicine, Beijing 100029, China
Qian-Hui Sun, Lu-Chang Cao, Xin-Yi Ma, Jia-Xi Wang, Ke-Xin Liu, Jie Li, Oncology Department, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China
Co-first authors: Zi-Yu Kuang and Qian-Hui Sun.
Author contributions: Li L mainly conceived this manuscript and gave instructions. Kuang ZY, Sun QH, and Cao LC critically analyzed the current literature and wrote the original manuscript; Ma XY, Wang JX, and Liu KX were responsible for extracting data and drawing charts; all authors have read and agreed to the published version of the manuscript. Kuang ZY and Sun QH are the co-first authors of this study as this study was conceived by Kuang ZY and Sun QH.
Supported byNational Natural Science Foundation of China, No. 82305347.
Conflict-of-interest statement: Authors have no conflicts of interest to declare.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jie Li, MD, PhD, Chief Doctor, Doctor, Oncology Department, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, No. 5 North Line Pavilion, Xicheng District, Beijing 100053, China. qfm2020jieli@yeah.net
Received: December 21, 2023 Peer-review started: December 21, 2023 First decision: January 13, 2024 Revised: January 14, 2024 Accepted: February 4, 2024 Article in press: February 4, 2024 Published online: March 15, 2024 Processing time: 82 Days and 7 Hours
Abstract
BACKGROUND
Gastric cancer (GC) is the fifth most commonly diagnosed malignancy worldwide, with over 1 million new cases per year, and the third leading cause of cancer-related death.
AIM
To determine the optimal perioperative treatment regimen for patients with locally resectable GC.
METHODS
A comprehensive literature search was conducted, focusing on phase II/III randomized controlled trials (RCTs) assessing perioperative chemotherapy and chemoradiotherapy in treating locally resectable GC. The R0 resection rate, overall survival (OS), disease-free survival (DFS), and incidence of grade 3 or higher nonsurgical severe adverse events (SAEs) associated with various perioperative regimens were analyzed. A Bayesian network meta-analysis was performed to compare treatment regimens and rank their efficacy.
RESULTS
Thirty RCTs involving 8346 patients were included in this study. Neoadjuvant XELOX plus neoadjuvant radiotherapy and neoadjuvant CF were found to significantly improve the R0 resection rate compared with surgery alone, and the former had the highest probability of being the most effective option in this context. Neoadjuvant plus adjuvant FLOT was associated with the highest probability of being the best regimen for improving OS. Owing to limited data, no definitive ranking could be determined for DFS. Considering nonsurgical SAEs, FLO has emerged as the safest treatment regimen.
CONCLUSION
This study provides valuable insights for clinicians when selecting perioperative treatment regimens for patients with locally resectable GC. Further studies are required to validate these findings.
Core Tip: This study provides an update of the literature on perioperative therapy for locally resectable gastric cancer (GC) as of April 21, 2023. This study aimed to provide a multidimensional approach to perioperative treatment regimens for resectable GC using Bayesian network meta-analysis.
