Background
Methods
Search strategy
Studies selection
Data extraction
Statistical analysis
1. Objective tumor response
2. Improved or stable performance status
3. Severe chemotherapy toxicity
Study quality evaluation
Eight-item of the modified Jadad scale | Score | |
---|---|---|
Was the study described as randomized? | Yes | +1 |
No | 0 | |
Was the method of randomization appropriate? | Yes | +1 |
No | -1 | |
Not described | 0 | |
Was the study described as blinding?a | Yes | +1 |
No | 0 | |
Was the method of blinding appropriate? | Yes | +1 |
No | -1 | |
Not described | 0 | |
Was there a description of withdrawals and dropouts? | Yes | +1 |
No | 0 | |
Was there a clear description of the inclusion/exclusion criteria? | Yes | +1 |
No | 0 | |
Was the method used to assess adverse effects described? | Yes | +1 |
No | 0 | |
Was the methods of statistical analysis described? | Yes | +1 |
No | 0 |
Sensitivity analysis
Publication bias analysis
Results
Study characteristics and quality
Studies (Author) | Year | Chemotherapy regimena | Number (T/C) | Type of Assessable Outcomes | Jadad Scoresb | |
---|---|---|---|---|---|---|
treatment | control | |||||
Hao XL[20] | 2008 | NP+SFI | NP | 60/68 | WBC/HB/PLT/nausea and vomiting toxicity, KPS | 3 |
Wang K[21] | 2007 | NP+SFI | NP | 18/18 | tumor response, WBC/PLT toxicity, KPS | 3 |
Kang GY[22] | 2006 | NP+SFI | NP | 36/36 | tumor response, WBC/PLT/HB/nausea and vomiting toxicity, KPS | 2 |
Gong ZM[23] | 2008 | NP+SFI | NP | 33/32 | tumor response, WBC/PLT/HB/nausea and vomiting toxicity, KPS | 2 |
Wang XY[24] | 2007 | NP+SFI | NP | 35/34 | tumor response, WBC/PLT/HB/nausea and vomiting toxicity, | 4 |
Wang YZ[25] | 2007 | NP+SFI | NP | 28/27 | tumor response, KPS, WBC/PLT/HB toxicity | 3 |
Li TW[26] | 2009 | NP+SFI | NP | 36/33 | tumor response, the KPS | 4 |
Li Y[27] | 2007 | NP+SFI | NP | 44/43 | tumor response, WBC/PLT/nausea and vomiting toxicity, | 4 |
Lv J[28] | 2008 | NP+SFI | NP | 40/40 | tumor response, WBC/PLT/HB/nausea and vomiting toxicity, KPS | 4 |
Zhao ZY[29] | 2007 | NP+SFI | NP | 35/34 | tumor response, WBC/PLT/HB nausea and vomiting toxicity, | 4 |
Geng L[30] | 2004 | NP+SFI | NP | 25/15 | tumor response, KPS | 2 |
Yu QZ[31] | 2007 | NP+SFI | NP | 30/32 | tumor response, KPS | 4 |
Liu CL[32] | 2004 | NP+SFI | NP | 60/60 | tumor response, WBC/PLT/HB toxicity | 2 |
Liu PH[33] | 2007 | NP+SFI | NP | 30/30 | tumor response, KPS | 1 |
Pan YK[34] | 2008 | NP+SFI | NP | 45/45 | tumor response, WBC/PLT/HB toxicity | 2 |
Zheng JH[35] | 2009 | NP+SFI | NP | 42/42 | tumor response, WBC/PLT/HB/nausea and vomiting toxicity | 4 |
Miao SR[36] | 2010 | NP+SFI | NP | 38/41 | tumor response, the KPS, WBC/PLT/nausea and vomiting toxicity | 3 |
Li YQ[37] | 2010 | NP+SFI | NP | 43/42 | KPS | 5 |
Geng D[38] | 2007 | NP+SFI | NP | 42/26 | tumor response, WBC/the nausea and vomiting toxicity | 2 |
Zou Y[39] | 2005 | TP+SFI | TP | 24/24 | tumor response, KPS | 3 |
Luo SZ[40] | 2006 | TP+SFI | TP | 25/25 | tumor response, KPS, WBC/PLT/nausea and vomiting toxicity | 2 |
Luo SW[41] | 2007 | TP+SFI | TP | 30/30 | tumor response, WBC/PLT/HB/nausea and vomiting toxicity, KPS | 2 |
Zhang FL[42] | 2008 | TP+SFI | TP | 30/30 | tumor response, WBC/PLT/HB/nausea and vomiting toxicity, KPS | 3 |
Zhao YX[43] | 2009 | TP+SFI | TP | 40/40 | tumor response, KPS | 2 |
Yu F[44] | 2007 | DC+SFI | DC | 30/30 | tumor response, WBC/PLT/HB toxicity | 4 |
He WJ[45] | 2008 | GP+SFI | GP | 35/35 | tumor response, WBC/PLT/HB/nausea and vomiting toxicity, KPS | 3 |
Liang K[46] | 2010 | GP+SFI | GP | 39/37 | tumor response, KPS, | 2 |
Chen J[47] | 2007 | TP/NP+SFI | TP/NP | 41/39 | tumor response, KPS | 2 |
Wu L[48] | 2004 | TP/NP+SFI | TP/NP | 30/30 | tumor response, WBC toxicity | 5 |
The result of meta-analysis for Objective tumor response
The result of meta-analysis for Performance status
The result of meta-analysis for grade 3 or 4 WBC, PLT, HB, Nausea and Vomiting Toxicity
The result of sensitivity analysis
Outcomes | All Studies | Good Quality Studies | ||||||
---|---|---|---|---|---|---|---|---|
N | Patients | RR (95%CI) | P | N | Patients | RR (95%CI) | P | |
Tumor response | 27 | 1849 | 1.19[1.07,1.32] | 0.001 | 9 | 640 | 1.16[0.98,1.38] | 0.08 |
KPS | 20 | 1336 | 1.57[1.45,1.70] | <0.00001 | 4 | 296 | 1.45[1.25,1.68] | <0.00001 |
WBC | 20 | 1463 | 0.37[0.29,0.47] | <0.00001 | 7 | 510 | 0.32[0.21,0.48] | <0.00001 |
PLT | 18 | 1335 | 0.33[0.21,0.52] | <0.00001 | 6 | 450 | 0.21[0.09,0.50] | 0.0005 |
HB | 15 | 1161 | 0.44[0.30,0.66] | <0.001 | 5 | 362 | 0.37[0.19,0.72] | 0.003 |
Nausea and Vomiting | 14 | 1031 | 0.32[0.22,0.47] | <0.00001 | 5 | 389 | 0.41[0.22,0.77] | 0.006 |