PMID- 31403035
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20200930
IS  - 2234-943X (Print)
IS  - 2234-943X (Electronic)
IS  - 2234-943X (Linking)
VI  - 9
DP  - 2019
TI  - COMplot, A Graphical Presentation of Complication Profiles and Adverse Effects 
      for the Curative Treatment of Gastric Cancer: A Systematic Review and 
      Meta-Analysis.
PG  - 684
LID - 10.3389/fonc.2019.00684 [doi]
LID - 684
AB  - Background: For the curative treatment of gastric cancer, several neoadjuvant, 
      and adjuvant treatment-regimens are available which have shown to improve overall 
      survival. No overview is available regarding toxicity and surgery related 
      outcomes. Our aim was to construct a novel graphical method concerning adverse 
      events (AEs) associated with multimodality treatment and perform a meta-analysis 
      to compare different clinically relevant cytotoxic regimens with each other. 
      Methods: The PubMed, EMBASE, CENTRAL, and ASCO/ESMO databases were searched up to 
      May 2019 for randomized controlled trials investigating curative treatment 
      regimens for gastric cancer. To construct single and bidirectional bar-charts 
      (COMplots), grade 1-2 and grade 3-5 AEs were extracted per cytotoxic regimen. For 
      surgery-related outcomes a pre-specified set of complications was used. 
      Thereafter, treatment-arms comparing the same regimens were combined in a 
      single-arm random-effects meta-analysis and pooled-proportions were calculated 
      with 95% confidence-intervals. Comparative meta-analyses were performed based on 
      clinical relevance and compound similarity. Results: In total 16 RCTs (n = 4,526 
      patients) were included investigating pre-operative-therapy and 39 RCTs 
      investigating adjuvant-therapy (n = 13,732 patients). Pre-operative COMplots were 
      created for among others; 5-fluorouracil/leucovorin-oxaliplatin-docetaxel (FLOT), 
      epirubicin-cisplatin-fluoropyrimidine (ECF), cisplatin-fluoropyrimidine (CF), and 
      oxaliplatin-fluoropyrimidine (FOx). Pre-operative FLOT showed a minor increase in 
      grade 1-2 and grade 3-4 AEs compared to pre-operative ECF, CF, and FOx. A pooled 
      analysis of patients who had received pre-operative therapy compared to patients 
      who underwent direct surgery did not reveal any significant difference in surgery 
      related morbidity/mortality. When we compared three commonly used adjuvant 
      regimens; S-1 had the lowest amount of grade 3-4 AEs compared to capecitabine 
      with oxaliplatin (CAPOX) and 5-FU with radiotherapy (5-FU+RT). Conclusion: 
      COMplot provides a novel tool to visualize and compare treatment related AEs for 
      gastric cancer. Based on our comparisons, pre-operative FLOT had a manageable 
      toxicity profile compared to other pre-operative doublet or triplet regimens. We 
      found no evidence indicating surgical outcomes might be hampered by pre-operative 
      therapy. Adjuvant S-1 had a more favorable toxicity profile compared to CAPOX and 
      5-FU+RT.
FAU - van den Ende, Tom
AU  - van den Ende T
AD  - Department of Medical Oncology, Cancer Center Amsterdam, Amsterdam University 
      Medical Centers (UMC), University of Amsterdam, Amsterdam, Netherlands.
FAU - Abe Nijenhuis, Frank A
AU  - Abe Nijenhuis FA
AD  - Department of Medical Oncology, Cancer Center Amsterdam, Amsterdam University 
      Medical Centers (UMC), University of Amsterdam, Amsterdam, Netherlands.
FAU - van den Boorn, Hector G
AU  - van den Boorn HG
AD  - Department of Medical Oncology, Cancer Center Amsterdam, Amsterdam University 
      Medical Centers (UMC), University of Amsterdam, Amsterdam, Netherlands.
FAU - Ter Veer, Emil
AU  - Ter Veer E
AD  - Department of Medical Oncology, Cancer Center Amsterdam, Amsterdam University 
      Medical Centers (UMC), University of Amsterdam, Amsterdam, Netherlands.
FAU - Hulshof, Maarten C C M
AU  - Hulshof MCCM
AD  - Department of Radiotherapy, Cancer Center Amsterdam, Amsterdam University Medical 
      Centers (UMC), University of Amsterdam, Amsterdam, Netherlands.
FAU - Gisbertz, Suzanne S
AU  - Gisbertz SS
AD  - Department of Surgery, Cancer Center Amsterdam, Amsterdam University Medical 
      Centers (UMC), University of Amsterdam, Amsterdam, Netherlands.
FAU - van Oijen, Martijn G H
AU  - van Oijen MGH
AD  - Department of Medical Oncology, Cancer Center Amsterdam, Amsterdam University 
      Medical Centers (UMC), University of Amsterdam, Amsterdam, Netherlands.
FAU - van Laarhoven, Hanneke W M
AU  - van Laarhoven HWM
AD  - Department of Medical Oncology, Cancer Center Amsterdam, Amsterdam University 
      Medical Centers (UMC), University of Amsterdam, Amsterdam, Netherlands.
LA  - eng
PT  - Systematic Review
DEP - 20190725
PL  - Switzerland
TA  - Front Oncol
JT  - Frontiers in oncology
JID - 101568867
PMC - PMC6677173
OTO - NOTNLM
OT  - chemotherapy
OT  - curative
OT  - gastric cancer
OT  - meta-analysis
OT  - toxicity
EDAT- 2019/08/14 06:00
MHDA- 2019/08/14 06:01
PMCR- 2019/01/01
CRDT- 2019/08/13 06:00
PHST- 2019/04/26 00:00 [received]
PHST- 2019/07/11 00:00 [accepted]
PHST- 2019/08/13 06:00 [entrez]
PHST- 2019/08/14 06:00 [pubmed]
PHST- 2019/08/14 06:01 [medline]
PHST- 2019/01/01 00:00 [pmc-release]
AID - 10.3389/fonc.2019.00684 [doi]
PST - epublish
SO  - Front Oncol. 2019 Jul 25;9:684. doi: 10.3389/fonc.2019.00684. eCollection 2019.