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Article Open Access

Meta‑analysis of current chemotherapy regimens in advanced pancreatic cancer to prolong survival and reduce treatment‑associated toxicities

  • Authors:
    • Jie Chen
    • Linli Chen
    • Jianping Yu
    • Yanmei Xu
    • Xiaohui Wang
    • Ziqian Zeng
    • Ning Liu
    • Fan Xu
    • Shu Yang
  • View Affiliations / Copyright

    Affiliations: School of Chinese Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, SAR 999077, P.R. China, Division of General Practice, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P.R. China, Department of Neurology, The First Affiliated Hospital of Chengdu Medical College, Chengdu, Sichuan 610500, P.R. China, Department of General Surgery, Bayingol Mongolia Autonomous Prefecture People's Hospital, Urumqi, Xinjiang Uygur Autonomous Region 841300, P.R. China, Public Health School, Chengdu Medical College, Chengdu, Sichuan 610500, P.R. China, Department of Medicine, Sunshine Guojian Pharmaceutical Co., Ltd., Shanghai 201203, P.R. China
    Copyright: © Chen et al. This is an open access article distributed under the terms of Creative Commons Attribution License [CC BY 4.0].
  • Pages: 477-489
    |
    Published online on: November 9, 2018
       https://doi.org/10.3892/mmr.2018.9638
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Abstract

Unresectable advanced pancreatic cancer (APC) is a highly lethal malignancy. Although numerous chemotherapeutic regimens are available, evidence regarding the survival extension, the life quality improvement, the associated risks and occurrence rates of adverse effects, is required. The effects of 19 chemotherapy regimens on survival and treatment‑associated toxicities in the context of APC treatment were comparatively assessed. A total of 23 randomized controlled trials were included in this network meta‑analysis. For overall survival, five regimens, Gemcitabine (Gem)+radiotherapy (Radio), Gem+cisplatin (Cis), Gem+erlotinib (Erl)+bevacizumab (Bev), Gem+capecitabine (Cap)+Erl, and Gem+exatecan, were the most effective treatments, according to their respective high surface under the cumulative ranking (SUCRA) probabilities. Regarding the progression‑free survival, five regimens, including Gem+Radio, Gem+Erl+Bev, Gem+Cis, Gem+Cap+Erl and Gem+pemetrexed, were the most effective treatments based on their SUCRA probabilities. Each regimen exhibited advantages and disadvantages, and 14 common treatment‑associated toxicities were present in different proportions. The three principal toxic effects included haematological, gastrointestinal and constitutional symptoms. To improve survival, chemotherapy regimens with high SUCRA probabilities require prioritizing. Although treatment‑associated toxicities are unavoidable, the regimens presented toxicities in distinct proportions. Therefore, clinicians should assess the disease status of the patients, and balance the benefits and risks of the selected treatment.
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Copy and paste a formatted citation
Spandidos Publications style
Chen J, Chen L, Yu J, Xu Y, Wang X, Zeng Z, Liu N, Xu F and Yang S: Meta‑analysis of current chemotherapy regimens in advanced pancreatic cancer to prolong survival and reduce treatment‑associated toxicities. Mol Med Rep 19: 477-489, 2019.
APA
Chen, J., Chen, L., Yu, J., Xu, Y., Wang, X., Zeng, Z. ... Yang, S. (2019). Meta‑analysis of current chemotherapy regimens in advanced pancreatic cancer to prolong survival and reduce treatment‑associated toxicities. Molecular Medicine Reports, 19, 477-489. https://doi.org/10.3892/mmr.2018.9638
MLA
Chen, J., Chen, L., Yu, J., Xu, Y., Wang, X., Zeng, Z., Liu, N., Xu, F., Yang, S."Meta‑analysis of current chemotherapy regimens in advanced pancreatic cancer to prolong survival and reduce treatment‑associated toxicities". Molecular Medicine Reports 19.1 (2019): 477-489.
Chicago
Chen, J., Chen, L., Yu, J., Xu, Y., Wang, X., Zeng, Z., Liu, N., Xu, F., Yang, S."Meta‑analysis of current chemotherapy regimens in advanced pancreatic cancer to prolong survival and reduce treatment‑associated toxicities". Molecular Medicine Reports 19, no. 1 (2019): 477-489. https://doi.org/10.3892/mmr.2018.9638
Copy and paste a formatted citation
x
Spandidos Publications style
Chen J, Chen L, Yu J, Xu Y, Wang X, Zeng Z, Liu N, Xu F and Yang S: Meta‑analysis of current chemotherapy regimens in advanced pancreatic cancer to prolong survival and reduce treatment‑associated toxicities. Mol Med Rep 19: 477-489, 2019.
APA
Chen, J., Chen, L., Yu, J., Xu, Y., Wang, X., Zeng, Z. ... Yang, S. (2019). Meta‑analysis of current chemotherapy regimens in advanced pancreatic cancer to prolong survival and reduce treatment‑associated toxicities. Molecular Medicine Reports, 19, 477-489. https://doi.org/10.3892/mmr.2018.9638
MLA
Chen, J., Chen, L., Yu, J., Xu, Y., Wang, X., Zeng, Z., Liu, N., Xu, F., Yang, S."Meta‑analysis of current chemotherapy regimens in advanced pancreatic cancer to prolong survival and reduce treatment‑associated toxicities". Molecular Medicine Reports 19.1 (2019): 477-489.
Chicago
Chen, J., Chen, L., Yu, J., Xu, Y., Wang, X., Zeng, Z., Liu, N., Xu, F., Yang, S."Meta‑analysis of current chemotherapy regimens in advanced pancreatic cancer to prolong survival and reduce treatment‑associated toxicities". Molecular Medicine Reports 19, no. 1 (2019): 477-489. https://doi.org/10.3892/mmr.2018.9638
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