Table 7.
Summary of Evidence.
| Author | Outcomes | Studies (Participants) | Heterogeneity (%) | Relative effect (95% CI) | P-value | Quality |
|---|---|---|---|---|---|---|
| Tan et al 32 | Objective response rate (ORR) | 40 (3029) | 0 | RR = 1.35 (1.25, 1.45) | <.001 | Moderate |
| Disease control rate (DCR) | 40 (3029) | 0 | RR = 1.12 (1.08, 1.16) | <.001 | Moderate | |
| Incidence of myelosuppression | 11 (819) | 0 | RR = 0.50 (0.41, 0.61) | <.001 | Low | |
| Incidence of leucopenia | 23 (1717) | 0 | RR = 0.54 (0.48, 0.61) | <.001 | Moderate | |
| Incidence of anemia | 14 (926) | 3.25 | RR = 0.77 (0.64, 0.92) | <.001 | Low | |
| Incidence of thrombocytopenia | 21 (1484) | 0 | RR = 0.57 (0.47, 0.70) | <.001 | Moderate | |
| Incidence of gastrointestinal reaction | 14 (1017) | 11 | RR = 0.55 (0.47, 0.64) | <.001 | Moderate | |
| Incidence of diarrhea | 9 (620) | 0 | RR = 0.54 (0.42, 0.69) | <.001 | Low | |
| Incidence of nausea and vomiting | 20 (1506) | 39.16 | RR = 0.61 (0.51, 0.73) | <.001 | Low | |
| Incidence of hepatorenal toxicity | 9 (779) | 0 | RR = 0.71 (0.56, 0.89) | <.001 | Low | |
| Incidence of hepatotoxicity | 20 (1374) | 23.38 | RR = 0.65 (0.52, 0.81) | <.001 | Moderate | |
| Incidence of renal toxicity | 12 (802) | 0 | RR = 0.55, (0.40, 0.77) | <.001 | Low | |
| Incidence of neurotoxicity | 27 (1980) | 0 | RR = 0.70 (0.61, 0.80) | <.001 | Moderate | |
| Zhang et al 33 | Objective response rate (ORR) | 12 (853) | 0 | RR = 1.28 (1.10-1.48) | .001 | Low |
| Disease control rate (DCR) | 11 (796) | 9 | RR = 1.12 (1.04-1.20) | .003 | Low | |
| Overall Survival Time | 2 (205) | 0 | HR = 0.94 (0.75-1.18) | .59 | Low | |
| Improvement rate of KPS | 6 (NR) | 0 | RR = 1.83 (1.40-2.39) | <.001 | Very low | |
| Incidence of leucopenia | 6 (NR) | 50 | RR = 0.76 (0.58-0.99) | .04 | Very low | |
| Incidence of nausea and vomiting | 5 (NR) | 47 | RR = 0.68 (0.53-0.86) | .001 | Very low | |
| Incidence of hand-foot syndrome | 3 (NR) | 0 | RR = 0.55 (0.33-0.91) | .02 | Low | |
| Pain relief rate (PRR) | 2 (NR) | 0 | RR = 1.81 (1.30-2.54) | <.001 | Low | |
| Incidence of anemia | 3 (NR) | 0 | RR = 0.79 (0.58-1.08) | .14 | Low | |
| Incidence of diarrhea | 5 (NR) | 0 | RR = 0.77 (0.52-1.15) | .21 | Very low | |
| Incidence of neurotoxicity | 3 (NR) | 91 | RR = 0.57 (0.23-1.43) | .23 | Very low | |
| Incidence of oral mucositis | 2 (NR) | 88 | RR = 0.37 (0.04-3.47) | .39 | Very low | |
| Sun et al 34 | Objective response rate (ORR) | 26 (1898) | 0 | OR = 1.88 (1.54-2.31) | <.001 | Moderate |
| Disease control rate (DCR) | 25 (1841) | 0 | OR = 2.05 (1.63-2.58) | <.001 | Moderate | |
| Overall Survival Time | 3 (366) | 0 | OR = 1.43 (0.89-2.30) | .14 | Low | |
| Score of KPS | 3 (180) | 79 | MD = 7.00 (2.25-11.75) | .004 | Very low | |
| Quality of life improved rate (QIR) | 12 (947) | 5 | OR = 2.39 (1.81-3.15) | <.001 | Moderate | |
| Pain relief rate (PRR) | 3 (201) | 32 | OR = 4.06 (2.24-7.35) | <.001 | Low | |
| Incidence of nausea and vomiting | NR (889) | 37 | OR = 0.55 (0.41-0.74) | <.001 | Low | |
| Incidence of diarrhea | NR (774) | 0 | OR = 0.65 (0.46-0.90) | .01 | Moderate | |
| Incidence of leucopenia | NR (849) | 34 | OR = 0.62 (0.47-0.82) | <.001 | Moderate | |
| Incidence of thrombocytopenia | NR (356) | 0 | OR = 0.69 (0.44-1.11) | .13 | Low | |
| Incidence of hepatotoxicity | NR (386) | 56 | OR = 0.53 (0.24-1.16) | .11 | Very low | |
| Incidence of renal toxicity | NR (224) | 0 | OR = 0.56 (0.16-1.95) | .36 | Low | |
| Incidence of oral mucositis | NR (468) | 64 | OR = 0.62 (0.28-1.34) | .22 | Very low | |
| Incidence of alopecia | NR (263) | 0 | OR = 0.61 (0.24-1.56) | .3 | Low | |
| Incidence of hand-foot syndrome | NR (690) | 0 | OR = 0.57 (0.41-0.79) | <.001 | Moderate | |
| Incidence of anemia | NR (583) | 0 | OR = 0.69 (0.48-0.99) | .05 | Moderate | |
| Incidence of gastrointestinal reaction | NR (572) | 57 | OR = 0.56 (0.32-1.00) | .05 | Low | |
| Incidence of neurotoxicity | NR (528) | 0 | OR = 0.32 (0.20-0.50) | <.001 | Moderate | |
| Incidence of neutropenia | NR (110) | 0 | OR = 0.45 (0.14-1.42) | .17 | Low | |
| Incidence of myelosuppression | NR (184) | 80 | OR = 0.38 (0.08-1.84) | .23 | Very low | |
| Zhang et al 35 | Disease control rate (DCR) | 9 (664) | 0 | OR = 1.96 (1.39, 2.78) | <.001 | Moderate |
| 1-year survival rate | 4 (311) | 0 | OR = 3.25 (1.90, 5.54) | <.001 | Low | |
| 3-year survival rate | 4 (311) | 0 | OR = 1.71 (1.06, 2.78) | .03 | Low | |
| Incidence of nausea and vomiting | 10 (760) | 0 | OR = 0.47 (0.34, 0.64) | <.001 | Moderate | |
| Chen et al 36 | Disease control rate (DCR) | 8 (890) | 0 | OR = 1.44 (1.09, 1.90) | .01 | High |
| Improvement rate of KPS | 10 (1011) | 0 | OR = 2.86, (2.11, 3.86) | <.001 | Moderate | |
| Incidence of leucopenia | 15 (2218) | 6 | OR = 0.21 (0.16, 0.26) | <.001 | Moderate | |
| Incidence of thrombocytopenia | 9 (1173) | 29 | OR = 0.30 (0.19, 0.48) | <.001 | Moderate | |
| Incidence of anemia | 7 (648) | 54 | OR = 0.33 (0.19, 0.59) | <.001 | Low | |
| Incidence of gastrointestinal reaction | 12 (1919) | 37 | OR = 0.31 (0.24, 0.40) | <.001 | Low | |
| Incidence of neurotoxicity | 5 (356) | 0 | OR = 0.33, (0.20, 0.55) | <.001 | Low | |
| Incidence of hand-foot syndrome | 5 (495) | 0 | OR = 0.31 (0.21, 0.45) | <.001 | Low | |
| Incidence of myelosuppression | 3 (196) | 0 | OR = 0.31 (0.17, 0.56) | <.001 | Low | |
| Li et al 37 | Objective response rate (ORR) | 13 (948) | 12 | RR = 1.39 (1.24, 1.57) | <.001 | Low |
| Improvement rate of KPS | 4 (246) | 0 | RR = 1.53 (1.19, 1.96) | <.001 | Low | |
| Incidence of neutropenia | 5 (392) | 44 | RR = 0.68 (0.55, 0.84) | <.001 | Very low | |
| Incidence of leucopenia | 4 (292) | 40 | RR = 0.69 (0.54, 0.90) | .006 | Very low | |
| Incidence of anemia | 5 (373) | 0 | RR = 0.65 (0.40, 1.04) | .07 | Low | |
| Incidence of thrombocytopenia | 6 (414) | 32 | RR = 0.66 (0.46, 0.96) | .03 | Low | |
| Incidence of nausea and vomiting | 8 (562) | 85 | RR = 0.50 (0.32, 0.80) | .004 | Very low | |
| Incidence of hepatotoxicity | 3 (260) | 0 | RR = 0.63 (0.33, 1.20) | .16 | Low | |
| Incidence of neurotoxicity | 3 (188) | 0 | RR = 0.64 (0.26, 1.55) | .32 | Low | |
| Qiao et al 38 | Disease control rate (DCR) | 19 (1673) | 26 | RR = 1.77 (1.12, 1.22) | <.001 | Moderate |
| Overall survival time | 6 (469) | 50 | RR = 0.57 (0.44, 0.73) | <.001 | Low | |
| Incidence of nausea and vomiting | 14 (1228) | 48 | RR = 0.49 (0.41, 0.57) | <.001 | Low | |
| Incidence of leucopenia | 14 (1228) | 34 | RR = 0.49 (0.44, 0.55) | <.001 | Moderate | |
| Liang et al 39 | Quality of life improved rate (QIR) | 3 (360) | 83 | OR = 12.88 (2.30, 71.99) | .004 | Very low |
| Overall survival time | 2 (188) | 0 | OR = 1.80 (0.98, 3.28) | .06 | Very low | |
| Xu et al 40 | 1-year survival rate | 4 (399) | 0 | OR = 2.17 (1.15, 4.08) | .02 | Low |
| 3-year survival rate | 4 (407) | 0 | OR = 2.26 (1.51, 3.99) | <.001 | Very low | |
| Incidence of leucopenia | 10 (666) | 0 | OR = 0.16 (0.11, 0.23) | <.001 | Low | |
| Incidence of nausea and vomiting | 10 (728) | 9 | OR = 0.20 (0.14, 0.28) | <.001 | Low | |
| Chen et al 41 | Objective response rate (ORR) | 17 (1447) | 0 | OR = 1.90 (1.53, 2.36) | <.001 | Moderate |
| Improvement rate of KPS | 9 (869) | 53 | OR = 2.35 (1.77, 3.13) | <.001 | Very low | |
| Incidence of nausea and vomiting | 11 (958) | 56 | OR = 0.29 (0.19, 0.45) | <.001 | Very low | |
| Wang et al 42 | Score of KPS | 6 (455) | 74 | MD = 7.24 (5.17, 9.31) | <.001 | Very low |
| Incidence of leucopenia | 6 (404) | 79 | RR = 0.64 (0.46, 0.89) | .007 | Very low | |
| Incidence of anemia | 5 (344) | 83 | RR = 0.60 (0.39, 0.93) | .02 | Very low | |
| Incidence of thrombocytopenia | 5 (347) | 34 | RR = 0.72 (0.54, 0.97) | .03 | Very low | |
| Incidence of hepatotoxicity | 5 (359) | 0 | RR = 0.69 (0.29, 1.64) | .41 | Very low | |
| Incidence of renal toxicity | 5 (359) | 0 | RR = 0.59 (0.18, 2.00) | .4 | Very low | |
| Incidence of nausea and vomiting | 4 (267) | 0 | RR = 0.54 (0.41, 0.70) | <.001 | Very low | |
| Incidence of diarrhea | 4 (267) | 38 | RR = 0.61 (0.39, 0.95) | .03 | Very low | |
| Incidence of neurotoxicity | 3 (207) | 0 | RR = 0.47 (0.21, 1.06) | .07 | Very low | |
| Wu et al 43 | Disease control rate (DCR) | 15 (797) | 0 | OR = 1.67 (1.24, 2.26) | <.001 | Low |
| Improvement rate of KPS | 8 (466) | 0 | OR = 4.75 (2.87, 7.86) | <.001 | Low | |
| Incidence of nausea and vomiting | 10 (640) | 0 | OR = 0.33 (0.22, 0.48) | <.001 | Low | |
| Incidence of diarrhea | 8 (389) | 0 | OR = 0.30 (0.19, 0.48) | <.001 | Very low | |
| Incidence of leucopenia | 12 (679) | 41 | OR = 0.52 (0.36, 0.74) | <.001 | Very low | |
| Incidence of neurotoxicity | 9 (437) | 19 | OR = 0.48 (0.31, 0.75) | .001 | Very low | |
| Zhao et al 44 | Disease control rate (DCR) | 13 (1215) | 45 | RR = 1.51 (1.34, 1.70) | <.001 | Low |
| Incidence of adverse reactions (Mainly including gastrointestinal reaction and myelosuppression) | 5 (505) | 12 | RR = 0.51 (0.38, 0.69) | <.001 | Low |
Abbreviations: NR, not report.