Table 1.
Characteristics of the included RCTs
| References | Kwon et al. [14] | Kim et al. [15] | Zhu et al. [16] | ARTIST 2012/2015 | ||||
|---|---|---|---|---|---|---|---|---|
| Characteristics | CRT | CT | CRT | CT | CRT | CT | CRT | CT |
| Patient number | 31 | 30 | 46 | 44 | 186 | 165 | 230 | 228 |
| Age year | 56 (23–73) | 49 (29–70) | >60, (19.6 %) | >60, (31.8 %) | 56 (38–73) | 59 (42–75) | 56 (28–76) | 56 (22–77) |
| Sex no. (%) | ||||||||
| Male | 21 (67.7) | 23 (76.7) | 34 (73.9) | 25 (56.8) | 135 (72.9) | 126 (76.4) | 143 (62.2) | 153 (67.1) |
| Female | 10 (32.3) | 7 (23.3) | 12 (26.1) | 19 (43.2) | 51 (27.1) | 39 (23.6) | 87 (37.8) | 75 (32.9) |
| ECOG PS no. (%) | ||||||||
| 0 | NR | NR | 35 (76.1) | 27 (61.4) | NR | NR | 99 (43.0) | 96 (42.1) |
| 1 | NR | NR | 11 (23.9) | 17 (38.6) | NR | NR | 131 (57.0) | 132 (57.9) |
| Primary tumor site no. (%) | ||||||||
| Proximal | 6 (16.1) | 4 (13.3) | 3 (6.5) | 2 (4.5) | 30 (16.1) | 15 (9.1) | 13 (5.7) | 9 (3.9) |
| Body | 9 (29.0) | 11 (36.7) | 26 (56.5) | 19 (43.2) | 21 (11.3) | 33 (20) | 107 (46.5) | 112 (49.1) |
| Antrum | 17 (54.8) | 15 (50.0) | 14 (30.5) | 18 (40.9) | 135 (72.6) | 117 (70.9) | 90 (39.1) | 87 (38.2) |
| Multiple/diffuse | 0 | 0 | 3 (6.5) | 5 (11.4) | 0 | 0 | 20 (8.7) | 20 (8.8) |
| Laurén’s classification no. (%) | ||||||||
| Intestinal | 5 (16.1) | 12 (40.0) | 16 (34.8) | 15 (34.1) | NR | NR | 75 (32.6) | 88 (38.6) |
| Diffuse | 20 (64.4) | 13 (43.3) | 26 (56.5) | 24 (54.5) | NR | NR | 144 (62.6) | 130 (57.0) |
| Mixed/unclassified | 6 (19.4) | 5 (16.7) | 4 (8.6) | 5 (11.3) | NR | NR | 11 (4.8) | 10 (4.4) |
| Tumor stage no. (%) | ||||||||
| Ib | 0 | 0 | 0 | 0 | 20 (10.8) | 15 (9.1) | 49 (21.3) | 50 (21.9) |
| II | 0 | 0 | 0 | 0 | 36 (19.4) | 30 (18.2) | 84 (36.5) | 86 (37.7) |
| III | 24 (77.4) | 27 (90.0) | 34 (73.9) | 31 (75.0) | 103 (55.4) | 96 (58.2) | 71 (30.8) | 65 (28.6) |
| IV (M0) | 7 (22.6) | 3 (10) | 12 (26.1) | 11 (25.0) | 27 (14.5) | 24 (14.5) | 26 (11.3) | 27 (11.8) |
| pN+ | NR | NR | 46 (100) | 42 (95.5) | 158 (84.9) | 143 (86.7) | 203 (88.2) | 193 (84.6) |
| Lymphadenectomy | D2 | D2 | D2 | D2 | ||||
| Treatment regimens | FP/RT | FP | FL/RT | FL | FL/IMRT | FL | XP/XRT/XP | XP |
| Total RT dose/technique | 45 Gy/3D-CRT | 45 Gy/AP-PA fields | 45 Gy/IMRT | 45 Gy/AP-PA fields | ||||
| Endpoints | 3-ys DFS: 80.0 % vs 75.2 %; P = 0.887 5-ys DFS: 76.7 % vs 59.1 %; P = 0.222 5-ys OS: 70.1 % vs 70.0 %; P = 0.814 |
5-ys DFS: 60.9 % vs 50.0 %; P = 0.246 5-ys OS: 65.2 % vs 54.6 %; P = 0.67 |
5-ys RFS: 45.2 % vs 35.8 %, P = 0.029 5-ys OS: 48.4 % vs 41.8 %, P = 0.122 |
3-ys DFS: 78.2 % vs 74.2 %; P = 0.0862 7-ys DFS: P = 0.740 5-ys OS: 75 % vs 73 %; P = 0.484 |
||||
| Median follow-up months | 77.2 (24–92.8) | 86.7 (60.3–116.5) | 42.5 | 2012: 53.2(36.9–77.3) 2015: 7 years |
||||
FP regimen: 5-Fu 1000 mg/m2 continuous infusion on days 1–5, cisplatin 60 mg/m2 on day 1 every 3 weeks, totally 6 cycles; FP/RT: 1 cycle of FP, then RT (45 Gy of radiation at 1.8 Gy per day, 5 days per week, for 5 weeks with continuous capecitabine 825 mg/m2 twice daily during radiotherapy), followed by 3 cycles of FP; FL regimen: 5-Fu 425 mg/m2, leucovorin 20 mg/m2, for 5 days with a 4-week interval, totally 5 cycles; FL/RT: 1 cycle of FL, then RT (45 Gy of radiation at 1.8 Gy per day, 5 days per week, for 5 weeks with 2 cycles of FL), followed by 2 cycles of FL; XP regimen: capecitabine 1000 mg/m2 twice daily on days 1 to 14; cisplatin 60 mg/m2 on day 1 every 3 weeks, totally 6 cycles; XP/XRT/XP: 2 cycles of XP, then XRT (45 Gy of radiation at 1.8 Gy per day, 5 days per week, for 5 weeks with continuous capecitabine 825 mg/m2 twice daily during radiotherapy), followed by 2 cycles of XP
CT chemotherapy, CRT chemoradiotherapy, NR not reported, 3-ys DFS 3-year disease-free survival, 5-ys DFS 5-year disease-free survival, 5-ys OS 5-year overall survival, 3D-CRT 3D conformal radiotherapy, IMRT intensity-modulated radiotherapy, LN lymph node