Shirao 2013.

Methods	Multicentre RCT 2 arms Quality score: B The study was conducted in Japan .
Participants	n = 237 Median age: 60 years Metastatic disease: 100% (all patients had peritoneal metastasis), confirmed by imaging and/or ascites ECOG 2‐3: 3.4%
Interventions	5‐FU: 5‐FU 800 mg/m² d 1‐5, repeated at d 29 versus MF: methotrexate 100 mg/m² d 1 + 5‐FU 600 mg/m² d 1 + leucovorin rescue (leucovorin 10 mg/m² x 6) d 1, repeated at d 8
Outcomes	Overall survival, ingestion‐possible survival (=surviving days free from nutrition support in patients with sufficient ingestion aat baseline, ingestive improvement in patients without sufficient ingestion at baseline), safety
Notes	The study was registered as NCT00149201 and UMIN‐CTR number C000000123.
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Minimization
Allocation concealment (selection bias)	Low risk	Algorithm concealed to investigators
Incomplete outcome data (attrition bias) efficacy	Low risk	2 non‐treated patients were excluded in each group.
Incomplete outcome data (attrition bias) safety	Low risk	2 non‐treated patients were excluded in each group.
Selective reporting (reporting bias)	High risk	No response and PFS reported
Other bias	High risk	Second‐line treatment was given to 80.7% of patients in the 5‐FU group and 72.9 in the MF group, planned interim analysis
Blinded review of CT/MRI‐scans?	Unclear risk	N/A (no response and PFS reported)