Comparison of Efficacy Between S-1 and Capecitabine/Fluorouracil on Advanced Colorectal Cancer: A Meta-analysis

Objective To conduct a meta-analysis on the data of S-1 and capecitabine or fluorouracil in the treatment of advanced colorectal cancer, to demonstrate the feasibility of S-1 replacing capecitabine or fluorouracil.

Methods We searched published literature in the PubMed, Cochrane Library, Embase and CNKI databases, and searched for controlled trials at the Clinical Trials Center (https://www.clinicaltrials.gov/). The data extraction and quality evaluation were conducted according to Cochrane Handbook 5.1.0, and RevMan 5.3 software was used for the meta-analysis of relevant case-control studies.

Results The data of 3462 patients from 11 randomized controlled trials were included. Compared with the capecitabine/fluorouracil regimen, OS was improved in the S-1 treatment group, but there was no statistically significant difference in PFS, DCR or ORR. The incidence of diarrhea, renal insufficiency and hand-foot syndrome in the S-1 group was lower than that in the control group. But the incidence of platelet reduction in the S-1 group was higher than that in the control group at a reasonable contrast dose.

Conclusion S-1 has a certain therapeutic advantage after replacing capecitabine or fluorouracil in conventional chemotherapy on advanced colorectal cancer.