An electronic search was undertaken to identify randomized controlled trials comparing
raltitrexed-based regimen to 5-fluorouracil-based regimen in patients with advanced
colorectal cancer. The outcomes included overall survival, overall response rate and toxicities.
RESULTS: This meta-analysis included 11 studies with 4622 patients. Overall, there were no significant differences between the two regimens in terms of overall survival (HR=1.06, 95% CI: 0.96-1.17, P=0.23) or overall response rate (RR=1.09, 95% CI: 0.86-1.38, P=0.47). In subgroup analysis, patients in
raltitrexed/
oxaliplatin group had significantly higher partial response (RR=1.53, 95% CI: 1.17-2.00, P=0.002), overall response rate (RR=1.42, 95% CI: 1.10-1.82, P=0.006), disease control rate (RR=1.16, 95% CI: 1.04-1.29, P=0.009) and lower progressive disease (RR=0.61, 95% CI: 0.45-0.84, P=0.002) when compared to
5-fluorouracil/
leucovorin/
oxaliplatin group. Occurrence of severe
anemia (RR=2.23, 95% CI: 1.38-3.59, P=0.0001),
asthenia (RR=2.29, 95% CI: 1.36-3.84, P=0.002), hepatic disorders (RR=7.51, 95% CI: 1.30-43.56, P=0.02), and
nausea/vomit (RR=1.70, 95% CI: 1.03-2.81, P=0.04) were significantly higher with the
raltitrexed arm treatment, while frequencies of grade 3/4
alopecia (RR=0.36, 95% CI: 0.26-0.50, P<0.00001) and
stomatitis/
mucositis (RR=0.14, 95% CI: 0.07-0.31, P<0.00001) were increased in the
5-fluorouracil group.
CONCLUSIONS: