title: Optimized dose of imatinib for treatment of gastrointestinal stromal tumors: a meta-analysis.
abstract: OBJECTIVE
  To investigate the efficacy and safety of standard-dose versus high-dose imatinib.
  
  
  METHODS
  After a systematic review of English language articles, five studies including 2008 patients were eligible for the meta-analysis. Data extracted from each study were synthesized into overall odds ratios (OR).
  
  
  RESULTS
  The overall OR for the high dose vs standard dose was 1.19 (95% CI 1.00-1.42) and the Z-score for the overall effect was 1.93 (P = 0.054), suggesting that high-dose imatinib added no survival benefits. The dose-related toxicity was also assessed in the same way. The rates of rash, hemorrhage, nausea, vomiting and taste disturbance increased as dose increased (P < 0.05), whereas the incidence of headache, abdominal pain, edema, fatigue, anemia, infection, muscle cramp and constipation was nearly identical and showed no significant difference.
  
  
  CONCLUSIONS
  Imatinib at a standard dose produces a similar effect to that at a high dose. The severity of the toxicity is associated with the dose of imatinib. However, larger and randomized studies are needed to draw definitive conclusions.
authors.affiliation: Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
authors.forename: Shang Long
authors.initials: SL
authors.lastname: Liu
authors.forename: Ge
authors.initials: G
authors.lastname: Chen
authors.forename: Yu Pei
authors.initials: YP
authors.lastname: Zhao
authors.forename: Wen Ming
authors.initials: WM
authors.lastname: Wu
authors.forename: Tai Ping
authors.initials: TP
authors.lastname: Zhang
mesh_terms: D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000009:adverse effects*; D001549:Benzamides / Q000008:administration & dosage* / Q000009:adverse effects*; D016001:Confidence Intervals; D005770:Gastrointestinal Neoplasms / Q000188:drug therapy*; D046152:Gastrointestinal Stromal Tumors / Q000188:drug therapy*; D006801:Humans; D000068877:Imatinib Mesylate; D016017:Odds Ratio; D010879:Piperazines / Q000008:administration & dosage* / Q000009:adverse effects*; D011743:Pyrimidines / Q000008:administration & dosage* / Q000009:adverse effects*; D015996:Survival Rate
chemical_list: D000970:Antineoplastic Agents; D001549:Benzamides; D010879:Piperazines; D011743:Pyrimidines; D000068877:Imatinib Mesylate