title: S-1-based regimens and the risk of leucopenic complications; a Meta-analysis with comparison to other fluoropyrimidines and non fluoropyrimidines.
abstract: BACKGROUND
  We performed a meta-analysis oriented at the risk of leucopenic complications associated with S-1-based regimens.
  
  
  METHODS
  The studies that were granted eligibility for inclusion include randomized phase II and III trials of patients with solid tumors on S-1; that entailed details of events of febrile neutropenia, all-grade and high-grade neutropenia and leucopenia.
  
  
  RESULTS
  After rejecting ineligible studies, a total of 28 clinical trials were elected eligible for further quantitative analysis. The RR of febrile neutropenia, all-grade and high-grade neutropenia for S-1 vs.non fluoropyrimidine controls was 0.27 [95% CI 0.16, 0.46; P < 0.0001] 0.69 [95% CI 0.58, 0.81; P < 0.00001] and 0.47 [95% CI 0.32, 0.70; P = 0.0002], correspondingly; while The RR of all-grade and high-grade leucopenia for S-1 vs.non fluoropyrimidine controls was 0.60 [95% CI 0.46, 0.79; P = 0.0002] and 0.34 [95% CI 0.14, 0.79; P = 0.01], respectively.
  
  
  CONCLUSIONS
  The risk of febrile neutropenia, all-grade and high-grade neutropenia and leucopenia is less in S-1-based therapy than in non fluoropyrimidine regimens; yet comparable to the risk associated with infusional 5FU or capecitabine-based regimens.
authors.affiliation: a Clinical Oncology Department, Faculty of Medicine , Ain Shams University , Cairo , Egypt.
authors.forename: Omar
authors.initials: O
authors.lastname: Abdel-Rahman
authors.affiliation: a Clinical Oncology Department, Faculty of Medicine , Ain Shams University , Cairo , Egypt.
authors.forename: Hesham
authors.initials: H
authors.lastname: ElHalawani
authors.affiliation: a Clinical Oncology Department, Faculty of Medicine , Ain Shams University , Cairo , Egypt.
authors.forename: Shaimaa
authors.initials: S
authors.lastname: Essam-Eldin
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D017322:Clinical Trials, Phase II as Topic; D017326:Clinical Trials, Phase III as Topic; D004338:Drug Combinations; D006801:Humans; D009369:Neoplasms / Q000188:drug therapy*; D009503:Neutropenia / Q000139:chemically induced*; D010094:Oxonic Acid / Q000009:adverse effects* / Q000627:therapeutic use*; D011743:Pyrimidines / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D012306:Risk; D005641:Tegafur / Q000009:adverse effects* / Q000627:therapeutic use*
chemical_list: D004338:Drug Combinations; D011743:Pyrimidines; C079198:S 1 (combination); D005641:Tegafur; D010094:Oxonic Acid
keywords: S-1; febrile neutropenia; leucopenia; neutropenia