title: Gemcitabine plus cisplatin versus gemcitabine alone in the treatment of pancreatic cancer: a meta-analysis.
abstract: BACKGROUND
  Pancreatic cancer ranks as the fourth leading cause of cancer-related mortality in the USA. And gemcitabine has been the standard of care for advanced pancreatic cancer. However, a combined use of gemcitabine plus cisplatin (GemCis) has shown promising efficacies in pancreatic cancer patients. Here, system review and meta-analysis were performed to compare the efficacy and safety of GemCis versus gemcitabine (Gem) alone in the treatment of pancreatic cancer.
  
  
  METHODS
  The databases of MEDLINE (PubMed), EMBASE, and Cochrane Library were systematically searched for retrieving the relevant publications prior to 31 September 2014. The primary end point was overall survival (OS) and secondary end points included 6-month survival, 1 year survival, overall response rate (ORR), clinical benefit rate (CBR), time to progression/progression-free survival (TTP/PFS), and toxicities.
  
  
  RESULTS
  A total of nine randomized controlled trials involving 1354 patients were included for systematic evaluations. Overall, as compared with Gem alone, GemCis significantly improved the 6-month survival rate (relative risk (RR) = 1.303, 95% confidence interval (CI) 1.090-1.558, P = 0.004), ORR (RR = 1.482, 95% CI 1.148-1.913, P = 0.003), PFS/TTP (hazard ratio (HR) = 0.87; 95% CI 0.78-0.93, P = 0.022), and the overall toxicities (RR = 2.164, 95% CI 1.837-2.549, P = 0.000). However, no significance difference existed in overall survival (HR = 0.90, 95% CI 0.80-1.42, P = 1.02), 1-year survival rate (RR = 0.956, 95% CI 0.770-1.187, P = 0.684), and CBR (RR = 0.854, 95% CI 0.681-1.072, P = 0.175). As for grade III/IV toxicity, seven kinds of toxicities were higher in the GemCis group. However, no significant inter-group statistical differences existed in the incidence of leukopenia, thrombocytopenia, or diarrhea.
  
  
  CONCLUSIONS
  Despite a higher incidence of three-fourths toxicity, GemCis offers better outcomes of ORR, PFS/TTP, and 6-month survival, which indicates GemCis may be a promising therapy for pancreatic cancer.
authors.affiliation: Department of General Surgery, The Second Xiangya Hospital,Central South University, No.139 Renmin Road, Changsha, 410011, Hunan, People's Republic of China.
authors.forename: Guoqing
authors.initials: G
authors.lastname: Ouyang
authors.affiliation: Department of General Surgery, The Second Xiangya Hospital,Central South University, No.139 Renmin Road, Changsha, 410011, Hunan, People's Republic of China.
authors.forename: Zhipeng
authors.initials: Z
authors.lastname: Liu
authors.affiliation: Department of General Surgery, The Second Xiangya Hospital,Central South University, No.139 Renmin Road, Changsha, 410011, Hunan, People's Republic of China.
authors.forename: Shengfu
authors.initials: S
authors.lastname: Huang
authors.affiliation: Department of General Surgery, The Second Xiangya Hospital,Central South University, No.139 Renmin Road, Changsha, 410011, Hunan, People's Republic of China.
authors.forename: Qianglong
authors.initials: Q
authors.lastname: Li
authors.affiliation: Department of General Surgery, The Second Xiangya Hospital,Central South University, No.139 Renmin Road, Changsha, 410011, Hunan, People's Republic of China.
authors.forename: Li
authors.initials: L
authors.lastname: Xiong
authors.affiliation: Department of General Surgery, The Second Xiangya Hospital,Central South University, No.139 Renmin Road, Changsha, 410011, Hunan, People's Republic of China.
authors.forename: Xiongying
authors.initials: X
authors.lastname: Miao
authors.affiliation: Department of General Surgery, The Second Xiangya Hospital,Central South University, No.139 Renmin Road, Changsha, 410011, Hunan, People's Republic of China. wenyu2861@163.com.
authors.forename: Yu
authors.initials: Y
authors.lastname: Wen
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002945:Cisplatin / Q000008:administration & dosage; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D006801:Humans; D009367:Neoplasm Staging; D010190:Pancreatic Neoplasms / Q000188:drug therapy*; D011379:Prognosis; D015996:Survival Rate; D000093542:Gemcitabine
chemical_list: D003841:Deoxycytidine; D002945:Cisplatin; D000093542:Gemcitabine