Regional versus systemic chemotherapy in the treatment of colorectal carcinoma metastatic to the liver: Is there a survival difference?‐‐Meta‐analysis of the published literature

摘要: BACKGROUND A number of articles have appeared in the medical literature regarding regional infusion chemotherapy for treatment metastatic colorectal carcinoma confined to liver. The results and conclusions been varied. A meta-analysis was undertaken determine if using either 5-fluorouracil or floxuridine (FUDR) confers a survival advantage over systemic this disease. METHODS A MEDLINE search conducted encompassing period from January 1976 May 1995. narrowed include only that referenced prospective randomized clinical trials. total 149 abstracts were reviewed potential eligibility meta-analysis. Six met current study inclusion criteria. One 2-year rates each modality directly retrieved calculated Kaplan–Meier curves presented. Prior pooling estimates differences, test homogeneity effect statistic proposed by DerSimonian Laird 1986. fixed model then used obtain summary differences group studies. RESULTS Regional with FUDR produced 10% (P = 0.041) 6% 0.124) increased at 1 2 years, respectively. CONCLUSIONS Based on meta-analysis, it appears hepatic artery modest benefit chemotherapy. Whether is clinically relevant depends quality rather than just duration survival. Cancer 1996;78:1639-45.