PURPOSE To compare the efficacy and safety profile of S-1-based versus non-S-1-based chemotherapy as first-line treatment in mCRC. METHODS Relevant randomized controlled trials (RCTs) were obtained from PubMed, Embase, and Ovid databases and the Cochrane library from database set up in May 2018. The RCTs of S-1-based monotherapy or combination therapy as first-line treatment were selected. The impact of S-1-based chemotherapy on progression-free survival (PFS) and overall survival (OS) was assessed by pooling data via RevMan 5.3. RESULTS Meta-analysis of 10 RCTs showed that S-1-based chemotherapy significantly improved PFS (HR 0.90, 95% CI 0.84-0.97, P = 0.006). In subgroup analysis, there was a statistically significant increase in PFS when S-1-based chemotherapy was compared with 5-FU-based (HR 0.92, 95% CI 0.84-1.00, P = 0.04) or capecitabine-based chemotherapy (HR 0.85, 95% CI 0.73-0.99, P = 0.04). The meta-analysis of OS (HR 0.95, 95% CI 0.86-1.05, P = 0.36), overall response rate (ORR) (HR 0.99, 95% CI 0.84-1.17, P = 0.90), and disease control rate (DCR) (HR 1.61, 95% CI 0.87-3.00, P = 0.13) showed no statistical significance between S-1-based and non-S-1-based chemotherapy. The statistically significant differences in the meta-analysis indicated less incidence of graded 3-4 leucopenia (OR = 0.30, 95% CI 0.13-0.71, P = 0.006) and hand-foot syndrome (HFS) (OR = 0.24, 95% CI 0.10-0.58, P = 0.001) in the S-1-based chemotherapy, and there was no statistically significant difference for other adverse events. CONCLUSIONS S-1-based chemotherapy in mono or combined therapy was an attractive alternative to standard first-line regimen for patients of mCRC.

中文翻译：

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对转移性结直肠癌中S-1单一疗法或联合疗法作为一线治疗的有效性和安全性进行荟萃分析。

目的比较基于S-1和非基于S-1的化疗作为mCRC一线治疗的疗效和安全性。方法从2018年5月建立的PubMed，Embase和Ovid数据库以及Cochrane库中获得相关的随机对照试验（RCT）。选择基于S-1的单一疗法或联合疗法作为一线治疗的RCT。通过RevMan 5.3汇总数据，评估了基于S-1的化疗对无进展生存期（PFS）和总体生存期（OS）的影响。结果对10个RCT的荟萃分析显示，基于S-1的化疗显着改善了PFS（HR 0.90，95％CI 0.84-0.97，P = 0.006）。在亚组分析中，将基于S-1的化学疗法与基于5-FU的化学疗法相比，PFS有统计学上的显着增加（HR 0.92，95％CI 0.84-1.00，P = 0。04）或基于卡培他滨的化疗（HR 0.85，95％CI 0.73-0.99，P = 0.04）。OS的荟萃分析（HR 0.95，95％CI 0.86-1.05，P = 0.36），总体缓解率（ORR）（HR 0.99，95％CI 0.84-1.17，P = 0.90）和疾病控制率（DCR ）（HR 1.61，95％CI 0.87-3.00，P = 0.13）在基于S-1的化疗和非基于S-1的化疗之间无统计学意义。荟萃分析中统计学上的显着差异表明，分级3-4白细胞减少症（OR = 0.30，95％CI 0.13-0.71，P = 0.006）和手足综合征（HFS）（OR = 0.24，95％CI在基于S-1的化疗中为0.10-0.58，P = 0.001），其他不良事件无统计学差异。结论在单一或联合治疗中，基于S-1的化疗是mCRC患者标准一线方案的一种有吸引力的替代方案。