S-1-based regimens and the risk of leucopenic complications; a Meta-analysis with comparison to other fluoropyrimidines and non fluoropyrimidines

<b>Background</b>: We performed a meta-analysis oriented at the risk of leucopenic complications associated with S-1-based regimens. <b>Patients and methods</b>: 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. <b>Results</b>: 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 <b>Conclusions</b>: 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.

**背景**：本研究针对以S-1为基础的治疗方案相关的白细胞减少症并发症风险开展了一项Meta分析。**患者与方法**：本研究纳入的合格研究为针对实体瘤患者采用S-1治疗的随机Ⅱ期及Ⅲ期临床试验，需涵盖发热性中性粒细胞减少症、各等级及高级别中性粒细胞减少症与白细胞减少症的事件详情。**结果**：经不合格研究剔除后，最终共有28项临床试验符合进一步定量分析的纳入标准。与非氟嘧啶类对照方案相比，S-1方案对应的发热性中性粒细胞减少症、各等级及高级别中性粒细胞减少症的相对风险（RR）为0.27 [95%置信区间（CI）0.16, 0.46; P<**结论**：以S-1为基础的治疗方案，其发热性中性粒细胞减少症、各等级及高级别中性粒细胞减少症与白细胞减少症的发生风险均低于非氟嘧啶类治疗方案；但其风险与静脉输注5-氟尿嘧啶（5FU）或卡培他滨为基础的治疗方案相当。