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Gemcitabine/cisplatin versus methotrexate/vinblastine/doxorubicin/cisplatin for muscle-invasive bladder cancer: A systematic review and meta-analysis


 Department of Urology, Xiangya Hospital, Central South University, Changsha, Hunan 410000, China

Correspondence Address:
Ding Jian,
Department of Urology, Xiangya Hospital, Central South University, Changsha, Hunan 410000
China
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Source of Support: None, Conflict of Interest: None

Objective: The objective of this study was to perform a systematic review and meta-analysis to evaluate the two most commonly used chemotherapy regimens gemcitabine plus cisplatin (GC) and methotrexate, vinblastine, doxorubicin/adriamycin, and cisplatin (MVAC) regimens for muscle-invasive bladder cancer (MIBC) patients. Methods: We searched for all studies investigating GC and MVAC for MIBC patients in PubMed, Web of Knowledge, and the Cochrane Central Search Library. A systematic review and meta-analysis were performed. Results: Our searches identified 13 studies among 2174 patients. In the meta-analysis, the pathological complete response to GC regimens was superior to MVAC regimens. No significant difference in pathological partial response was found between the two groups. GC regimens were associated with a significant decrease risk in Grade 3–4 neutropenia, mucositis, and febrile neutropenia, but a significant increase risk in Grade 3–4 thrombocytopenia. There was no significant difference in overall survival (OS), disease-specific survival (DSS) and disease-free survival (DFS) when compared GC regimens to MVAC regimens. Conclusions: GC regimens significantly improved pathological complete response compared to MVAC regimens. GC regimens were associated with a significant decrease risk in Grade 3–4 neutropenia, mucositis, and febrile neutropenia, but a significant increase risk in Grade 3–4 thrombocytopenia. There was no significant difference in OS, DSS, and DFS when compared the two regimens.


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    -  Yu C
    -  Hequn C
    -  Jinbo C
    -  Feng Z
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