Chronomodulated chemotherapy versus conventional chemotherapy for advanced XXXX : a meta-analysis of five randomized controlled trials.

@entity1 @entity137 @entity390 @entity294 @entity391 @entity33 @entity1395 @entity1897 @entity1398 @entity14
PURPOSE: The purpose of this study was to systematically compare the efficacy and safety of chronomodulated chemotherapy with conventional chemotherapy in @entity1 with advanced @entity14 . METHOD: Eligible studies were identified from electronic databases (Medline, Embase, and the Cochrane Library). The efficacy data included overall survival (OS) and objective response rate (ORR), and @entity137 data contained @entity294 , @entity391 and @entity390 , @entity33 , @entity1395 , and @entity1897 . The meta-analysis was performed with the fixed-effect model or random-effect model according to heterogeneity. RESULT: From 79 articles screened, five randomized controlled trials (RCTs) met the inclusion criteria contributing a total of 958 @entity1 . There was a significant OS benefit (hazard ratio (HR)=0.82; 95% confidence interval (CI) 0.69 to 0.97; P=0.023) in favor of the chronomodulated chemotherapy. The ORR was not significantly different between two arms (relative risk=1.27; 95% CI 0.88 to 1.83; P=0.196). A higher incidence of grade 3/4 @entity33 (odds ratio=2.26, 95% CI 1.34 to 3.83; P=0.724), @entity1395 (2.15, 1.30 to 3.56; P=0.428), and a lower incidence of grade 3/4 @entity1398 (0.26, 0.16 to 0.42; P=0.641) were associated with the chronomodulated chemotherapy. The two arms were similar in terms of grade 3/4 @entity294 (1.10, 0.72 to 1.69; P=0.756), @entity391 and @entity390 (0.69, 0.42 to1.13; P=0.239), and @entity1897 (0.56, 0.25 to 1.27, 0.164). CONCLUSION: Chronomodulated chemotherapy showed significant improvement in OS comparing with conventional chemotherapy. Side effects of the chronomodulated chemotherapy are predictable and manageable. But these results still need more high-quality RCTs for confirmation.
