Abstract: ObjectiveTo summarize the research results at home and abroad of raltitrexed on the patients with advanced gastric cancer, and to evaluate the clinical efficacy and adverse reactions of raltitrexed. MethodsClinical controlled trials of evaluating effects of raltitrexed on the advanced gastric cancer were searched in PubMed, EMBase, Ovid, Springer, Wanfang database, VIP database and China Biology Medicine disc. Besides, references and conference abstracts were searched manually. Literature screening and data extraction were performed according to inclusion and exclusion criteria. Then Metaanalysis was performed using RevMan 4.2. ResultsFortyfour studies were found and 5 clinical controlled trails including 338 patients were included in this analysis. The results of Metaanalysis showed that there was a significant beneficial effect of raltitrexed on objective effective rate for the patients with advanced gastric cancer (RR=1.55, 95%CI: 1.211.99, Z=3.44, P=0.00) compared with other treatments. The incidences of ⅢⅣadverse reactions in raltitrexed group such as neutropenia (RR=1.97, 95%CI: 0.854.56, Z=1.59, P=0.11), thrombocytopenia (RR=1.56, 95%CI: 0.604.07, Z=0.92, P=0.36), anemia (RR=2.43, 95%CI: 0.619.78, Z=1.25, P=0.21), arthralgia (RR=3.20, 95%CI: 0.7313.98, Z=1.55, P=0.12), elevated transaminase (RR=1.37, 95%CI: 0.296.48, Z=0.39, P=0.69) were higher than those in other group, with no statistical significance. However, the adverse reactions in raltitrexed group such as diarrhea (RR=0.18, 95%CI: 0.031.07, Z=1.88, P=0.06), nausea and vomiting (Z=1.79, RR=0.45, 95%CI: 0.191.08, P=0.07), neurotoxicity (RR=0.07, 95%CI: 0.010.52, Z=2.59, P=0.01), handfoot syndrome (RR=0.26, 95%CI: 0.041.59, Z=1.46, P=0.14), alopecia (RR=0.57, 95%CI: 0.132.55, Z=0.73, P=0.46) were lower than those in other group. There were no statistical significances except neurotoxicity. ConclusionCompared with other treatments, raltitrexedbased chemotherapy has a beneficial effect on objective effective rate and less adverse reactions for the patients with advanced gastric cancer, which is worthy of clinical use.

Key words: Stomach neoplasms, Meta-analysis, Raltitrexed