Efficacy and safety of omitting 5-fluorouracil bolus in combination chemotherapy regimens for gastrointestinal cancers: a systematic review and meta-analysis

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dc.authorid0000-0002-1976-3951
dc.contributor.authorIlhan, Yusuf
dc.contributor.authorBalcik, Onur Yazdan
dc.contributor.authorSahin, Elif
dc.contributor.authorMerc Cetinkaya, Aysegul
dc.contributor.authorAlmuradova, Elvina
dc.contributor.authorBardakci, Murat
dc.contributor.authorDinckal, Cigdem
dc.date.accessioned2026-01-24T12:31:28Z
dc.date.available2026-01-24T12:31:28Z
dc.date.issued2025
dc.departmentAlanya Alaaddin Keykubat Üniversitesi
dc.description.abstractIntroductionThis meta-analysis aimed to evaluate the impact of omitting the 5-FU bolus in chemotherapy regimens for gastrointestinal cancers on treatment efficacy and toxicity.MethodsWe searched major databases and congress proceedings until 25 October 2024 to identify studies comparing 5-FU bolus and non-5-FU bolus regimens in patients with gastrointestinal cancers. The studies included those reporting on progression-free survival (PFS), overall survival (OS), and adverse events in metastatic gastrointestinal cancer patients.ResultsThe analysis included 7 studies with 12,698 patients. No significant differences in PFS (HR: 0.94, 95% CI: 0.83-1.07) or OS (HR: 0.96, 95% CI: 0.89-1.03) were found between the 5-FU bolus and non-bolus groups. However, significantly higher rates of grade 3-4 neutropenia (OR: 0.46, 95% CI: 0.37-0.57) and any grade thrombocytopenia (OR: 0.53, 95% CI: 0.35-0.80) were observed in the 5-FU bolus group. No significant differences were found for other toxicities like febrile neutropenia, diarrhea, or nausea.ConclusionsThis meta-analysis demonstrates that the omission of 5-FU bolus from the commonly used 5-FU-based chemotherapy regimens in gastrointestinal cancers, with the use of only 5-FU infusion, may reduce the risk of hematologic toxicities such as neutropenia and thrombocytopenia without affecting survival outcomes in metastatic gastrointestinal cancers.Protocol registrationwww.crd.york.ac.uk/prospero identifier is CRD42024602968.
dc.identifier.doi10.1080/14740338.2025.2527962
dc.identifier.issn1474-0338
dc.identifier.issn1744-764X
dc.identifier.pmid40590359
dc.identifier.scopus2-s2.0-105009734941
dc.identifier.scopusqualityQ2
dc.identifier.urihttps://doi.org/10.1080/14740338.2025.2527962
dc.identifier.urihttps://hdl.handle.net/20.500.12868/5906
dc.identifier.wosWOS:001521892700001
dc.identifier.wosqualityQ2
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.language.isoen
dc.publisherTaylor & Francis Ltd
dc.relation.ispartofExpert Opinion on Drug Safety
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/closedAccess
dc.snmzKA_WoS_20260121
dc.subject5-FU bolus
dc.subjectefficacy
dc.subjectgastrointestinal cancers
dc.subjectsurvival
dc.subjecttoxicity
dc.titleEfficacy and safety of omitting 5-fluorouracil bolus in combination chemotherapy regimens for gastrointestinal cancers: a systematic review and meta-analysis
dc.typeReview Article

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