A systematic review and meta-analysis of gastrointestinal events associated with nonoperative therapies for neuroendocrine tumors

Quhui Wu,1,* Bo Chen,2,* Guofu Yan,1 Zhulin Yang,2 Li Xiong,2 Jun He2 1Graduate School, Hunan University of Chinese Medicine, Changsha 410208, China; 2Department of General Surgery, Second Xiangya Hospital, Central South University, Changsha 410011, China *These authors contributed equally to this work Abstract: The risk of gastrointestinal (GI) events induced by nonoperative therapies in patients with neuroendocrine tumors (NETs) is unclear. Nonoperative therapies include somatostatin analogs, molecular targeted agents, cytotoxic chemotherapy, interferon-α, and peptide receptor radionuclide therapy. We undertook an up-to-date meta-analysis to determine the incidence and relative risks (RRs) of GI events in NET patients treated with these therapies. MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov were searched to identify relevant trials. Eligible trials were selected according to the PRISMA statement. Summary incidence, RR, and 95% CIs were calculated using random- and fixed-effects models. We included 2,890 patients from 17 randomized controlled trials in this meta-analysis. The experimental treatments led to increased incidence and risks of GI events compared to the control treatments (P