ObjectiveTo assess the effectiveness and safety of capacitance combined with irinotecan (CAPIRI) versus fluorouracil combined with irinotecan (FOLFIRI) for patients with advanced metastatic colorectal cancer. MethodsDatabases such as Pubmed, Embase, Wanfang data, CNKI, Cochran Library were searched from January 2000 to October 2015. We evaluated the quality of randomized controlled trials (RCTs) and then extracted data from them. RevMan 5.2 software was used to perform the meta-analysis. ResultsEight RCTs studies with 1 634 advanced metastatic colorectal cancer patients were included based on our standard. CAPIRI regimen was equal to FOLFIRI regimen in complete response rate [RR=1.17, 95%CI (0.70, 1.96), P=0.56], overall respond rate [RR=0.90, 95%CI (0.79, 1.03), P=0.12], disease control rate [RR=0.93, 95%CI (0.87, 1.00), P=0.06], median progression-free survival [HR=1.00, 95%CI (0.72, 1.37), P=0.99], and median overall survival [HR=0.94, 95%CI (0.63, 1.40), P=0.77]. For safety, higher incidence rate of grade 3/4 vomiting [RR=1.91, 95%CI (1.13, 3.22), P=0.02], diarrhea [RR=2.84, 95%CI (2.22, 3.63), P<0.000 01], hand-foot syndrome [RR=4.55, 95%CI (2.15, 9.61), P<0.000 1] were confirmed for CAPIRI. The two methods had similar toxicities: nausea [RR=0.77, 95%CI (0.64, 0.93), P=0.005], fatigue [RR=1.19, 95%CI (0.73, 1.94), P=0.47], febrile neutropenia [RR=1.59, 95%CI (0.89, 2.87), P=0.12], anemia [RR=1.74, 95%CI (0.59, 5.18), P=0.32], and leukopenia [RR=0.77, 95%CI (0.64, 0.93), P=0.005]. ConclusionCapecitabine combined with irinotecan treatment for advanced colorectal cancer is effective and its toxicity is acceptable.