背景:辅助化疗(AC)方案替加氟/吉马拉西/奥瑟拉西(S-1)和卡培他滨联合奥沙利铂(CAPOX)占主导地位,然而,一直缺乏关于它们疗效差异的研究.方法:我们进行了配对荟萃分析,比较了S-1和CAPOX方案对II期或III期GC患者的总生存期(OS)和无病生存期(DFS)的疗效。结果:纳入了三项研究,并使用森林地块进行了荟萃分析。其中两项是倾向得分匹配研究,其余一项为回顾性观察性研究.在所有阶段,两种方案的5年OS无差异(HR0.96,95%CI0.78~1.17;p=0.56).此外,5年DFS在任何阶段均无差异(HR1.00,95%CI0.85-1.18;p=0.21).在省略回顾性观察研究后,S-1的五年OS(HR1.40,95%CI0.53-3.73)和DFS(HR1.41,95%CI0.57-3.44)在第二阶段趋于更好,CAPOX的五年OS(HR0.81,95%CI0.56-1.16)和DFS(HR0.85,95%CI0.63-1.13)在第三阶段趋于更好,没有统计学意义。结论:在本荟萃分析中,在S-1和CAPOX方案中,II期或III期GC患者的5年OS和DFS与AC具有可比性.
Background: Adjuvant chemotherapy (AC) regimens tegafur/gimeracil/oteracil (S-1) and capecitabine plus oxaliplatin (
CAPOX) have predominated, however, there has been a lack of studies on their differences in efficacy. Methods: We conducted pairwise meta-analyses comparing the efficacy of S-1 and
CAPOX regimens for overall survival (OS) and disease-free survival (DFS) in stage II or III GC patients. Results: Three studies were enrolled and analyzed using a forest plot for meta-analysis. Two of them were propensity score matching studies, and the remaining one was a retrospective observational study. In all stages, the five-year OS was not different between the two regimens (HR 0.96, 95% CI 0.78-1.17; p = 0.56). Additionally, the 5-year DFS was not different at any stage (HR 1.00, 95% CI 0.85-1.18; p = 0.21). After omitting the retrospective observational study, the five-year OS (HR 1.40, 95% CI 0.53-3.73) and DFS (HR 1.41, 95% CI 0.57-3.44) of S-1 tended to be better in stage II, and the five-year OS (HR 0.81, 95% CI 0.56-1.16) and DFS (HR 0.85, 95% CI 0.63-1.13) of
CAPOX tended to be better in stage III, without statistical significance. Conclusions: In the present meta-analysis, the five-year OS and DFS for stage II or III GC patients were comparable between S-1 and
CAPOX regimens as AC.