Guo Yanan, Zheng Tongsen, Zhang Chunhui, Zhang Yanqiao
Department of Gastrointestinal Medical Oncology, Harbin Medical University Cancer Hospital, Institute of Prevention and Treatment of Cancer of Heilongjiang Province, Harbin Heilongjiang 150081, China.
Department of Phase I Clinical Trials, Harbin Medical University Cancer Hospital.
J Cancer. 2020 Jan 20;11(7):1839-1845. doi: 10.7150/jca.36929. eCollection 2020.
To compare the 2-year overall survival (OS) rate and safety between patients using S-1 and capecitabine in the first-treatment of metastatic colorectal cancer in the real clinical setting. In this retrospective cohort study, patients satisfying the following criteria were identified from 10 centers in China. The 2-year OS rate and safety were assessed. The propensity score matching (PSM) was used to control basic characteristics of the two groups to balance the processing bias and confoundings. A total of 1367 patients were identified, 824 patients accepted capecitabine and 546 patients accepted S-1. After PSM, 533 eligible patients were included in each group without statistical significance in age, sex, BMI, KPS score and comorbidities. The 2-year OS rate between two groups was without significant statistical difference (61.9% vs. 62.9%, p=0.4295). The subgroup analysis showed that the 2-year OS rate had no significant difference between men and women, younger and older than 60 years old, different metastatic sites, different chemotherapy courses between S-1 and capecitabine groups. The hematological adverse events were all without statistical difference between two groups, but the incidence of diarrhea (16.4% vs. 23.6%, p=0.0018) and hand-foot syndrome (28.7% vs. 46.7%, p<0.001) in S-1 group were lower than those in the capecitabine group. Compared to capecitabine, S-1 had a similar 2-year OS rate but had a lower incidence of adverse events in the real clinical setting. So, S-1 could be a good choice in the first-treatment of patients with metastatic colorectal cancer in China.
在真实临床环境中，比较使用S-1和卡培他滨进行一线治疗的转移性结直肠癌患者的2年总生存率（OS）和安全性。在这项回顾性队列研究中，从中国10个中心筛选出符合以下标准的患者。评估2年总生存率和安全性。采用倾向评分匹配（PSM）来控制两组的基本特征，以平衡处理偏倚和混杂因素。共识别出1367例患者，824例接受卡培他滨治疗，546例接受S-1治疗。经过PSM后，每组纳入533例符合条件的患者，两组在年龄、性别、BMI、KPS评分和合并症方面无统计学差异。两组之间的2年总生存率无显著统计学差异（61.9%对62.9%，p = 0.4295）。亚组分析显示，S-1组和卡培他滨组在男性和女性、年龄小于60岁和大于60岁、不同转移部位、不同化疗疗程之间的2年总生存率无显著差异。两组血液学不良事件均无统计学差异，但S-1组腹泻发生率（16.4%对23.6%，p = 0.0018）和手足综合征发生率（28.7%对46.7%，p < 0.001）低于卡培他滨组。在真实临床环境中，与卡培他滨相比，S-1的2年总生存率相似，但不良事件发生率较低。因此，S-1可能是中国转移性结直肠癌患者一线治疗的良好选择。
