文章：

真实世界中辅助De Gramont方案与Xelox方案化疗用于可切除胃癌的疗效比较：一项倾向评分匹配分析（ASTER研究）

Real-world outcomes of Adjuvant De Gramont versus Xelox chemotherapy in reSected gasTric cancER: a propensity score-matched analysis (ASTER study)

原文发布日期：2025-07-26 

英文摘要：

The role of adjuvant chemotherapy (aCT) in gastric and esophago-gastric junction cancer (GC/EGJC) remains controversial. This study (ASTER study) aimed to compare the clinical outcomes of De Gramont (DG) versus XELOX/FOLFOX (OXA) regimens in a European real-world setting. This retrospective, bicentric study included patients treated with aCT between January 2001 and January 2018. A propensity score-matched (PSM) analysis was performed to compare oncological outcomes between DG and OXA regimens. Primary endpoints were disease-free survival (DFS) and overall survival (OS). Statistical analyses included the chi-square test, Kaplan–Meier method, and Cox proportional hazards modeling. Among 255 patients (127 DG, 128 OXA), 160 were matched (80 per arm) by PSM. Median DFS and OS did not differ significantly between groups (mDFS: 102.3 vs. 85.4 months, p = 0.91; mOS: 119.5 vs. 89.8 months, p = 0.69). In PSM-adjusted analysis, DG showed a trend towards longer DFS (p = 0.052) and significantly improved OS (p = 0.016). Multivariate analysis confirmed age, ECOG PS, resection margins, and stage as major prognostic factors. DG and OXA regimens demonstrated similar efficacy in the adjuvant treatment of resected GC/GEJC in a European cohort. Further prospective studies are warranted to optimize regimen selection and refine patient stratification.

摘要翻译：

辅助化疗（aCT）在胃癌和食管胃结合部癌（GC/EGJC）中的作用仍存在争议。本研究（ASTER研究）旨在比较欧洲真实世界环境下De Gramont（DG）方案与XELOX/FOLFOX（OXA）方案的临床结局。这项回顾性、双中心研究纳入了2001年1月至2018年1月期间接受a治疗的患者。通过倾向评分匹配（PSM）分析比较DG与OXA方案的肿瘤学结局。主要终点为无病生存期（DFS）和总生存期（OS）。统计分析包括卡方检验、Kaplan-Meier法和Cox比例风险模型。在255例患者（127例DG，128例OXA）中，通过PSM成功匹配160例（每组80例）。两组的中位DFS和OS无显著差异（mDFS：102.3个月 vs 85.4个月，p=0.91；mOS：119.5个月 vs 89.8个月，p=0.69）。经PSM校正后分析显示，DG方案呈现较长DFS的趋势（p=0.052）且OS显著改善（p=0.016）。多变量分析证实年龄、ECOG PS状态、切除边缘和分期是主要预后因素。在欧洲队列中，DG和OXA方案在切除后GC/GEJC的辅助治疗中表现出相似疗效。需要进一步前瞻性研究以优化方案选择和细化患者分层。

原文链接：

Real-world outcomes of Adjuvant De Gramont versus Xelox chemotherapy in reSected gasTric cancER: a propensity score-matched analysis (ASTER study)