晚期结直肠癌三种化疗方案的成本-效果分析

Cost-effectiveness analysis of three chemotherapeutic regimens for advanced colorectal cancer

目的:探讨晚期结直肠癌不同化疗方案临床疗效和经济学效果。方法:92例晚期结直肠癌患者,根据不同治疗方案分为3组。FOLFOX方案:奥沙利铂85 mg·m-2,iv,d1;亚叶酸钙200 mg·m-2,iv,d1～2;氟尿嘧啶400 mg·m-2,iv,d1～2,600 mg·m-2·d-1,44 h持续静脉点滴,d1～2。14 d为一周期。FOLFIRI方案:伊立替康180 mg·m-2,iv,d1;亚叶酸钙200 mg·m-2,iv,d1～2;氟尿嘧啶400 mg·m-2,iv,d1～2,600 mg·m-2·d-1,44 h持续静脉点滴,d1～2。14 d为一周期。XELOX方案:卡培他滨2 000 mg·m-2·d-1,po,d1～14;奥沙利铂130 mg·m-2,iv,d1。21 d为一周期。运用药物经济学成本-效果分析方法,对3组治疗方案进行分析和评价。结果:FOLFOX方案、FOL- FIRI方案、XELOX方案的有效率分别为40．0％,48．6％,11．8％。化疗一个疗程住院费用分别为4 704．60元、11 167．25元、6 387．97元。在FOLFOX方案的基础上,每增加一个单位效果,FOLFIRI方案和XELOX方案所追加的成本分别为751．47元和-59．69元。结论:根据本研究结果表明,FOLFOX方案为晚期结直肠癌化疗的较好方案。

Objective ：To assess efficacy and pharmacoeconomics of three chemotherapeutic regimens in the treatment of advanced colorectal cancer. Methods ：92 patients with advanced colorectal cancer were categorized into three groups as per of their therapeutic regimens： FOLFOX scheme-oxaliplation 85 mg· m^- 2, iv, dl ; calcium folinate 200 mg· m^- 2, iv, d1 - 2 ; fluorouraci 400 mg· m^- 2, iv, d1 - 2,600 mg·m^-2 ·d^-1,44 h ,civ,d1 -2, in a 14-day cycle. FOLFIRI scheme-irinotecan 180 mg＇m ,iv,d1 ;calcium folinate 200 mg·m^-2,iv,d1 -2;fluorouraci 400 mg·m^-2, iv, d1 -2, 600 mg·m^-2 · d^-1 , 44 h civ, d1 - 2, in a 14-day cycle. XELOX scheme-capecitabine 2000 mg· m^-2·d^-1 , po, d1 - 14 ; oxaliplation 130 mg·m^-2, iv, d1 , in a 21-day cycle. The efficacy and costs of the three regimens were compared by using cost-effectiveness analysis. Results： The efficacy rate of FOLFOX, FOLFIRI and XELOX was 40. 0% , 48.6% and 11.8% , respectively, and the inhospitalization cost per chemotherapeutic cycle was ￥4 704.60, ￥ 11 167.25 and ￥6 387.97, respectively. The superadditive unit cost of FOLFOX followed by FOLFIRI or XELOX scheme reached at ￥751.47 and ￥ （-59.69） , respectively. Conclusion： FOLFOX scheme offered the best option in the chemotherapy of advanced eoloreetal cancer.