两种新药方案治疗进展期胃癌成本效益比较

Cost Effectiveness Analyses of 2 Schemes for Advanced Gastric Cancer

目的:比较TCF方案治疗48例进展期胃癌(AGC)患者的疗效、不良反应及成本效益。方法:全组48例,其中TCF组22例,FOLFOX4组26例。化疗至少2个周期后评价疗效及不良反应。并进一步计算疾病控制成本。结果:TCF组有效率是50.0%,FOLFOX4组有效率为46.1%(P>0.05)。TCF组的中位疾病进展时间(TTP)为5.8月;FOLFOX4组的中位TTP为5.1月(P>0.05)。在Ⅲ、Ⅳ级毒性中,TCF组的恶心呕吐(44.7%)、脱发(16.4%)较为突出,神经毒性明显低于FOLFOX4组(18.7%)(P<0.05)。患者疾病控制期间每月所需成本为6 023.13元(TCF组)与6 150.04元(FOLFOX4组)。结论:TCF方案以较少的化疗周期获得与FOLFOX4方案相似的中位TTP,在一定程度上节约了医疗成本,值得进一步研究。

OBJECTIVE： To compare the curative effects of TCF and FOLFOX4 for 48 patients with advanced gastric cancer. METHODS： Of a total of 48 cases, 22 were assigned to receive TCF and 26 to receive FOLFOX4. The curative effects and adverse drug reactions of 2 groups were evahuated and the costs for disease control of the 2 were calculated. RESULTS： The effective rates of TCF group and FOLFOX4 group were 50.0% and 46.1%, respectively （ P 〉 0.05）, and the median TTP of the 2 groups was 5.8 months and 5. t months, respectively （ P 〉 0.05）. WHO grade 3 or 4 toxicities in TCF group were characterized by nausea and vomiting （44.7%）and Alopecia （16.4%）, and the neurotoxicity in this group was significantly lower than in FOLFOX4 group （18.7%）（ P 〉 0.05）. The monthly cost for discasc control was￥ 6 023.13 in TCF group and￥ 6 150.04 in FOLFOX4 group. CONCLUSION： TTP scheme is able to achieve the similar median as in FOLFOX4 group with less chemotherapy cycle so that the medical cost was saved, yet which remains to be further studied.