晚期胃癌3种化疗方案的成本-效果分析

Cost-effectiveness Analysis of Three Chemotherapy Regimens for Advanced Gastric Cancer

目的:探讨晚期胃癌不同化疗方案的临床疗效和经济学效果。方法:58例晚期胃癌患者,根据不同治疗方案分为3组,运用药物经济学成本-效果分析方法,对3组治疗方案进行回顾性分析。A组:奥沙利铂85 mg.(m2)-1,iv,d1;亚叶酸钙200 mg.(m2)-1,iv,d1～2;5-Fu 400 mg.(m2)-1,iv,d1～2,600 mg.(m2)-1.d-1持续静脉滴注22 h,d1～2。B组:多西他赛75 mg.(m2)-1,iv,d1;DDP 30 mg.(m2)-1,iv,d1～3;5-Fu 500 mg.(m2)-1,iv,d1,d8。C组:卡培他滨2 000 mg.(m2)-1.d-1,po,d1～14;L-OHP 130 mg.(m2)-1,iv,d1。3组方案均以21 d为1个周期。结果:A组、B组和C组方案的有效率分别为33.3%、38.9%和43.8%。化疗1个疗程住院费用分别为5 063.7元、6 940.0元和6 951.9元。每获得1个单位效果,3组方案所需成本分别为152.1元、178.4元和158.7元,在A组方案的基础上,每增加1个单位效果,B组和C组所追加的成本分别为335.1元和179.8元。结论:本文研究结果提示,C组方案为治疗晚期胃癌的较好方案。

OBJECTIVE： To study the clinical efficacy and economic effectiveness of three different chemotherapy regimens in the treatment of advanced gastric cancer. METHODS ： A total of 58 patients with gastric cancer were divided into three groups according to the different chemotherapy regimens applied and retrospectively assessed by using cost-effectiveness analysis in pharmacoeconomics. Group A ： Oxaliplatin [ 85 mg·（m^2）^-1, iv, d1 ] plus Calcium Leucovorin [ 200 mg·（m^2）^-1, iv, d1-2 ] plus 5-Fu [ 400 mg·（m^2）^-1 , iv, d1-2 and 600 mg·（m^2）^-1·d^-1, iv, 22 h, d1- 2 ] ; Group B ： Docetaxel [75 mg·（m^2）^-1, iv, d1] plus DDP [30mg·（m^2）^-1, iv, d1-3] and 5-Fu [500 mg·（m^2）^-1, iv, d1and d8]; Group C： Capecitahine [2 000 mg·（m^2）^-1·d^-1, po, d1-14] plus L-OHP [130 mg·m^2, iv, d1 ]. One cycle of treatment lasted 21 days for all the three groups. RESULTS： The effective rates of the three groups were 33.3%, 38.9% and 43.8 %, respectively. The hospitalization costs for each course of chemotherapy treatment in the three groups were 5 063.7, 6 940.0 and 6 951.9 Yuan, respectively. The costs for each unit of effectiveness in Group A, B and C were 152.1, 178.4 and 158.7 Yuan respectively. On the basis of Group A, the supplemental cost for each unit increment of effectiveness was 335.1 Yuan in Group B and 179.8 Yuan in Group C. CONCLUSION： The results show that Group C is the preferable chemotherapy regimen for advanced gastric cancer.