长春瑞滨联合卡铂与联合顺铂治疗晚期乳腺癌对照研究

A control study of vinorelbine plus carboplatin or cisplatin in the treatment of advanced breast cancer

目的评价长春瑞滨联合卡铂与联合顺铂治疗晚期乳腺癌患者的临床疗效、安全性及成本-效果。方法将68例晚期乳腺癌患者随机分为两组各34例，研究组给予长春瑞滨联合卡铂治疗，对照组给予长春瑞滨联合顺铂治疗，观察2个周期（56d），随访2a。于治疗后对两组临床疗效、生存质节、不良反应及成本效果进行对比分析。结果治疗后研究组有效率41．18％，对照组为38．24％，两组比较无显著性差异（P〉0．05）；研究组生存质量好转率显著高于对照组（P〈0．01）；0．5a、1a生存率高于对照组，但差异无显著性（P均〉0．05）；研究组平均治疗成本为4912．3元，对照组为6390．6元；研究组成本-效果显著低于对照组；药品价格对成本-效果的影响最大。研究组恶心呕吐、Ⅲ～Ⅳ度白细胞降低、血小板减少等不良反应发生率均显著低于对照组（P〈0．05或0．01）。结论两组疗效相当，但长春瑞滨联合卡铂治疗近期临床疗效较为满意，患者生存质量高，不良反应发生率低，治疗成本低廉，可作为治疗晚期乳腺癌的优选方案。

Objective To evaluate the clinical efficacy,safety and cost effectiveness of vinorelbine plus ear boplatin or cisplatin in the treatment of advanced stage breast cancer. Methods Sixty-eight patients with advanced stage breast cancer were randomly divided into two groups of 34 ones each, research group re ceived vinorelbine plus carboplatin and control group did vinorelbine plus cisplatin for two periods, and followed up for two years. After treatment, efficacy, quality of life, adverse reactions and cost-effectiveness of the 2 groups were contrastively analyzed. Results After treatment, effective rates were respectively 41.18% in the research and 38.24% in the control,which showed no significant difference（P〉0.05） ;compared with control group,the improvement rate of quality of life was significantly higher（P〈0.01）; sur vival rates of six months and one year were higher in the research, group differences not significant（both P〈0.05） ;The mean costs were respectively 3 671.9 yuan in the research and 3653 yuan in the control; the cost-effectiveness was significantly lower in the research than in the control group; drugs＇ prices had the most effect on cost-effectiveness. Incidences of nausea, vomiting, Grade 3 - 4 leukopenia decrease and thrombocytopenia were significantly lower in the research than in the control group（P〈0.05 or 0.01）. Conclusion Curative effects of the two groups are equivalent, but shortterm efficacy of vinorelbine com bined with carboplatin is more satisfactory, patients＇ quality of life higher, incidence of adverse reaction low,cost cheap and can be regarded as the preferred plan for advanced breast cancer.