两种新辅助化疗方案治疗进展期胃癌的成本-效果评价

A cost-effectiveness analysis of two neoadjuvant chemotherapy schemes for advanced gastric cancer

目的 评价两种新辅助化疗方案治疗进展期胃癌所产生的经济学效果.方法 2006年1月至2009年3月我院收治的53例进展期胃癌患者分别接受氟尿嘧啶＋多西他赛＋奥沙利铂（A方案组）和FOLFOX4（B方案组）新辅助化疗,观察其疗效及不良反应,并运用药物经济学的成本-效果分析法对两种方案进行分析评价.结果 两种化疗方案的平均总成本分别为21 320.01元和17 158.50元;化疗有效率为57.14%（16/28）和52.00%（13/25）（P〉0.05）;相应成本-效果比为373.12和329.97;总不良反应发生率为82.14%（23/28）和76.00%（19/25）（P〉0.05）.以B方案为基准,增量成本-效果为809.63.结论 B方案是进展期胃癌新辅助化疗的较佳用药方案.

Objective To explore the cost-effectiveness of two neoadjuvant chemotherapy schemes for the treatment of advanced gastric cancer.Methods Fifty-three patients from Jan.2006 to Mar.2009 of advanced gastric cancer underwent the neoadjuvant chemotherapy of Docetaxel＋Oxaliplatin＋Fluorouracil（scheme A）and FOLFOX4 （scheme B）,repectively.Therapeutic efficacy and adverse drug responses （ADRs） were observed.The pharmacoeconomics of cost- effectiveness analysis was performed on two schemes as well.Results The costs were RMB 21 320.01 yuan for scheme A and RMB 17 158.50 yuan for scheme B.The effective rates were 57.14%（16/28） in scheme A and 52.00%（13/25） in scheme B （P〉0.05）,and the cost-effectiveness ratio were 373.12 and 329.97 per effective rate respectively.The ADRs rates were 82.14%（23/28） and 76.00%（19/25） （P〉0.05）.The incremental cost- effectiveness ratio was 809.63 of scheme A as against scheme B.Conclusions The scheme B is a better neoadjuvant chemotherapy for advanced gastric cancer.