静脉与口服氟尿嘧啶方案一线治疗转移性结直肠癌的成本-效益分析

Drug Economic Comparison between Infusion Fluorouracil and Oral Fluorouracil in Treatment of Metastatic Colorectal Cancer

目的回顾性分析静脉与口服方案治疗转移性结直肠癌的疗效及药物成本经济学指标,为临床医生选择药物提供参考。方法初治的转移性结直肠癌,分两组进行姑息化疗:静脉组,奥沙利铂联合亚叶酸钙、5-FU双周方案;口服组,奥沙利铂联合卡培他滨3周方案。统计疗效、毒性及药物经济学数据并进行比较分析。结果 84例患者中,静脉组46例,有效率52.2,口服组38例,有效率47.4,差异无统计学意义(P>0.05);静脉组粒细胞减少和神经毒性发生率较高,口服组腹泻和手足综合征发生率较高,差异有统计学意义(P<0.05)。两组平均住院总费用相似;静脉组间接住院费用较高,口服组药费比例较高,差异有统计学意义(P<0.05);静脉组和口服组每单位效果成本分别为2064.7元和2082.5元,比较接近。结论治疗转移性结直肠癌,口服给药为主的XELOX方案药品费用比例较高,但间接住院费用较低,患者生活质量高,是更易被患者和医生接受的治疗方案。

Objective A research was performed to assess the clinical efficacy and cost-effectiveness of 2 different regimens（FOLFOX,XELOX） in treatment of metastatic colorectal cancer.Methods Chemotherapy-naive patients with MCRC were assigned to receive XELOX or FOLFOX.Clinical and drug economic data were collected and analyzed statistically.Results A total of 84 patients（XELOX n=38;FOLFOX n=46） were included in this research.ORR was 47.4% and 52.2% with XELOX and FOLFOX,respectively（P0.05）.XELOX patients had significantly more Hand-Foot syndrome and diarrhoea,but significantly less neutropenia and neuropathy than FOLFOX patients.The mean chemotherapy costs were similar between the two regimens.The indirect hospital costs were significantly lower in XELOX patients（P0.05）.The rate of drug cost of XELOX was 65.6% and statistically higher than 50.2% of FOLFOX（P0.05）.The C/E ratio of FOLFOX and XELOX were 2064.7 and 2082.5,respectively.Conclution Compare to FOLFOX with infusion drugs,XELOX with more oral drugs could give patients higher quality of life,higher drug cost ratio and lower indirect hospital costs.XELOX maybe a better regimen in treatment of MCRC.