4种化疗方案治疗结直肠癌不良反应治疗成本分析

Analysis on ADR treatment cost of the four chemotherapy regimens for colorectal cancer

目的:探讨卡培他滨与5-氟尿嘧啶(5-FU)治疗结直肠癌化疗方案的药品不良反应(ADR)的药物经济学分析。方法:比较单药组卡培他滨口服与5-FU静脉注射或分别联用奥沙利铂治疗结直肠癌的ADR治疗费用分析。结果:口服卡培他滨组与5-FU组和XELOX组与FOLFOX4组疗效相近。卡培他滨组平均每个疗程医疗总费用低于5-FU组(P=0.008),ADR治疗费用也低于5-FU组(P=0.029);XELOX组医疗总费用低于FOLFOX4组(P=0.028),ADR治疗费用也低于FOLFOX4组(P=0.038)。卡培他滨组ADR发生率较低,主要是轻度的手足综合症,而5-FU组主要是白细胞降低及胃肠道反应;与FOLFOX4组比较,XELOX组ADR发生率较低,ADR患者经过对症治疗后,患者均治愈及好转,生活质量没有较大变化。结论:从药物经济学和用药安全角度看,卡培他滨在结直肠癌的治疗中优于5-FU,XELOX方案优于FOLFOX4方案。

OBJECHVE To analyze the pharmacoeconomics on ADR treatment cost of colorectaI cancer with capecitabine or 5-FU（5-fluorouracil）. METHODS Single medicine group capeeitabine or 5 FU, or which combinated respectively with oxali- platin to treat colorectal cancer was compared by observing their effects, adverse drug reactions （ADR） and ADI treatment costs evaluated with pharmacoeconomic analysis. RESULTS The curative effects of the capecitabine group and the 5-FU group, or the XELOX group and the FOLFOX4 group were similar. The total fee of average each medical treatment of capecit- abine group（P = 0. 008） or its ADR treatment cost（P = 0. 029） was respectively lower than that of 5-FU group. The average to- tal medical cost（P = 0. 028）or its ADR treatment cost （P = 0. 03B）of XELOX group was obviously lower than that of FOL- FOX4 group. The ADR incidence in capecitabine group was lower than 5-FU group, which is mainly hand-foot syndrome in capecitabine group,and neutrophils reduction and gastrointestinal tract reaction in 5 FU. ADR incidence of XELOX was lower than that of FOLFOX4. Most of the ADR patients treated were recovered health and their living quality changed little. CON- CLUSION In view of pharmacoeconomics and safe,capecitabine is better than 5-FU,and XELOX scheme is better than FOL- FOX4 sclaeme in the treatment of colorectal cancer.