曲妥珠单抗治疗HER-2阳性乳腺癌成本-效果分析及对用药依从性的影响

Cost-Efficacy Analysis and Influence on Compliance of Trastuzumab for Treating HER-2 Positive Breast Cancer

目的比较曲妥珠单抗与CAF化疗2种方案治疗HER-2阳性乳腺癌的成本-效果及患者的依从性。方法选取2013年1月至2015年1月医院收治的HER-2阳性乳腺癌患者96例,随机分为对照组和观察组,各48例。对照组患者给予常规CAF化疗方案治疗,观察组患者给予曲妥珠单抗治疗,治疗时间均为18周。比较两组患者的临床疗效,检测实体肿瘤长径及血清肿瘤标志物水平变化,运用药物经济学方法对2种方案的成本-效果进行分析,观察两组患者治疗前后卡氏生活质量(KPS)评分及用药依从性,记录不良反应的发生情况。结果治疗后,观察组总有效率为60.42%,显著高于对照组的41.67%(P<0.05)。观察组实体肿瘤长径较对照组更短(P<0.05),肿瘤标记物,如癌胚抗原(CEA)、癌抗原153(CA153)、CA125水平较对照组更低(P<0.05);观察组成本-效果比值为1131.36,明显低于对照组的1500.71(P<0.05),若对照组增加1%的疗效,需追加成本19.70元。治疗后观察组KPS改善率为89.58%,显著高于对照组的81.25%(P<0.05),两组患者依从性及不良反应未见明显差异(P>0.05)。结论曲妥珠单抗治疗HER-2阳性乳腺癌,能显著提高临床疗效,降低肿瘤标志物水平,其成本-效果比显著优于CAF化疗方案,还能改善患者生存质量,依从性好,不良反应少,值得临床推广。

Objective To compare the cost-efficacy and the influence for compliance of trastuzumab injection in treating HER-2 positive breast cancer.Methods 96 patients with HER-2 positive breast cancer in the hospital were randomly divided into the observation group and the control group,48 cases in each group.The control group was treated with CAF regimen,the observation group was treated with trastuzumab.Both groups were treated 18 weeks.The clinical effect was compared,the level of the tumor marker and the length of solid tumor were detected and recorded,the cost-efficacy analysis of these two observation were calculated by the method of economics /the score of KPS and the compliance and the adverse reactions during the observation were observed.Results After treatment,the total effective rate of the observation group were 60.42%,which was significantly higher than 41.67%of the control group（P〈0.05）.Compared with the control group,the length of solid tumor in the observation group were shorten（P〈0.05）,and the level of the tumor marker CEA,CA153,CA125 were decreased（P〈0.05）,the cost-efficacy ratio in the observation group was 1 131.36,which was significantly lower than 1 500.71 in the control group（P〈0.05）,if the control group wanted to increase the effective rate,about19.70 yuan should be added to.The improvement rate of KPS in the observation group were 89.58%,which was significantly higher than 81.25%of the control group（P〈0.05）.The compliance and adverse reactions rate had no significantly difference in the two groups（P〉0.05）.Conclusion Trastuzumab for treating HER-2 positive breast cancer has good effect,and can reduce the level of the tumor marker,the cost-efficacy analysis were supenor to the CAF regimen.It can improve the survival quality of the patients with good compliance,and has less adverse reactions,which is worthy of clinical promotion.