恶性肿瘤患者医用直线加速器放射治疗的经济性评价

Economic evaluation of linear accelerator radiation therapy for patients with malignant tumors at hospitals in China

对医用直线加速器立体定向放射治疗和调强适形放射治疗(以下简称调强放疗)两种方法治疗恶性肿瘤进行成本-效果分析,为患者选择更具有成本效果优势的放疗手段提供参考.方法 2017年6月至2018年11月,收集湖北、广西、福建3个省份的320例恶性肿瘤(肺部肿瘤、头颈部肿瘤、骨转移瘤、肝脏肿瘤)放疗患者的基本情况(包括性别、年龄、入院日期、住院天数等)、住院费用、入院诊断、临床效果等资料,对患者住院放疗成本和治疗效果进行研究,比较两种方式的成本-效果比.结果 320 例患者中立体定向放疗109 例,调强放疗211 例,其有效率分别为99.1%(108/109)和97.2%(205/211),差异无统计学意义(P>0.05);两组患者的平均住院成本分别为37 545.56元和48 159.05元;其成本-效果比分别为37 886.54和49 546.35.结论立体定向放疗和调强放疗的近期疗效相似,但调强放疗的治疗成本较高,立体定向放疗更具有经济学优势.

Objective To make a cost-effectiveness analysis for stereotactic radiotherapy and intensity-modulated radiotherapy using linear accelerators against malignant tumors, then to provide references for choosing a more cost-effective radiotherapy for the patient. Methods Basic information of patients subject to radiotherapy(gender, age, date of admission, days of hospital stay), hospitalization cost, admission diagnosis, clinical outcomes among others of 320 patients with malignant tumors(lung tumor, head and neck tumor, bone metastases, liver tumor)were collected from Hubei, Guangxi and Fujian provinces.The cost of hospitalized radiotherapy and treatment effect of these patients were compared to identify the more cost effective of the two methods. Results The effective rates of stereotactic radiotherapy and intensity-modulated radiotherapy were 99.1%(108/109) and 97.2%(205/211) respectively, and the difference was not significant(P>0.05). The average hospitalization cost of treatment of the two groups was 37 545.56 yuan and 48 159.05 yuan respectively;the cost-effectiveness ratio was 37 886.54 and 49 546.35 respectively. Conclusions The short-term effects of stereotactic and intensity-modulated radiotherapy are similar, but the cost of intensity-modulated radiotherapy is higher.The minimum cost analysis shows that stereotactic radiotherapy is more cost effective.