晚期非小细胞肺癌化疗及化疗联合吉非替尼治疗的临床疗效及药物经济学分析

Analysis on Clinical Effects and Pharmacoeconomics of Late Non-Small Cell Lung Cancer Chemotherapy and Chemotherapy Combined with Gefitinib

目的从药物经济学角度对化疗及化疗联合吉非替尼治疗晚期非小细胞肺癌(NSCLC)的临床疗效和成本-效果分析,为临床合理用药提供参考。方法将89例一线采用不同治疗方案的晚期NSCLC患者作为研究对象分为两组:西他赛、顺铂联合吉非替尼治疗的试验组52例,多西他赛联合顺铂治疗的对照组37例,均在治疗后评价患者的疗效和药物不良事件,并运用药物经济学的成本-效果分析法进行研究。结果试验组与对照组的有效率分别为50.0%和40.54%(P>0.05),两组患者的药物不良事件发生率比较差异无统计学意义(P>0.05)。两组患者的成本-效果比分别为357.93、87.14,试验组高于对照组。结论本研究两种用于晚期NSCLC的治疗方案均具有较好的治疗效果和安全性,虽然单独使用多西他赛联合顺铂较为经济,但多西他赛+顺铂联合吉非替尼方案的有效率更高,在患者经济许可的情况下可选择该治疗方案。临床需考虑肿瘤发展状态及患者指征合理选择治疗方案。

Objective To evaluate the clinical effects and the cost-effectiveness of chemotherapy and chemotherapy combined with Gefitinib in the treatment of late non-small cell lung cancer(NSCLC)and and to provide reference for clinical rational medical use.Methods A total of 89 patients with late NSCLC,receiving different medical treatments were divided into 2 groups:52 patients in the experimental group were treated with docetaxel,cisplatin and gefitinib,and 37 patients in the control group were treated with docetaxel and cisplatin.After the treatment,the efficacy and untoward effects of the two medicines were evaluated and pharmacoeconomic cost-effectiveness analysis was used to evaluate two medicines.Results Effective rates of the experimental group and control group were 50%and 40.54%,respectively(P>0.05).There was no significant difference in the incidence of adverse reactions of the two groups(P>0.05).Costs-effectiveness of the two group of patients were 357.93 and 87.14,respectively,with experimental group higher than the control group.Conclusion Both of the two treatment regimens for late NSCLC in this study have good therapeutic effect and are safe.Although the combination of docetaxel and cisplatin is more economical,the combination of docetaxel and cisplatin and gefitinib is more effective.And it can be chosen with the patient’s economic permission.The development of tumors and the indication of patients should be taken into account in rational clinical treatment.