不同化疗方案治疗晚期非小细胞肺癌临床分析及药物经济学评价

目的比较4种化疗方案治疗晚期非小细胞肺癌的有效性、安全性及经济性。方法选择122例原发性非小细胞肺癌患者为研究对象。将患者按治疗方案分为培美曲塞+顺铂(PP)组(n=35)、吉西他滨+顺铂(GP)组(n=29)、多西他赛+顺铂(DP)组(n=28)和紫杉醇+顺铂(TP)组(n=30)。比较4组患者的疗效、不良反应和药物经济学评价。结果 4组(PP组、GP组、DP组、TP组)化疗方案有效率分别为42.9%、41.4%、42.9%、23.3%(P>0.05);疾病控制率分别为94.3%、93.1%、92.9%、83.3%(P>0.05);骨髓抑制不良反应发生率分别为85.7%、89.6%、71.4%、76.7%(P>0.05);胃肠道反应发生率分别为82.8%、86.1%、96.4%、96.7%(P>0.05);花费成本分别为40 510.48元、5 819.44元、7 323.48元、3 490.56元。结论 4组化疗方案中,PP组的有效率和疾病控制率最佳,但4组总体的有效率和疾病控制率差异并无统计学意义(P>0.05)。PP组胃肠道反应发生率最低,DP组骨髓抑制发生率最低,但4组总体的不良反应发生率差异无统计学意义(P>0.05)。PP组花费的成本最高,TP组最低,根据最小成本分析法,TP组最为经济。

Different chemotherapeutic programs in the treatment of advanced non-small cell lung cancer and pharmacoeconomic evaluation

Objective To compare the effectiveness,security and efficiency of four chemotherapeutic programs for advanced non-small cell lung cancer(NSCLC).Methods The 122 NSCLC patients were randomly divided into four groups such as Pemetrexed combined with Cisplatin group(PP group,n =35),Gemcitabine combined with Cisplatin group(GP group,n =29),Docetaxel combined with Cis platin group (DP group,n =28) and Taxol combined with Cisplatin group (TP group,n =30).The therapeutic effect,adverse reaction and pharmacoeconomic evaluation were compared among the four groups.Results The objective response rate(ORR) of chemothera py regimens in four groups (PP,GP,DP and TP) were 42.9％,41.4％,42.9％ and 23.3％,respectively (P ＞ 0.05);disease control rates (DCR) were 94.3 ％,93.1％,92.9 ％ and 83.3 ％,respectively (P ＞ 0.05);the occurrence rate of adverse reaction of bone marrow suppression were 85.7％,89.6％,71.4％ and 76.7％,respectively (P ＞ 0.05);the rates of gastrointestinal adverse reactions were 82.8％,86.1％,96.4％ and 96.7 ％,respectively (P ＞ 0.05);the average cost of each group were 40 510.48 yuan,5 819.44 yuan,7 323.48 yuan and 3 490.56 yuan(RMB),respectively.Conclusion In the four groups,PP group has the strongest ORR and DCR,while there is no statistically significant difference among the four groups (P ＞ 0.05).PP group has an advantage of the lowest incidence rate of gastrointestinal adverse reaction,and DP group has an advantage of the lowest incidence rate of bone marrow suppression adverse reaction,while there is no statistically significant difference among the four groups(P ＞ 0.05).The cost of PP group is the highest,while TP group was the lowest.To evaluate the cost-minimization of four chemotherapy regimens,TP group is the most ecnomical.