两种方案治疗晚期非小细胞肺癌的临床疗效及成本-效益比较研究

目的评价两种治疗方案对于晚期非小细胞肺癌(NSCLC)的临床疗效,探讨最具经济效益的治疗方案。方法采用随机、对照研究方法,将晚期NSCLC首治带瘤患者随机分为化疗组和中医综合组。以有效率、疾病控制率、生存期作为衡量指标,观察两种方案治疗两周期后的经济成本效益。结果治疗后化疗组和中医综合组的有效率分别为4.0%、16.0%,疾病控制率分别为28.0%、36.0%;直接成本分别为21 930.92(元)、23 642.24(元);有效率的成本/效益比分别为5 482.73、1 477.64;疾病控制率的成本/效益比分别为783.25、656.73;生存期的成本/效益比分别为38.07、25.61。增量分析法提示以化疗组作为参照,中医综合组的△C/△E有效、△C/△E疾病控制、△C/△E生存期为142.61、213.92、4.93。结论中医综合方案治疗晚期NSCLC,与化疗相比较,虽轻度增加成本,但可获得更好的有效率及较长的生存期,是一种经济、有效的治疗方案。

Comparative study on treatment of advanced nonsmall cell lung cancer by two methods

Objective To evaluate the clinical efficacy of two methods and search for a most cost-effective program for nonsmall cell lung cancer(NSCLC).Methods Fifty-two cases with advanced NSCLC were randomized into chemotherapy group(GroupⅠ,27 cases) and comprehensive group(Group Ⅱ,25 cases).The cost efficiency of the two methods were observed according to effective rate,disease control rate and life cycle.Results The effective rate was 4.0% in GroupⅠ and 16.0% in Group Ⅱ.The disease control rate was 28.0% in GroupⅠ and 36.0% in Group Ⅱ.The cost was 21 930.92 RMB and 23 642.24 RMB in GroupⅠ and Group Ⅱ,respectively.The cost/therapeutic effect ratios of disease control rate were 783.25 and 656.73 respectively;the cost/therapeutic effect ratios of life cycle were 38.07 and 25.61.The incremental analysis showed that △C/△E ratio of effective rate,disease control rate and life cycle in Group Ⅱ were 142.61,213.92 and 4.93 respectively.Conclusion Compared with chemotherapy,Chinese medicine is an effective and reasonable regimen for achieving better effective rate and prolonging life,although the cost is higher.