四种化疗药物膀胱灌注预防浅表性膀胱癌经尿道膀胱肿瘤切除术后复发的成本-效果研究

目的评价4种不同药物预防浅表性膀胱癌经尿道膀胱肿瘤切除术(TURBt)后复发的经济学效果。方法回顾性分析2005年1月—2009年6月收治行TURBt的166例浅表性膀胱癌患者的临床资料。术后根据用药不同将患者分为4组,分别予以丝裂霉素C(MMC)、吡柔比星(THP)、羟基喜树碱(HCPT)、表柔比星(EPI)膀胱灌注,疗程12个月。观察4组患者疗效及不良反应,采用成本-疗效分析法进行评价。结果所有患者随访24个月。4组有效率间差异无统计学意义(P>0.05);THP组的不良反应发生率最高,HCPT组的不良反应发生率最低;MMC、THP、HCPT、EPI四组成本-效果比分别为7 045.69、13 878.49、9 709.59、11 729.25;THP、HCPT、EPI组相对于MMC组的增量成本-效果比分别为97 650.74、31 959.60、74 193.55。结论从药物经济学来看,HCPT组方案较佳。

Cost-effectiveness Analyses of Four Drugs as Prophylaxis for Recurrence in Patients with Superficial Bladder Tumors by Bladder Instillation after TURBt

Objective To evaluate the economic efficacy of four drugs as prophylaxis for recurrence in patients with superficial bladder tumors by bladder instillation after transurethral resection of bladder tumor(TURBt).Methods The data of 166 patients with superficial bladder tumors who were given the operation of TURBt from January 2005 to June 2009 were retrospectively analyzed.According to different drugs of bladder instillation,the patients were divided into four groups: Mitomycin(MMC) group,Pirarubicin(THP) group,Hydroxycamptothecin(HCPT) group and Epirubicin(EPI) group.All patients were treated for 12 months.The therapeutic efficacy and side effect were monitored,and the cost-effectiveness analyses were conducted.Results All cases were followed up for 24 months.There was no significant difference among the effective rates of four groups(P>0.05).The incidence rate of side effect was the highest in the THP group,was and the lowest in the HCPT group.The cost-effectiveness ratios were respectively 7 045.69,13 878.49,9 709.59 and 11 729.25.Compared with the MMC group,the incremental costs-effectiveness ratios in other three groups were respectively 97 650.74,31 959.60 and 74 193.55.Conclusion The HCPT remedy is the preferable in terms of economics.