多西他赛联用替吉奥或卡培他滨治疗胃癌的成本—效果分析

目的比较替吉奥与卡培他滨分别联合多西他赛(TXT)治疗进展期胃癌的有效性、安全性及经济效果。方法试验分A、B两组,第1天均给予多西他赛75 mg/m2,静脉滴注2 h;第1～14天,A组每天给予卡培他滨2 000 mg/m2,B组每天给予替吉奥胶囊60 mg/m2,两组给药均分为两等份于早晚餐后0.5 h用水吞服,服用2周后休息1周,3周为1个周期,至少完成2个周期,最多完成6个周期后评价。结果 50例均可评价疗效。A、B两组的总有效率分别为46.21%和50.00%,疾病控制率为76.92%和75.00%(P>0.05),平均成本分别为17 158.90元和10 094.37元。成本–效果比分别为371.81和201.89。两组不良反应主要包括骨髓抑制、恶心呕吐、腹泻、口腔黏膜炎和手足综合征等,以1～2级为主,均可耐受。结论两组治疗晚期胃癌的疗效相当,不良反应均可耐受,但B组成本–效果明显低于A组,因此替吉奥联合多西他赛治疗进展期胃癌方法更优,值得临床推广。

Cost-effectiveness analysis for Gio Capsule and capecitabine in respective combination with docetaxel used for treating gastric cancer

Objective To compare the effectivity,safety,and economic effects on advanced gastric cancer of Gio Capsule and capecitabine combined with docetaxel(TXT) respectively.Methods Patients were divided into groups A and B: On day 1,TXT(75 mg/m2) was iv administrated for 2 h;On days 1―14,group A was administrated with capecitatime(2 000 mg/m2) and group B with Gio Capsule(60 mg/m2).The doses were divided into two equal parts and swallowed with water in half-hour after meal in the morning and evening.The administration was for two weeks and then one week rest,every three weeks as a cycle.The course of chemotherapy was repeated for three to four cycles.Results Fifty cases were available.The total effective rates of groups A and B were 46.26% and 50.00%,respectively;The disease control rates were 76.92% and 75.00%(P > 0.05);Average cost was 12 407.98 and 10 846.72 Yuan.The cost-effectiveness rates(C/E) were 268.86 and 195.24,respectively.The major adverse drug reactions of the two groups were bone marrow suppression,nausea,vomiting,diarrhea,oral mucositis,and hand foot syndrome,which were of grades 1―2 and could be tolerated.Conclusion Two groups have similar effects in the treatment of advanced gastric cancer and the adverse reactions could be tolerated.But the C/E of group B is significantly lower than that of group A,as a result Gio Capsule combined with TXT is better for treating advanced gastric cancer.