晚期非小细胞肺癌3种EGFR-TKI 治疗的临床疗效及药物经济学分析

目的：从药物经济学角度对治疗晚期非小细胞肺癌的3种表皮生长因子受体酪氨酸激酶抑制剂（EGFR-TKI）的临床疗效和成本原效果进行评价和分析，为临床合理用药提供参考。方法118例一线采用EGFR-TKI 治疗的晚期非小细胞肺癌患者分为3组：厄洛替尼组（38例），吉非替尼组（43例）和埃克替尼组（37例），均在治疗后评价疗效和药物不良事件，并运用药物经济学的成本原效果分析法进行研究。结果厄洛替尼组、吉非替尼组、埃克替尼组的有效率分别为71.05%、74.42%和67.57%（P >0.05）；药物不良事件发生率比较差异均无统计学意义（P 均>0.05）。3组的成本原效果比分别为268.30、201.63、182.28，埃克替尼组显著低于厄洛替尼组、吉非替尼组。结论本研究的3种 EGFR-TKI 用于晚期非小细胞肺癌的治疗均具有较好的治疗效果和安全性，其中埃克替尼是最经济的。

Clinical Effect and Pharmacoeconomics Analysis of EGFR-TKI in the Treatment of Advanced Non-small Cell Lung Cancer

Objective To evaluate the clinical effect and the cost-effectiveness of three epidermal growth factor receptor-tyrosine kinase inhibitors(EGFR-TKI)in the treatment of advanced non-small cell lung cancer for the pur-pose of higher quality medical care. Methods The 118 patients with non-small cell lung cancer received the EG-FR-TKI treatment were divided into three groups:the erlotinib group(n = 38),the gefitinib group(n = 43)and the icotinib group(n = 37). The efficacy of the three drugs was evaluated. Pharmacoeconomic cost-effectiveness analysis was used to evaluate three drugs. Results The effective rates of the erlotinib group,the gefitinib group and the ico-tinib group were 71. 05% ,74. 42% and 67. 57%(P > 0. 05),respectively. There was no statistical difference in the toxicities among the three groups(P > 0. 05). The cost-effectiveness ratio of the erlotinib group,the gefitinib group and the icotinib group were 268. 30,201. 63 and 182. 28,respectively,the icotinib group was significantly lower than the erlotinib group and the gefitinib groups. Conclusion Three EGFR-TKI are safe and effect in the treatment of advanced non-small cell lung cancer,icotinib is the most economical EGFR-TKI protocol.