晚期胃癌3种化疗方案的成本-效果分析

目的：探讨晚期胃癌不同化疗方案的临床疗效和经济学效果。方法：58例晚期胃癌患者，根据不同治疗方案分为3组，运用药物经济学成本-效果分析方法，对3组治疗方案进行回顾性分析。A组：奥沙利铂85 mg·（m^2）^-1，iv，d1；亚叶酸钙200 mg·（m^2）^-1，iv，d1～2；5-Fu 400 mg·（m^2）^-1，iv，d1～2，600 mg·（m^2）^-1·d^-1持续静脉滴注22 h，d1～2。B组：多西他赛75 mg·（m^2）^-1，iv，d1；DDP 30 mg·（m^2）^-1，iv，d1～3；5-Fu 500 mg·（m^2）^-1，iv，d1，d8。C组：卡培他滨2 000 mg·（m^2）^-1·d^-1，po，d1～14；L-OHP 130 mg·（m^2）^-1，iv，d1。3组方案均以21 d为1个周期。结果：A组、B组和C组方案的有效率分别为33.3%、38.9%和43.8%。化疗1个疗程住院费用分别为5 063.7元、6 940.0元和6 951.9元。每获得1个单位效果，3组方案所需成本分别为152.1元、178.4元和158.7元，在A组方案的基础上，每增加1个单位效果，B组和C组所追加的成本分别为335.1元和179.8元。结论：本文研究结果提示，C组方案为治疗晚期胃癌的较好方案。

Cost-effectiveness Analysis of Three Chemotherapy Regimens for Advanced Gastric Cancer

OBJECTIVE： To study the clinical efficacy and economic effectiveness of three different chemotherapy regimens in the treatment of advanced gastric cancer. METHODS ： A total of 58 patients with gastric cancer were divided into three groups according to the different chemotherapy regimens applied and retrospectively assessed by using cost-effectiveness analysis in pharmacoeconomics. Group A ： Oxaliplatin [ 85 mg·（m^2）^-1, iv, d1 ] plus Calcium Leucovorin [ 200 mg·（m^2）^-1, iv, d1-2 ] plus 5-Fu [ 400 mg·（m^2）^-1 , iv, d1-2 and 600 mg·（m^2）^-1·d^-1, iv, 22 h, d1- 2 ] ; Group B ： Docetaxel [75 mg·（m^2）^-1, iv, d1] plus DDP [30mg·（m^2）^-1, iv, d1-3] and 5-Fu [500 mg·（m^2）^-1, iv, d1and d8]; Group C： Capecitahine [2 000 mg·（m^2）^-1·d^-1, po, d1-14] plus L-OHP [130 mg·m^2, iv, d1 ]. One cycle of treatment lasted 21 days for all the three groups. RESULTS： The effective rates of the three groups were 33.3%, 38.9% and 43.8 %, respectively. The hospitalization costs for each course of chemotherapy treatment in the three groups were 5 063.7, 6 940.0 and 6 951.9 Yuan, respectively. The costs for each unit of effectiveness in Group A, B and C were 152.1, 178.4 and 158.7 Yuan respectively. On the basis of Group A, the supplemental cost for each unit increment of effectiveness was 335.1 Yuan in Group B and 179.8 Yuan in Group C. CONCLUSION： The results show that Group C is the preferable chemotherapy regimen for advanced gastric cancer.