Xelox及mFOLFOX-6方案治疗晚期结直肠癌药物经济学比较.docVIP

Xelox及mFOLFOX-6方案治疗晚期结直肠癌药物经济学比较摘 要 目的：通过前瞻性研究，观察比较Xelox与mFOLFOX-6方案治疗晚期结直肠癌的疗效、毒副作用及药物经济学指标，为临床医生选择药物提供参考。方法：初治的晚期结直肠癌患者分两组进行姑息化疗：Xelox组(奥沙利铂联合卡培他滨3周方案)和mFOLFOX-6组（奥沙利铂联合亚叶酸钙、氟尿嘧啶2周方案），密切随访，统计疗效、毒性及药物经济学数据并进行统计学分析。结果：共84例患者完成既定治疗方案，其中Xelox组有效率47.4%，mFOLFOX-6组有效率52.2%，差别无统计学意义（P＞0.05）；mFOLFOX-6组粒细胞减少和神经毒性发生率较高，Xelox组腹泻和手足综合征发生率较高，差异有统计学意义（P＜0.05）。两组平均住院总费用相似；Xelox组平均住院7.3次、住院55.0 d，显著低于mFOLFOX-6组的9.3次和88.3 d（P＜0.05）。但Xelox组药品所占费用比例65.6%，高于mFOLFOX-6组的50.2%（P＜0.05）。结论：两个方案的疗效相似，毒性不同。与mFOLFOX-6方案相比，Xelox方案住院总费用与之相似，药品费用比例较高，但住院次数少，住院天数较短，临床实践中医生可以根据实际情况选择不同化疗方案。 关键词 结直肠癌 卡培他滨 氟尿嘧啶 药物经济学 中图分类号：R956；R979.1 文献标识码：B 文章编号：1006-1533(2011)12-0594-04 Clinical and drug economic comparison between Xelox and mFOLFOX-6 in treatment of metastatic colorectal cancer WANG Wei，LIN Xiu-qiang，HU Bin，ZHAO Ying，XU Qi-hua，Lin Ben，ZHAO Li-rong （Department of Medical Oncology，the First People s Hospital of Foshan City，Foshan，528000） ABSTRACT Objective: A prospective study was performed to evaluate the clinical efficacy，side effects and costs of two different regimens (mFOLFOX-6，Xelox) in treatment of metastatic colorectal cancer (MCRC). Methods: Chemotherapy-naive patients with MCRC were assigned to receive Xelox （oxaliplatin and capecitabine） or mFOLFOX-6（oxaliplatin，leucovorin and 5-Fu）. The patients were followed-up intensively. Clinical and drug economic data were collected and analyzed statistically. Results: A total of 84 patients (Xelox n = 38；mFOLFOX-6 n = 46) completed the planned schedules. Obejective response rates（ORR） were 47.4% and 52.2% with Xelox and mFOLFOX-6，respectively （P＞0.05）. Xelox patients had significantly more hand-foot syndrome and diarrhea，but significantly less neutropenia and neuropathy than mFOLFOX-6 patients. The mean chemotherapy costs were similar between the two regimens. The mean hospitalization times and days were significantly lower in Xelox patients：7.3 vs 9.3 times and 55.0 vs 88.3 days，respectively （P＜0.05）. The rate of drug cost o