三种植物来源抗肿瘤药物在晚期食管癌中临床评价和药物经济学分析.docVIP

三种植物来源抗肿瘤药物在晚期食管癌中的临床评价和药物经济学分析 　　【关键词】抗肿瘤药物；食管癌；药物经济学 　　【中图分类号】R73.5【文献标识码】A【文章编号】1008-6455（2011）10-0010-02Clinical Evaluation and Cost-Effectiveness Analysis of Three Kinds of Plant Antineoplastic Drug in the treatment of Advanced Esophageal Cancer 　　Zhang Weichun1Zhang Jingfu2 　　【Abstract】Objective:To explore the clinical evaluation and cost-effectiveness analysis of three kinds of plant antineoplastic drug in the treatment of the advanced esophageal cancer. Methods:The 71 patients with advanced esophageal cancer were randomly divided into three treating groups. The Ⅰ group was NP which was given NVB and DDP. The Ⅱ group was TD which was given TAXOL and DDP .The Ⅲ group was EAP which was given ADM and VP-16 and DDP. The three groups were assessed by clinical evaluation of pharmacoepidemiology and cost effectiveness analysis of pharmacoeconomics. Results:There were no significant differences in clinical effects among three groups(P0.05);There were significant differences in abnormal white cells, neurotoxicity, and KPS?R10 increase among three groups(P0.05); Sensitive analysis of pharmacoepidemiology and pharmacoeconomics indicated: C/E in the Ⅲ group was obviously higher than that in the Ⅰ group and Ⅱ group. Conclusion:The NP group is the best one in both clinical effectiveness and cost effeciveness. 　　【Key words】Antineoplastic drug；Esophageal cancer；Pharmacoeconomics近年来植物来源的抗肿瘤药物较多的应用于临床，并呈现出明显的优势。尤其是长春瑞滨、紫杉醇、和依托泊苷等药物在临床的广泛应用，发挥了积极的治疗作用[1]。本研究对本院71例食管癌患者的化疗方案，进行了成本效果关系和临床疗效分析，报道如下： 　　1资料与方法 　　1.1病例来源：采用药物流行病学的回溯法，在2007-2009年本院肿瘤化疗病例中筛选出采用长春瑞滨、紫杉醇、和依托泊苷进行化疗符合要求的病例71份，均符合食管癌诊断的要求，并经最后确诊为原发性病例，所经治疗药物均耐受，且无禁忌。全部患者KPS评分60分，未接受过放疗，近60天内未用过其他药物[2]。依据不同的化疗方案将所选患者分为3组：Ⅰ组NP方案（长春瑞滨NVB+顺铂DDP）；Ⅱ组TD方案（紫杉醇TAXOL+顺铂DDP）；Ⅲ组EAP方案（多柔比星ADM+依托泊苷VP-16+顺铂DDP）。3组患者的年龄分别为49.2、48.1和50.3岁。 　　1.2治疗方案:各组患者治疗方案中的药物剂量根据患者个体体表面积或体重以及药物剂型等计算，疗程和周期也根据循证医学的原则结合患者具体情况实施。Ⅰ组NP方案，长春瑞滨25mg/m2静注，d1, d8, q21d; 顺铂30mg/m2静滴，d1~3, q21d.。 Ⅱ组TD方案，紫杉醇135mg/m2静滴，d1，q21d; 顺铂20mg/m2静滴，d1~3, q21d; Ⅲ组EAP方案，