经肝动脉化疗栓塞术中应用三氧化二砷载药微球与三氧化二砷碘化油治疗不可切除原发性肝癌的成本效益分析  

A cost-effect analysis of transarterial chemoembolization with CalliSpheres beads loaded with arsenic trioxide versus arsenic trioxide iodized oil emulsion in treatment of unresectable liver cancer

作　　者：王文辉 段旭华[1] 李浩[1] 琚书光 王满周 任建庄[1] 韩新巍[1] WANG Wenhui;DUAN Xuhua;LI Hao;JU Shuguang;WANG Manzhou;REN Jianzhuang;HAN Xinwei(Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China)

机构地区：[1]郑州大学第一附属医院放射介入科,郑州450052

出　　处：《临床肝胆病杂志》2021年第9期2125-2129,共5页Journal of Clinical Hepatology

基　　金：中国健康促进基金会(XM_2018_011_0006_01);河南省重点研发与推广专项(科技攻关)项目(202102310462)。

摘　　要：目的探讨经肝动脉化疗栓塞术(TACE)中应用三氧化二砷(ATO)载药栓塞微球和ATO碘油乳剂栓塞治疗不可切除的肝癌成本效益。方法选择2017年5月—2018年12月在郑州大学第一附属医院就诊的100例中晚期原发性肝癌患者作为研究对象,根据治疗方案不同分为CBATO组(n=45)和cTACE组(n=55)。采用无进展生存期(PFS)进行质量调整寿命年(QALY)的疗效评价,采用欧洲五维健康量表(EQ-5D)指数评估患者的生活质量。计量资料2组间比较采用t检验,计数资料2组间比较采用χ2检验,计算2组患者的手术次数、住院时间、治疗成本和增量成本效果比(ICER),并进行成本效益分析。结果在PFS内,CBATO组和cTACE组治疗中晚期肝癌的人均住院费用分别为96446元和91230.43元。2组间平均手术次数(2.5±0.7 vs 3.4±0.8)和平均住院时间[(5.8±1.2)d vs(7.5±1.8)d]比较,差异均有统计学意义(t值分别为16.911、12.459,P值均<0.01);CBATO组QALY高于cTACE组(0.804>0.512)。与cTACE组相比,CBATO组治疗不可切除肝癌的增量成本效益比为17861.53元/年。结论CBATO组手术花费虽高于cTACE组,但在减少手术次数和住院时间的同时其临床疗效优于cTACE组,术后患者的生活质量高于cTACE组,具有明显的成本效益优势。Objective To investigate the cost-effect of transarterial chemoembolization(TACE)with CalliSpheres beads loaded with arsenic trioxide(ATO)(CBATO)versus ATO iodized oil emulsion(conventional TACE,cTACE)in the treatment of unresectable liver cancer.Methods A total of 100 patients with advanced liver cancer who attended The First Affiliated Hospital of Zhengzhou University from May 2017 to December 2018 were enrolled and divided into CBATO group(n=45)and cTACE group(n=55)according to the treatment regimen.Progression-free survival(PFS)was used to evaluate the efficacy of quality-adjusted life year(QALY),and European Quality of Life-5 Dimensions(EQ-5D)index was used to evaluate quality of life.The t-test was used for comparison of continuous data between groups,and the chi-square test was used for comparison of categorical data between groups;the number of surgeries,length of hospital stay,treatment cost,and incremental cost-effectiveness ratio(ICER)were calculated for the two groups,and then a cost-effect analysis was performed.Results Within the PFS time,the per capita hospital cost was 96446 yuan in the CBATO group and 91230.43 yuan in the cTACE group.There were significant differences between the two groups in the mean number of surgeries(2.5±0.7 vs 3.4±0.8,t=16.911,P<0.01)and mean hospital stay(5.8±1.2 days vs 7.5±1.8 days,t=12.459,P<0.01).The CBATO group had a significantly higher QALY than the cTACE group(0.804 vs 0.512).Compared with the cTACE group,the CBATO group had an ICER of 17861.53 yuan/QALY for unresectable liver cancer.Conclusion Although CBATO has a higher surgery cost than cTACE,CBATO has a better clinical effect than cTACE and can reduce the number of surgeries and length of hospital stay,with a better postoperative quality of life than cTACE,suggesting that CBATO has marked cost-effect advantages.

关 键 词：肝肿瘤 化学栓塞 治疗性 微球体 碘化油 费用效益分析 

分 类 号：R735.7[医药卫生—肿瘤]