贝伐珠单抗和西妥昔单抗联合化学疗法治疗晚期结直肠癌的疗效和药物经济学评价  

Clinical efficacy and pharmacoeconomic evaluation of bevacizumab or cetuximab combined with chemotherapy in the treatment of advanced colorectal cancer

作　　者：王琛琳 罗爽 王丽娜[2] 张巧玲[2] 华云旗[2] Wang Chenlin;Luo Shuang;Wang Lina;Zhang Qiaoling;Hua Yunqi(Graduate School,Baotou Medical College of Inner Mongolia University of Science and Technology,Baotou 014000,China;Department of Digestive Oncology,Baotou Tumor Hospital,Baotou 014000,China)

机构地区：[1]内蒙古科技大学包头医学院研究生学院,包头014000 [2]包头市肿瘤医院消化肿瘤内科,包头014000

出　　处：《中国医师进修杂志》2023年第3期280-284,共5页Chinese Journal of Postgraduates of Medicine

基　　金：包头市科技计划项目(2017S2001-3)。

摘　　要：目的比较贝伐珠单抗和西妥昔单抗联合化学疗法治疗晚期结直肠癌的疗效和药物经济学价值。方法回顾性分析包头市肿瘤医院2018年1月至2020年12月68例晚期结直肠癌患者的临床资料。其中,采用贝伐珠单抗联合化学疗法治疗40例(贝伐珠单抗组),西妥昔单抗联合化学疗法治疗28例(西妥昔单抗组),化学疗法均为FOLFOX/FOLFIRI方案。分别比较两组患者的近期疗效、不良反应和药物经济学评价结果。结果贝伐珠单抗组和西妥昔单抗组有效率和疾病控制率比较差异无统计学意义[30.00%(12/40)比28.57%(8/28)和67.5%(27/40)比60.71%(17/28),P>0.05]。贝伐珠单抗组Ⅲ~Ⅳ度皮疹发生率明显低于西妥昔单抗组[2.50%(1/40)比71.43%(20/28)],差异有统计学意义(P<0.01);两组Ⅲ~Ⅳ度骨髓抑制、恶心呕吐、肝功能损害和腹泻发生率比较差异无统计学意义(P>0.05)。药物经济学评价结果显示,贝伐珠单抗组单抗药物费用和总成本明显低于西妥昔单抗组[(9009±1500)元比(27840±2202)元和(11242±1731)元比(29867±3002)元],差异有统计学意义(P<0.01);贝伐珠单抗组成本-效果比为37473.3,西妥昔单抗组为104430.1,两种方案增量成本-效果比为11640.6。结论贝伐珠单抗联合化学疗法治疗晚期结直肠癌与西妥昔单抗联合化学疗法治疗晚期结直肠癌疗效相近,但贝伐珠单抗联合化学疗法费用更低,不良反应更少,所以贝伐珠单抗更加经济适用。Objective To compare the clinical efficacy and pharmacoeconomic evaluation of bevacizumab or cetuximab combined with chemotherapy in the treatment of advanced colorectal cancer.Methods The clinical data of 68 patients with advanced colorectal cancer from January 2018 to December 2020 in Baotou Tumor Hospital were retrospectively analyzed.Among them,40 patients with treated with bevacizumab combined with chemotherapy(bevacizumab group),28 patients were treated with cetuximab combined with chemotherapy(cetuximab group),and the chemotherapy of two group was FOLFOX/FOLFIRI program.The short-term clinical efficacy,adverse reactions and pharmacoeconomic evaluation result were compared between two groups.Results There were no statistical differences in effective rate and disease control rate between bevacizumab group and cetuximab group:30.00%(12/40)vs.28.57%(8/28)and 67.5%(27/40)vs.60.71%(17/28),P>0.05.The incidence ofⅢtoⅣgrade erythra in bevacizumab group was significantly lower than that in cetuximab group:2.50%(1/40)vs.71.43%(20/28),and there was statistical difference(P<0.01);there were no statistical differences in the incidences ofⅢtoⅣgrade bone marrow suppression,nausea vomiting,hepatic functional lesion and diarrhea between two groups(P>0.05).The pharmacoeconomic evaluation result showed that the cost of monoclonal antibody and total cost in bevacizumab group were significantly lower than those in cetuximab group:(9009±1500)yuan vs.(27840±2202)yuan and(11242±1731)yuan vs.(29867±3002)yuan,and there were statistical differences(P<0.01);the cost-effectiveness ratio in bevacizumab group was 37473.3,and it in cetuximab group was 104430.1,the incremental cost-effectiveness ratio of two programs was 11640.6.Conclusions In the treatment of advanced colorectal cancer,the efficacy of bevacizumab combined with chemotherapy is similar to that of cetuximab combined with chemotherapy,but bevacizumab combined with chemotherapy has lower costs and fewer adverse reactions,so bevacizumab is more economical and applic

关 键 词：结直肠肿瘤 分子靶向治疗 药物疗法 贝伐珠单抗 西妥昔单抗 

分 类 号：R735.34[医药卫生—肿瘤] R956[医药卫生—临床医学]