摘要
目的评价乳腺癌治疗方案中遵循指南用药和未遵循指南用药的有效性、安全性和经济性。方法将78例共1206例次住院治疗的乳腺癌患者分为遵循指南组(n=57)和未遵循指南组(n=80),计算2组的平均相对剂量强度(ARDI)。根据实体瘤疗效评价标准(RECIST)V1.1版评价疗效,按照常见不良反应事件评价标准(CTACE)4.03版评价安全性。经济性评价包括抗肿瘤药物费用、总药费和住院费分析。结果未遵循指南组复发治疗和姑息治疗方案的ARDI显著低于遵循指南组(P<0.01),而遵循指南组有效率高于未遵循指南组(98%vs.73%,P<0.01)。遵循指南组血红蛋白降低、丙氨酸转氨酶升高、碱性磷酸酶升高、高尿酸血症等不良反应发生率低于未遵循指南组(P<0.01),而白细胞、中性粒细胞和肌酐清除率降低的发生率高于未遵循指南组(P<0.01)。遵循指南组的抗肿瘤药物费用、总药费及住院费均低于未遵循指南组(2881元vs.3664元,P<0.01;4056元vs.7210元,P<0.01;5354元vs.8705元,P<0.01)。结论与未遵循指南用药相比,遵循指南用药治疗有效率高、药物不良反应发生率有差异且治疗费用低。
AIM To evaluate the effectiveness,safety and economy of concordance or disconcordance guideline in breast cancer treatment regimens.METHODS Seventy-eight patients with 1206 times hospitalizations were divided into concordance guideline group(n=57)and disconcordance guideline group(n=80).The average relative dose density(ARDI)was calculated.Effectiveness was evaluated according to RECIST V1.1 standard.Safety was evaluated according to the CTACE 4.03 criteria for adverse events.The economic evaluation included anti-cancer drug costs,total drug costs,and hospitalization costs for treatment.RESULTS The ARDI of relapse therapy regimens and palliative therapy regimens were lower in the concordance guideline group than those in the disconcordance guideline group(P<0.01).The effective rate in the concordance guideline group was higher than that in the disconcordance guideline group(98%vs.73%,P<0.01).The incidences of adverse reactions such as hemoglobin reduction,alanine aminotransferase elevation,alkaline phosphatase elevation and hyperuricemia in the concordance guideline group were lower than those in the disconcordance guideline group(P<0.01),while incidences of leukopenia,neutropenia and creatinine clearance decrease were higher than those in the disconcordance guideline group(P<0.01).The anti-tumor drug expense,the total drug costs,and hospitalization expense of the concordance guideline group were lower than those of the disconcordance guideline group(2881 vs.3664 yuan,P<0.01,4056 vs.7210 yuan,P<0.01,5354 vs.8705 yuan,P<0.01).CONCLUSION Compared with guideline-discordant treatment,the effective rate of guideline-concordant treatment is higher,the cost of treatment is lower and with significant differences in the incidences of adverse drug reactions.
作者
尤海生
高乾
陈思颖
王陶陶
高春侠
田涛
潘国华
董亚琳
YOU Hai-sheng;GAO Qian;CHEN Si-ying;WANG Tao-tao;GAO Chun-xia;TIAN Tao;PAN Guohua;DONG Ya-lin(Department of Pharmacy,the First Affiliated Hospital of Xi-an Jiaotong University,Xian SHAANXI 710061,China;Department of Oncology,the First Affiliated Hospital of Xi-an Jiaotong University,Xian SHAANXI 710061,China;Department of Pharmacy,the First People's Hospital of Yinchuan,Yinchuan NINGXIA 750001,China)
出处
《中国新药与临床杂志》
CAS
CSCD
北大核心
2020年第3期186-190,共5页
Chinese Journal of New Drugs and Clinical Remedies
基金
陕西省重点研发计划项目(2017SF-089)
西安交通大学第一附属医院临床研究项目(XJTU1AF-CRF-2016-021)。
关键词
乳腺肿瘤
指南
治疗结果
费用效益分析
不良反应
breast neoplasms
guidebooks
treatment outcome
cost-benefit analysis
adverse reactions
