关键词: 癌, 非小细胞肺；培美曲塞；依托泊苷；经济学, 药学；疗效比较研究

Abstract: Background　Concomitant chemoradiotherapy is a standard treatment for patients with locally advanced non-small cell lung cancer （NSCLC）；however，the ideal combined chemotherapy regimen has not been established.Objective　To compare the efficacy of pemetrexed plus cisplatin （PP） and etoposide plus cisplatin （EP） regimens concomitant with chest radiotherapy in the treatment of locally advanced lung adenocarcinoma，and to compare the pharmacoeconomics of these regimens to provide a reference for choosing treatment regimen in the clinic.Methods　Sixty-four patients diagnosed with locally advanced lung adenocarcinoma and treated in the Radiotherapy Center of the Cancer Hospital Affiliated to Xinjiang Medical University between 2010 and 2015 were selected as study subjects.The patients were divided into EP group （n=34） and PP group （n=30） according to the regimen received.The patients were administered a corresponding chemotherapy regimen and radiotherapy.Short-term efficacy was evaluated after 2 months of treatment；the patients were followed up until December 31，2016 to observe long-term efficacy.The costs of the two regimens were also recorded and compared.Results　There were no significant differences in short-term efficacy，objective remission rate，disease control rate，grade ≥3 hematological adverse reactions，grade 1 or 2 radioactive esophagitis，grade ≥2 radioactive pneumonitis，grade ≥3 digestive tract reactions and grade ≥2 liver function damage between the two groups （P>0.05）．The one-year and two-year survival rates in the EP group were 100.0% and 24.2%，respectively，and the median overall survival time was 21.0 months〔95%CI（19.7，22.3）months〕；the one-year and two-year survival rates in the PP group were 83.3% and 29.6%，respectively，and the median overall survival time was 21.0 months 〔95%CI（18.4，23.6）months〕.Log-rank test did not indicate a significant difference in survival curve between the two groups （χ2=1.896，P=0.169）．The total cost of the PP group was higher than that of the EP group （P<0.05）．Cost-effectiveness analysis showed that the cost/effectiveness of the EP group and the PP group was 267.35 and 599.36，respectively，and the Δ cost/Δ effectiveness was 3 772.84.Conclusion　Radiotherapy combined with the PP versus the EP regimen has similar efficacy and safety in the treatment of locally advanced lung adenocarcinoma，while the EP regimen is more economical than the PP regimen.

Key words: Carcinoma, non-small-cell lung；Pemetrexed；Etoposide；Economics, pharmaceutical；Comparative effectiveness research