不同新辅助化疗方案治疗进展期胃癌的疗效和安全性及费用评估研究

doi:10.12114/j.issn.1007-9572.2019.00.774

摘要/Abstract

摘要： 背景　目前进展期胃癌新辅助化疗的优势得到认可，但相应的探索性化疗方案种类多，疗效各不相同，最佳方案的选择仍无定论。目的　旨在对比分析三种不同的新辅助化疗方案治疗进展期胃癌的安全性、疗效及费用，为进展期胃癌新辅助化疗方案的最优选择提供依据。方法　回顾性分析新疆医科大学附属肿瘤医院2011—2016年确诊的进展期胃癌353例。按照新辅助化疗方案不同，将患者分为SOX组（161例）、TOF组（111例）、EOF组（81例）进行化疗。SOX组采用奥沙利铂+替吉奥化疗，TOF组采用紫杉醇+奥沙利铂+替吉奥化疗，EOF组采用奥沙利铂+表柔比星+替吉奥化疗。对比分析各组间手术方式、毒副作用发生率、总生存率和直接住院费用，筛选效价比高的治疗方案。结果　三组患者手术方式比较，差异无统计学意义（χ2=1.368，P=0.505）。三组患者的主要毒副作用为恶心呕吐、腹泻、食欲减退、白细胞计数减少等；三组患者恶心呕吐、腹泻、食欲减退、白细胞计数减少发生率比较，差异均无统计学意义（P>0.05）。SOX组、TOF组和EOF组患者中位生存时间分别为63个月、81个月和67个月，三组患者总生存率比较，差异无统计学意义（χ2=4.102，P=0.129）。三组直接住院费用比较，差异有统计学意义（F=7.134，P=0.001）。SOX组直接住院费用为TOF组的78.3%、EOF组的69.9%。结论　进展期胃癌患者术前采用SOX、DOF及EOF三种不同新辅助化疗方案的安全性及疗效相当，SOX方案直接住院费用最低，效价比最优。

关键词: 胃肿瘤；进展期胃癌；放化疗, 辅助；卫生经济评价；治疗结果

Abstract: Background　Nowadays，the advantages of neoadjuvant chemotherapy（NACT） for advanced gastric cancer（AGC） are widely recognized.The diverse exploratory chemotherapeutic regimens also appeared with different curative effects and optimal choice remains inconclusive.Objective　We are aimed at evaluating the safety，efficacy and cost effect of three NACT regimens and providing a basis for the optimal selection of NACT for AGC.Methods　353 patients with AGC treated in Affiliated Cancer Hospital of Xinjiang Medical University from 2011 to 2016，were enrolled retrospectively and classified into three groups based on different NACT regimens（161 for SOX，111 for TOF and 81 for EOF）.SOX group used oxaliplatin and teggio chemotherapy，TOF group used taxol and oxaliplatin and teggio chemotherapy，EOF group used oxaliplatin and epirubicin and teggio chemotherapy.The operative type，toxicity，overall survival and hospitalization cost of three regimens were analyzed to select the optimum regimen.Results　No statistically significant difference was found in radical resection rate among the three groups（χ2=1.368，P=0.505）.The toxic effects were nausea，vomiting，diarrhea，anorexia and leucopenia for the three groups.There were no statistically significant differences in the incidences of nausea，vomiting，diarrhea，anorexia and leucopenia among the three groups（P>0.05）.The median survival times of patients for SOX，TOF and EOF groups were 63 months，81 months and 67 months，respectively.There was no statistically significant difference in overall survival among the three groups（χ2=4.102，P=0.129）.The difference in hospitalization cost of the three groups was statistically significant（F=7.134，P=0.001）.The hospitalization cost of SOX group occupied 78.3% of that of TOF and 69.9% of that of EOF groups.Conclusion　The curative effect and safety of the SOX，DOF and EOF regimens for AGC patients were similar，and the SOX is the economically optimal regimen.

Key words: Stomach neoplasms；Neoadjuvant chemotherapy；Chemoradiotherapy, adjuvant；Cost effect；Treatment outcome

艾克热木?玉苏甫,阿布都沙拉木?依米提,再依奴尔?阿不都外力,等. 不同新辅助化疗方案治疗进展期胃癌的疗效和安全性及费用评估研究[J]. 中国全科医学, 2020, 23(26): 3286-3290. DOI: 10.12114/j.issn.1007-9572.2019.00.774.
AIKEREMU?Yusufu,ABUDUSHALAMU?Yimiti,ZAIYINUER?Abuduwaili, et al. Evaluation of Safety，Efficacy and Hospitalization Cost of Three Neoadjuvant Chemotherapy Regimens for Advanced Gastric Cancer　[J]. Chinese General Practice, 2020, 23(26): 3286-3290. DOI: 10.12114/j.issn.1007-9572.2019.00.774.

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