Kennedy W, Reinharz D, Tessier G, Contandriopoulos A P, Trabut I, Champagne F, Ayoub J
Groupe de Recherche Interdisciplinaire en Santé, Université de Montréal, Québec, Canada.
Pharmacoeconomics. 1995 Oct;8(4):316-23. doi: 10.2165/00019053-199508040-00006.
Polychemotherapy is the therapeutic option recommended for nonresectable, non-small cell lung cancer (NSCLC). However, the modest gains in survival, and the frequent and often serious adverse effects, associated with chemotherapy should also be considered when deciding on therapy. We therefore performed a cost-utility analysis of chemotherapy and best supportive care in NSCLC. Effectiveness and costs were analysed on 70 patients who were randomised to receive one of 3 treatments: VP (vindesine and cisplatin), CAP (cyclophosphamide, doxorubicin and cisplatin), or best supportive care. Subsequently, an assessment of the value of polychemotherapy and best supportive care was performed by oncology personnel using the time trade-off technique. Polychemotherapy was found to be more effective than best supportive care, but was also more costly and had a lower value score. Because of its cost utility and its higher value, best supportive care should not be discarded as an alternative for the treatment of NSCLC.
多药化疗是推荐用于不可切除的非小细胞肺癌（NSCLC）的治疗选择。然而，在决定治疗方案时，也应考虑化疗带来的有限生存获益以及频繁且往往严重的不良反应。因此，我们对NSCLC患者化疗及最佳支持治疗进行了成本效用分析。对70例随机接受三种治疗之一的患者进行了有效性和成本分析：VP（长春地辛和顺铂）、CAP（环磷酰胺、阿霉素和顺铂）或最佳支持治疗。随后，肿瘤学专业人员采用时间权衡技术对多药化疗和最佳支持治疗的价值进行了评估。结果发现，多药化疗比最佳支持治疗更有效，但成本更高且价值评分更低。鉴于其成本效用和更高的价值，最佳支持治疗不应被摒弃作为NSCLC治疗的一种选择。
