Shanghai Lung Tumor Clinical Medical Center, Chest Hospital affiliated to Shanghai Jiaotong University, Shanghai, China.
Chemotherapy. 2010;56(6):472-7. doi: 10.1159/000321016. Epub 2010 Nov 23.
To study the cost-efficacy of docetaxel and pemetrexed as single agents versus platinum-based combination agents in second-line treatment of stage IIIb or IV non-small cell lung cancer (NSCLC) patients by evaluating chemotherapeutic indexes and medical costs.
Treatment responses were evaluated by progression-free survival (PFS), overall survival (OS), hematological and gastrointestinal toxicities.
Two hundred and seven stage IIIb or IV NSCLC patients were recruited to this clinical observation retrospective study. Thirty-four subjects were treated with docetaxel (group A), 98 with platinum-based doublet chemotherapy with docetaxel (group B), 42 with pemetrexed (group C), and 33 patients with platinum-based doublet combination therapy with pemetrexed (group D). The average PFS of groups A and B was 3.28 and 4.58 months, respectively (p = 0.042). The mean PFS of groups C and D was 3.1 and 4.98 months, respectively (p = 0.017). The mean OS of these groups was 12.88, 13.17, 12.40 and 13.04 months, respectively, without significant differences. The total medical costs in these four groups amounted to USD 5,533, 7,745, 8,569 and 15,291, respectively.
Platinum-based doublet chemotherapy with docetaxel or pemetrexed could significantly increase PFS, however, without significant OS improvement in comparison with using them as single agents. The medical expenses associated with doublet therapy were much higher than those associated with single therapy with a significant portion of the medical expenses spent on treating hematological and gastrointestinal toxicity.
通过评估化疗指数和医疗费用，研究多西他赛和培美曲塞单药与铂类联合方案在 IIIb 期或 IV 期非小细胞肺癌（NSCLC）二线治疗中的成本效益。
通过无进展生存期（PFS）、总生存期（OS）、血液学和胃肠道毒性评估治疗反应。
本临床观察回顾性研究共纳入 207 例 IIIb 期或 IV 期 NSCLC 患者。34 例患者接受多西他赛治疗（A 组），98 例患者接受含多西他赛的铂类双联化疗（B 组），42 例患者接受培美曲塞治疗（C 组），33 例患者接受含培美曲塞的铂类双联联合治疗（D 组）。A 组和 B 组的平均 PFS 分别为 3.28 个月和 4.58 个月（p=0.042）。C 组和 D 组的平均 PFS 分别为 3.1 个月和 4.98 个月（p=0.017）。这些组的平均 OS 分别为 12.88、13.17、12.40 和 13.04 个月，无显著差异。这四组的总医疗费用分别为 5533 美元、7745 美元、8569 美元和 15291 美元。
与单药治疗相比，含多西他赛或培美曲塞的铂类双联化疗可显著延长 PFS，但对 OS 无显著改善。与单药治疗相比，双联治疗的医疗费用明显更高，其中大部分医疗费用用于治疗血液学和胃肠道毒性。
