Moldvay Judit, Rokszin György, Abonyi-Tóth Zsolt, Katona Lajos, Fábián Katalin, Kovács Gábor
Department of Tumor Biology, National Korányi Institute of Pulmonology, Semmelweis University, Budapest, Hungary.
RxTarget Company Ltd, Szolnok, Hungary.
Onco Targets Ther. 2015 May 13;8:1031-8. doi: 10.2147/OTT.S65794. eCollection 2015.
Hungary is a world leader in lung cancer deaths, so it is of crucial importance that patients have access to modern treatments. The aim of our analysis was to explore how drug treatments are used in Hungary and how they are compatible with international practice. The inpatient and prescription database of the National Health Insurance Fund Administration of Hungary was used to study the frequency of certain chemotherapy protocols and duration of therapies during a 3-year period (2008-2010). During the study period, 12,326 lung cancer patients received first-line chemotherapy, a third of those (n=3,791) received second-line treatment, and a third of the latter (n=1,174) received third-line treatment. The average treatment duration was between 3 and 4 months. The first-line treatment of non-small-cell lung carcinoma mainly consisted of platinum treatment in combination with third-generation cytotoxic agents. A downward trend of gemcitabine, still the most common combination compound, was observed, in parallel with a significantly increased use of paclitaxel, and as a consequence carboplatin replaced cisplatin. Among the new agents, the use of pemetrexed and bevacizumab increased. Pemetrexed appeared mainly in second-line treatment, while erlotinib appeared also in second-line but mostly in third-line treatments. The first-line treatment of small-cell lung carcinoma consisted of a platinum-etoposide combination, while in the second-line setting topotecan was the most commonly used drug. According to our results, the chemotherapeutic combinations and sequencing are in accordance with international and national recommendations. Further detailed analysis of the available data may help to obtain a more accurate picture of the efficacy of lung cancer treatments as well.
匈牙利在肺癌死亡率方面位居世界前列，因此让患者能够获得现代治疗方法至关重要。我们分析的目的是探究匈牙利如何使用药物治疗以及这些治疗方法与国际惯例的契合程度。利用匈牙利国家健康保险基金管理局的住院和处方数据库，研究了特定化疗方案的使用频率以及3年期间（2008 - 2010年）的治疗时长。在研究期间，12326名肺癌患者接受了一线化疗，其中三分之一（n = 3791）接受了二线治疗，而后者中的三分之一（n = 1174）接受了三线治疗。平均治疗时长在3至4个月之间。非小细胞肺癌的一线治疗主要包括铂类治疗联合第三代细胞毒性药物。观察到仍是最常见联合用药的吉西他滨呈下降趋势，与此同时紫杉醇的使用显著增加，结果卡铂取代了顺铂。在新型药物中，培美曲塞和贝伐单抗的使用增加。培美曲塞主要出现在二线治疗中，而厄洛替尼也出现在二线治疗中，但大多用于三线治疗。小细胞肺癌的一线治疗由铂类 - 依托泊苷联合组成，而在二线治疗中，拓扑替康是最常用的药物。根据我们的结果，化疗联合用药及顺序符合国际和国内的推荐。对现有数据进行进一步详细分析可能也有助于更准确地了解肺癌治疗的疗效情况。
