Kamath Mangesh P, Lakshmaiah K C, Babu K Govind, Loknatha D, Jacob Linu A, Babu Suresh Mc
Department of Medical Oncology, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India.
Lung India. 2016 Mar-Apr;33(2):154-8. doi: 10.4103/0970-2113.177448.
The incidence of lung cancer is rising in developing countries like India. Due to unaffordability among the low socioeconomic status (SES) patients, there is a significant delay in seeking appropriate medical treatment due to which a high proportion of patients present in an advanced/metastatic stage and the outcomes are poor.
In this study, we studied the progression-free survival (PFS) and the pharmacoeconomic benefits with the cisplatin plus etoposide (EtoP) chemo regimen and compared it with the current generation chemo regimen.
We performed a retrospective analysis of metastatic nonsmall cell lung cancer patients who received one or more cycles of platinum-based chemotherapy between 2011 and 2014.
Of the 304 patients, 56.6% of the patients were of the low SES. Of the low socioeconomic group patients, 67.45% and 31.4% received etoposide and paclitaxel platinum doublet combination regimen as first line, respectively. The mean PFS with the etoposide, paclitaxel, pemetrexed, and gemcitabine platinum-based doublet regimens were 9.35, 10, 10.76, and 9.83 months, respectively. Kaplan-Meier survival curve analysis showed a statistically significant initial survival with the first line EtoP cisplatin regimen for the initial 6 months of starting chemotherapy in comparison with the other regimens.
This study showed a substantial pharmacoeconomic benefit with the cisplatin and etoposide chemo regimen in the lower socioeconomic group of patients. We believe that this is the first pharmacoeconomic study on metastatic non small cell lung treatment of great relevance to countries with limited resources.
在印度等发展中国家,肺癌发病率正在上升。由于社会经济地位较低(SES)的患者无力承担费用,寻求适当医疗治疗存在显著延迟,导致很大比例的患者在晚期/转移阶段就诊,治疗结果不佳。
在本研究中,我们研究了顺铂加依托泊苷(EtoP)化疗方案的无进展生存期(PFS)和药物经济学效益,并将其与当代化疗方案进行比较。
我们对2011年至2014年间接受一个或多个周期铂类化疗的转移性非小细胞肺癌患者进行了回顾性分析。
在304例患者中,56.6%为低SES患者。在社会经济地位较低的患者组中,分别有67.45%和31.4%的患者一线接受依托泊苷和紫杉醇铂双联联合方案。依托泊苷、紫杉醇、培美曲塞和吉西他滨铂双联方案的平均PFS分别为9.35、10、10.76和9.83个月。Kaplan-Meier生存曲线分析显示,与其他方案相比,一线EtoP顺铂方案在开始化疗的最初6个月具有统计学显著的初始生存期。
本研究表明,顺铂和依托泊苷化疗方案在社会经济地位较低的患者组中具有显著的药物经济学效益。我们认为,这是第一项关于转移性非小细胞肺癌治疗的药物经济学研究,对资源有限的国家具有重要意义。