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结直肠癌姑息治疗中的靶向治疗——生存率与医疗成本

Targeted Therapy in the Palliative Setting of Colorectal Cancer-Survival and Medical Costs.

作者信息

Inci Kamuran, Nilsson Bengt, Ny Lars, Strömberg Ulf, Wilking Nils, Lindskog Stefan, Giglio Daniel

机构信息

Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, 40530 Gothenburg, Sweden.

Department of Surgery, Halland Hospital Varberg, Region Halland, 43237 Varberg, Sweden.

出版信息

Cancers (Basel). 2023 Jun 1;15(11):3022. doi: 10.3390/cancers15113022.

Abstract

(1) Background: Targeted therapy is used alone or together with chemotherapy in metastatic colorectal cancer. The aim of this study was to assess overall survival and medical costs in a cohort of patients with metastatic colorectal cancer. (2) Methods: Demographic and clinical characteristics of 337 patients and pathological data of colorectal tumors were retrospectively collected in this population-based study. The overall survival and medical costs for patients receiving chemotherapy plus targeted therapy were compared with those for patients receiving chemotherapy only. (3) Results: Patients administered chemotherapy plus targeted therapy were less frail and had more often RAS wild-type tumors but had higher CEA levels than patients receiving chemotherapy only. No prolonged overall survival could be observed in patients receiving palliative targeted therapy. The medical costs for patients undergoing treatment with targeted therapy were significantly higher than for patients treated only with chemotherapy; they were especially higher in the group receiving targeted therapy early than late in the palliative setting. (4) Conclusions: The use of targeted therapy in metastatic colorectal cancer leads to significantly higher medical costs when used early in the palliative setting. No positive effects of the use of targeted therapy could be observed in this study; therefore, we suggest that targeted therapy be used in later lines of palliative therapy in metastatic colorectal cancer.

摘要

(1) 背景:在转移性结直肠癌中,靶向治疗可单独使用或与化疗联合使用。本研究旨在评估一组转移性结直肠癌患者的总生存期和医疗费用。(2) 方法:在这项基于人群的研究中,回顾性收集了337例患者的人口统计学和临床特征以及结直肠肿瘤的病理数据。将接受化疗加靶向治疗的患者的总生存期和医疗费用与仅接受化疗的患者进行比较。(3) 结果:与仅接受化疗的患者相比,接受化疗加靶向治疗的患者身体较弱程度较低,RAS野生型肿瘤更为常见,但癌胚抗原(CEA)水平较高。接受姑息性靶向治疗的患者未观察到总生存期延长。接受靶向治疗的患者的医疗费用显著高于仅接受化疗的患者;在姑息治疗中,早期接受靶向治疗的组费用尤其高于晚期接受靶向治疗的组。(4) 结论:在姑息治疗早期使用靶向治疗会导致转移性结直肠癌的医疗费用显著更高。本研究未观察到使用靶向治疗的积极效果;因此,我们建议在转移性结直肠癌的姑息治疗后期使用靶向治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7b4e/10252087/bb9578cc46cc/cancers-15-03022-g001.jpg

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