四种化疗药物膀胱灌注预防浅表性膀胱癌经尿道膀胱肿瘤.pdf

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1、·2188··论著·四种化疗药物膀胱灌注预防浅表性膀胱癌经尿道膀胱肿瘤切除术后复发的成本－效果研究陈学建，夏振和，陈茂章，霍介格【摘要】目的评价4种不同药物预防浅表性膀胱癌经尿道膀胱肿瘤切除术(TURBt)后复发的经济学效果。方法回顾性分析2005年1月—2009年6月收治行TURBt的166例浅表性膀胱癌患者的临床资料。术后根据用药不同将患者分为4组，分别予以丝裂霉素C(MMC)、吡柔比星(THP)、羟基喜树碱(HCPT)、表柔比星(EPI)膀胱灌注，疗程12个月。观察4组患者疗效及不良反应，采用成本－疗效分析法进行评价。结果所有患者随访24个月。4组有效率间差异无统计学意义

2、(P＞0.05);THP组的不良反应发生率最高，HCPT组的不良反应发生率最低;MMC、THP、HCPT、EPI四组成本－效果比分别为7045.69、13878.49、9709.59、11729.25;THP、HCPT、EPI组相对于MMC组的增量成本－效果比分别为97650.74、31959.60、74193.55。结论从药物经济学来看，HCPT组方案较佳。【关键词】浅表性膀胱癌;经尿道膀胱肿瘤切除术;丝裂霉素C;吡柔比星;羟基喜树碱;表柔比星;成本－效果分析【中图分类号】R699.5R191.1【文献标识码】A【文章编号】1007－9572(2012)07－2188－03C

3、ost－effectivenessAnalysesofFourDrugsasProphylaxisforRecurrenceinPatientswithSuperficialBladderTumorsbyBladderInstillationafterTURBtCHENXue－jian，XIAZhen－he，CHENMao－zhang，etal．DepartmentofPharmacy，TraditionalChineseMedicalHospitalofGanyuCountyinJiangsuProvince，Ganyu222100，China【Abstract】Object

4、iveToevaluatetheeconomicefficacyoffourdrugsasprophylaxisforrecurrenceinpatientswithsuperficialbladdertumorsbybladderinstillationaftertransurethralresectionofbladdertumor(TURBt).MethodsThedataof166patientswithsuperficialbladdertumorswhoweregiventheoperationofTURBtfromJanuary2005toJune2009were

5、retro-spectivelyanalyzed．Accordingtodifferentdrugsofbladderinstillation，thepatientsweredividedintofourgroups:Mitomycin(MMC)group，Pirarubicin(THP)group，Hydroxycamptothecin(HCPT)groupandEpirubicin(EPI)group．Allpatientsweretreatedfor12months．Thetherapeuticefficacyandsideeffectweremonitored，andt

6、hecost－effectivenessanalyseswereconducted.ResultsAllcaseswerefollowedupfor24months．Therewasnosignificantdifferenceamongtheeffectiveratesoffourgroups(P＞0.05)．TheincidencerateofsideeffectwasthehighestintheTHPgroup，wasandthelowestintheHCPTgroup．Thecost－effectivenessratioswererespectively7045.69

7、，13878.49，9709.59and11729.25．ComparedwiththeMMCgroup，theincrementalcosts－effectivenessratiosinotherthreegroupswererespectively97650.74，31959.60and74193.55.ConclusionTheHCPTremedyisthepreferableintermsofeconomics.【Keywords】Superficialbladdertumors;T