Analysis Of MPT And VDT Regimen To Treat Initial Multiple Myeloma In Clinical Efficacy And Cost-effectiveness

Objective To further improve the level of our department for thetreatment of MM, We analyzed results of treatment in patients withmultiple myeloma (MM) in our hospital in recent five years,retrospectively, and compared the MPT solutions to VDT in curativeeffect, adverse reaction and cost-effectiveness of differences. Methods Atotal of49patients with MM in initial treatment between January2009and January2012, was used to conduct the study, comparing two kindsof general response rate of chemotherapy regimens and completeremission rate, the side effects of chemotherapy, and cost-effectivenessanalysis according to the principles of economics. We Applied SPSS19.0statistical software for statistical processing, count data by chi-square test,measurement data using t test, survival analysis using the Kaplan-meiermethod, univariate survival compared using the Log-rank test,analysis thedata with average±standard deviation said, and P <0.05promptdifference was statistically significant. Results Among49cases with MM,37cases were given MPT regimens, and12cases VDT regimens. Theoverall response rate was67.6%,5cases (13.5%) CR,4cases (10.8%)VGPR,16cases (43.2%) PR in MPT group,83.3%,5cases (41.7%),3cases (25%),2cases (16.7%) in the VDTgroup. There was no statistically significant difference for overall reponse rate between twogroups (P=0.293). CR rate in VDTgroup was significantly higher thanthat in MPT group (P=0.035). Two sets of scheme for40monthssurvival rate (MPT group was15.7%, the VDT group41.7%)comparative difference was statistically significant (P=0.035). And themedian progression-free survival time (21±0.707) months in VDT groupwas obviously longer than that (15.000±0.935) months in MPT group (P=0.032). The median overall-survival time (40.000±4.968) months inVDT group was obviously longer than that (28.000±3.446) months inMPT group (P=0.011). Hematology toxicity in VDT group was higherthan that in MPT group (grade1-2and grade3P values were0.018and0.023), Greater incidence of peripheral nerve toxicity in the VDT (P=0.000), mainly was1-2levels of neurotoxicity. Incidence of herpeszoster in VDT group was higher than that in MPT group (P=0.022). Thecost-effectiveness analysis has been made to the group, MPT group ofthis effect was232.1yuan, VDT group was2712.25yuan, theincremental cost-effectiveness ratio was13391.08yuan. Conclusion CRrate in VDT group was higher than that in MPT group, VDT regimen inpatients with MM is superior to MPT regimen in progression-freesurvival time, but hematology toxicity, peripheral nerve toxicity andsecondary herpes zoster incidence was more. Total response rate wasalmost no difference between them, MPT regimen cost-effectiveness analysis is superior to VDT.