Efficacy And Cost-effectiveness Analysis Of FOLFOX6 And XELOX Regimen For Postoperative Colon Cancer

Objective: To study the differences between FOLFOX6 regimen and XELOX regimen with DFS and subgroup recurrence rate of postoperative colon cancer patients in 3 years.And to evaluate the effect of different factors for DFS.Studying on the effect and cost of the two therapies and analyze cost-benefit,then trying to find the more suitable scheme to help the patients get the best treatment and less economic burden.Methods : This study used retrospective analysis.After the operation,all of the 121 colon cancer patients(?high-risk,?)were assigned to FOLFOX6 and XELOX groups in a month who were admission to Dalian Medical University Affiliated Hospital between 1/1/2005 and 1/1 /2013.Evaluating DFS of 121 patients by iconography and physico-chemical test every 4 cylces and calculating the total cost of each patient and comparing the DFS to discuss the cost-effectiveness between the therapy groups.All of the patients data were imported into Excel,The interval of DFS started from chemotherapy to tumor clinical metastasis or recurrence.All data were analyzed by SPSS21.0.Chi-square test were used to analyze the baseline characteristics of the two groups.Using t and Chi-square test to analyze DFS and subgroups recurrence rate.And using Cox regressionl for the prognostic factors.For all the test,when P < 0.05 that there was a statistically significant difference.Results:1.The baseline characteristics of patients with FO LFOX6 and XELOX program are similar(P > 0.05).The disease free survival rate are 66.7%vs67.5%.The DFS have no significant difference in the patients between FOLFOX6 and XELOX(29.5 months VS 30.1 months).There are no significant difference(P= 0.752).2.Subgroup analysis: The recurrence rate of T4 betweem FOLFOX6 and XELOX regimen in were 8.7%vs46.7%.,P=0.007,so there is a difference.Gender(male and female),age(<60 years old,?60 years old),macroscopic type(ulcer type,protrude type),pathological type(non-mucinous adenocarcinoma,mucinous adenocarcinoma),degree of differentiation(high differentiation,moderate differentiation,low differentiation),lesion location(left semi colon,right colon),T stage(T3,T4),N stage(N0,N1,N2),clinical stages(?high-risk,?).When P > 0.05,the subgroup recurrence rates of them are not different.3.Single factor statistical analysis shows that the age and N stage may impact the DFS of colon cancer patients.The COX regressionl result shows: N stage is the independent predictors of DFS in patients with colon cancer after operation.4.For the average adult body surface area is 1.6 ?.Calculating FOLFOX6 and XELOX patients with completed 8 cycles of chemotherapy for the total costs are 24148 RMB and 38915.6 RMB.Conclusion:1.There are no differences for?high-risk and ? postoperative colon cancer patients treated by FOLFOX6 or XELOX in short-term efficacy.2.Subgroup analysis showed that gender,age,macroscopic type,pathological type,degree of differentiation,lesion location,T3 stage,N stage,clinical stages on the FOLFOX three weeks and XELOX are no different in the short-term efficacy.In the T4 stage,FOLFOX6 is better than XELOX.3.The independent prognostic factors of DFS is N stage.4.The cost of FOLFO X6 is cheaper than XELOX for medicare patients,but XELOX program is easy to go.It is more convenient to do in the outpatient department.