| Objective:This study compared Gemcitabine plus cisplatin scheme to Docetaxel plus Cisplatin scheme about the curative effect of treatment of advanced metastatic nasopharyngeal carcinoma,side effects and cost-effectiveness analysis,aims to choose for advanced nasopharyngeal carcinoma patients with high efficiency,low toxicity,high cost-effective plan,It can use national drug resources reasonably so that patients can get the best treatment effect while getting smaller economic burden.Methods:1)60 patients with advanced metastatic nasopharyngeal carcinoma confirmed by pathology and imaging in Xiangxi Autonomous Prefecture People's Hospital from January 1,2014 to December 31,2018 were collected.2)60 patients were divided into two groups:gemcitabine+cisplatin group(GP)30 cases,docetaxel+cisplatin group(DP)30 cases.3)Treatment of two groups of patients:cisplatin(75mg/m~2 intravenously on day 1 to day 3,total amount divided into 3 days),21 days for a cycle.(75mg/m~2 intravenously drip,on day 1 to day 3,total amount divided into 3days),21 days for a cycle.All the patients will be received at least 4 cycles of chemotherapy.3)Observation indicators:Response Evaluation Criteria in Solid Tumors 1.1 was used for efficacy Evaluation,which was divided into Complete Response(CR),Partial Response(PR),Stable disease(SD)and Progressive disease(PD).Objective Response Rate(ORR);Disease control rate(DCR);Median progression-free survival(m PFS).Toxic and side effects were evaluated according to the National Cancer Institute's(NCI)common toxicity rating criteria(3rd edition).4)Query the hospital records and electronic medical records,the cost of drug,laboratory,examination,bed,nursing and other expenses incurred in a single hospitalization will be recorded,and add them up to get the final total cost.5)According to the follow-up and disease records,progression-free survival of 60 patients was obtained,and the cost-effectiveness ratio of the two treatment regiments was calculated based on the cost per unit(1 month)of progression-free survival.Results:1)There was no statistically significant difference in general information between GP and DP(P>0.05),which was comparable.2)Efficacy can be evaluated in 60 patients,including GP:CR 0 case(0%),PR 19 cases(63.3%),SD 6 cases(20%),PD 5 cases(16.7%).DP:CR0 cases(0%),PR in 16 cases(53.3%),SD in 7 cases(35%),and PD in 7cases(23.3%);ORR in the GP and DP were 63.3%and 53.3%,respectively,with no significant difference(P>0.05);DCR of GP and DP were:83.3%and 76.7%,the difference was not statistically significant(P>0.05);m PFS of GP and DP were 6.559 and 5.333 months,no difference Statistical significance(P>0.05).3)There were no significant differences in ORR and DCR between GP and DP in gender,age,KPS(Karnofsky)score and metastatic sites(P>0.05).4)The incidence of 3-4 degree leukopenia in GP and DP was 13.3%and13.3%,the incidence of neutropenia in the degree 3-4 was 3.3%and 13.3%,and the incidence of the degree 3-4 anemia was 10%and 3.3%.The incidence of thrombocytopenia at 3-4 degrees was 10.0%and 0%,and the differences were not statistically significant(P>0.05);the incidence of gastrointestinal reactions at 3-4 degrees was 0%;the incidence of 3-4 degree liver damage.The rates were 0%and 3.3%,and the difference was not statistically significant(P>0.05).5)The cost-effectiveness ratios of GP and DP were 7285.45 yuan/PFS and 8149.79 yuan/PFS.GP was lower than DP.Taking DP as a reference,the incremental cost ratio of the GP group was 2707.72 yuan.Conclusion:1)Both GP and DP can be effective treatments for advanced metastatic nasopharyngeal carcinoma.2)Compared with the DP regimen,although GP increase the cost,it can achieve a longer PFS with high cost performance. |
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