摘要
目的综合回顾有关贝伐珠单抗联合化疗治疗效果及不良反应的Meta分析,及联合化疗对比单一化疗的成本效果分析,探讨贝伐珠单抗联合化疗为转移性结直肠癌患者带来的效果及不良反应及成本效果分析,为贝伐珠单抗在治疗的应用提供一定的参考。方法检索Pubmed、中国期刊全文数据库(CNKI)等发表的对比mCRC患者中贝伐珠单抗联合化疗及单一化疗的Meta分析及成本效果分析。综述Meta分析及成本效果分析的结果。结果纳入的6个Meta分析,显示贝伐珠单抗联合化疗较单一化疗显著提高了患者无进展生存时间、中位总生存期,然而使用贝伐珠单抗可能增加高血压、蛋白尿、出血等风险,而对胃穿孔、血栓等并无显著差异。成本效果分析表明,贝伐珠单抗相较于西妥昔单抗在成本上具有优势,效果相差并不非常显著。结论贝伐珠单抗具有较高成本,然而贝伐珠联合化疗能显著提高患者的生存收益,一定程度上增加不良反应,基于中国本土数据的成本效果分析还需进一步开展。
Objective Literature review meta-analysis and cost-effectiveness analysis on standard chemotherapy plus bevacizumab in metastatic colorectal cancer（mCRC）to explore the efficacy,safety and cost-effectiveness on the addition of bevacizumab.Methods To Search meta-analysis and cost-effectiveness analysis of chemotherapy plus bevacizumab on databases,such as MEDLINE,PubMed,CNKI chemotherapy.Results Six included analyses indicate that chemotherapy plus bevacizumab significantly prolonged progression-free survival（PFS）and overal survival（OS）.The risk of hypertension,bleeding and proteinuria are significantly increased,whereas there are no significant differences on gastric perforation,thrombosis. Eleven cost-effectiveness analysis demonstrate that the addition of bevacizumab lead to higher medical cost and healthcare cost. In most countries involved in this review,chemotherapy plus bevacizumab is not cost-effective comparing with standard chemotherapy. However,the medical and healthcare cost of using bevacizumab is lower than cetuximab.Conclusion The addition of bevacizumab significantly increases survival benefits and slightly leads to more adverse events.Due to higher cost of bevacizumab,it is not cost-effective therapy for mCRC patients. According to the potential considerable differences on economic status,epidemiology,clinical efectiveness,the generalizability of included meta-analyses and cost-efectiveness analyses need to be taken into account. Analyses based on China local data should be done in the future.
出处
《中国药物经济学》
2014年第1期9-15,共7页
China Journal of Pharmaceutical Economics
关键词
贝伐珠单抗
转移性结直肠癌
成本效果
研究
Bevacizumab
Metastatic colorectal cancer
Cost-effectiveness
Research
