乳腺癌辅助化疗后预防性使用乙二醇化重组人粒细胞刺激因子的成本效果分析和对生活质量的影响

doi:10.3969/j.issn.1009-976X.2022.05.004

岭南现代临床外科 ›› 2022, Vol. 22 ›› Issue (05): 451-457.DOI: 10.3969/j.issn.1009-976X.2022.05.004

乳腺癌辅助化疗后预防性使用乙二醇化重组人粒细胞刺激因子的成本效果分析和对生活质量的影响

陈玩娜^1#, 梁小立^1#, 张展强^1#, 徐荷洋², 林勃¹, 张兆禧¹, 禹菊¹, 郑亮¹, 黄津耀¹, 张景¹, 陆漪琳¹, 黄佳泳¹, 李瑞霞¹, 李杰^3,*, 吕伟明^1,*

1.中山大学附属第一医院甲状腺外科,广州 510080;
2.中国医学科学院肿瘤医院深圳医院,深圳 518116;
3.广州市妇女儿童医疗中心甲乳外科,广州 510623

通讯作者: *吕伟明,Email: lvwm@mail.sysu.edu.cn;李杰,Email：lijie78@mail.sysu.edu.cn
作者简介:#陈玩娜、梁小立、张展强为共同第一作者
基金资助:
广东省科技厅工业高新领域项目（2017A010105029）; 广东省医学科研基金（A2020569）

Cost-effectiveness and Qol of PEGrhGCSF prophylaxis for breast cancer patients receiving adjuvant chemotherapy

CHEN Wan-na^1#, LIANG Xiao-li^1#, ZHANG Zhan-qiang^1#, XU He-yang², LIN Bo¹, ZHANG Zhao-xi¹, YU Ju¹, ZHENG Liang¹, HUANG Jin-yao¹, ZHANG Jing¹, LU Yi-lin¹, HUANG Jia-yong¹, LI Rui-xia¹, LI Jie^3,*, LV Wei-ming^1,*

1. Department of Thyroid Surgery, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China;
2. National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen 518116, China;
3. Department of Breast and Thyroid Surgery, Guangzhou Women and Children′s Medical Center, Guangzhou 510623, China.

Received:2022-09-15 Online:2022-10-20 Published:2022-12-06
Contact: LV Wei-ming, lvwm@mail.sysu.edu.cn; LI Jie, lijie78@mail.sysu.edu.cn
About author:#CHEN Wan-na, LIANG Xiao-li and ZHANG Zhan-qiang contributed equal to this article

摘要/Abstract

摘要： 目的探究乳腺癌辅助化疗后预防性使用聚乙二醇化重组人粒细胞刺激因子（PEG-rhG-CSF）的成本效果及对生活质量的影响。方法本研究是一项前瞻性队列研究。纳入我科乳腺癌辅助化疗的患者,根据是否预防性使用PEG-rhG-CSF分组,并进行血常规监测。比较两组化疗间期重度粒细胞减少发生率、延迟化疗率、成本费用指标及生活质量,计算增量成本效果比（Incremental cost benefit ratio,ICER）。结果共256例患者纳入分析。与对照组相比,PEG-rhG-CSF组重度中性粒细胞减少和延迟化疗的发生率较低,生理状况方面生活质量更好,总费用稍高,针对重度粒细胞减少发生率和延迟化疗率的ICER分别为25.32元/1%和24.45元/1%。结论乳腺癌辅助化疗后预防性使用PEG-rhG-CSF效果良好并提高生活质量,性价比较高。

关键词: 乳腺癌, 化疗, PEG-rhG-CSF, 成本效果分析, 生活质量

Abstract: Objective To analyze the cost-effectiveness of PEGrhGCSF prophylaxis for breast cancer patients receiving adjuvant chemotherapy and its effect on quality of life （Qol）. Methods This is a prospective cohort study. The breast cancer patients receiving adjuvant chemotherapy in our department were included and grouped by whether PEGrhGCSF was used or not. Complete blood count was monitored during chemotherapy cycle. Medical related bills were recorded and Qol was evaluated using FACT-B questionnaire. The rates of severe neutropenia and delay of next chemotherapy, medical related cost and Qol were compared between groups. Incremental cost benefit ratio （ICER） was calculated. Results Totally 256 patients were included in analysis. Compared with control group, PEG-rhG-CSF group had lower rates of severe neutropenia （9.3% vs. 20.6%, P = 0.030） and delay of next chemotherapy （5.2% vs. 15.9%, P=0.010）, and better Qol in physical well-being scale. The total cost was higher in PEG-rhG-CSF group, but the difference was not statistically significant （2102.95 CNY vs. 1816.85 CNY, P=0.31）. The ICERs for severe neutropenia and delay of next chemotherapy were 25.32 CNY/1% and 24.45 CNY/1%, respectively. Conclusion PEGrhGCSF prophylaxis for breast cancer patients receiving adjuvant chemotherapy was cost-effective and associated with better Qol.

Key words: breast cancer, chemotherapy, PEG-rhG-CSF, cost-effective analysis, quality of life

中图分类号:

R737.9

陈玩娜, 梁小立, 张展强, 徐荷洋, 林勃, 张兆禧, 禹菊, 郑亮, 黄津耀, 张景, 陆漪琳, 黄佳泳, 李瑞霞, 李杰, 吕伟明. 乳腺癌辅助化疗后预防性使用乙二醇化重组人粒细胞刺激因子的成本效果分析和对生活质量的影响[J]. 岭南现代临床外科, 2022, 22(05): 451-457.

CHEN Wan-na, LIANG Xiao-li, ZHANG Zhan-qiang, XU He-yang, LIN Bo, ZHANG Zhao-xi, YU Ju, ZHENG Liang, HUANG Jin-yao, ZHANG Jing, LU Yi-lin, HUANG Jia-yong, LI Rui-xia, LI Jie, LV Wei-ming. Cost-effectiveness and Qol of PEGrhGCSF prophylaxis for breast cancer patients receiving adjuvant chemotherapy[J]. Lingnan Modern Clinics In Surgery, 2022, 22(05): 451-457.

参考文献

[1] Bray F, Jemal A, Grey N, et al.Global cancer transitions according to the Human Development Index (2008-2030): a population-based study[J]. Lancet Oncol, 2012, 13(8): 790-801.
[2] 黄哲宙, 陈万青, 吴春晓, 等. 中国女性乳腺癌的发病和死亡现况——全国32个肿瘤登记点2003—2007年资料分析报告[J]. 肿瘤, 2012, 32(6): 435-439.
[3] 张嘉扬, 刘雅昕, 王环, 等. 预防性应用长效粒细胞集落刺激因子在乳腺癌辅助化疗中的作用[J]. 中华医学杂志, 2018, 98(34): 2718-2721.
[4] 李惠平, 樊征夫, 郑虹, 等. 聚乙二醇化重组人粒细胞集落刺激因子初级与次级预防化疗后中性粒细胞减少的有效性和安全性临床研究[J]. 中国肿瘤临床, 2019, 46(14): 739-744.
[5] Fernandes R, Mazzarello S, Stober C, et al.Optimal primary febrile neutropenia prophylaxis for patients receiving docetaxel-cyclophosphamide chemotherapy for breast cancer: a systematic review[J]. Breast Cancer Res Treat, 2017, 161(1): 1-10.
[6] Zekri J, Nawaz A, Rasool H, et al.Impact of granulocyte-colony stimulating factor on docetaxel-induced febrile neutropenia in patients with breast cancer[J]. J Oncol Pharm Pract, 2022, 28(8): 1681-1686.
[7] Kim CG, Sohn J, Chon H, et al.Incidence of Febrile Neutropenia in Korean Female Breast Cancer Patients Receiving Preoperative or Postoperative Doxorubicin/Cyclophosphamide Followed by Docetaxel Chemotherapy[J]. J Breast Cancer, 2016, 19(1): 76-82.
[8] Kim HS, Lee SY, Kim JW, et al.Incidence and Predictors of Febrile Neutropenia among Early-Stage Breast Cancer Patients Receiving Anthracycline-Based Chemotherapy in Korea[J]. Oncology, 2016, 91(5): 274-282.
[9] Shin KH, Lim KS, Lee H, et a1.An assessment of the pharmacokinetics, pharmacodynamics, and tolerability of GCPGC, a novel pegylated granulocyte colony-stimulating factor (G-CSF), in healthy subjects[J]. Invet New Drugs, 2014, 32(4):636-643.
[10] 江泽飞, 许凤锐, 樊菁, 等. 聚乙二醇化重组人粒细胞刺激因子预防乳腺癌患者化疗后中性粒细胞减少的多中心随机对照Ⅳ期临床观察[J]. 中华医学杂志, 2018, 98(16): 1231-1235.
[11] 石远凯, 何小慧, 杨晟, 等. 聚乙二醇化重组人粒细胞集落刺激因子预防化疗后中性粒细胞减少症的多中心随机对照Ⅱ期临床研究[J]. 中华医学杂志, 2006, 86(48): 3414-3419.
[12] 万崇华, 张冬梅, 汤学良, 等. 乳腺癌患者生命质量测定量表FACT_B中文版介绍[J]. 中国肿瘤, 2002, 11(6): 318-320.
[13] Xie J, Cao J, Wang JF, et al.Advantages with prophylactic PEG-rhG-CSF versus rhG-CSF in breast cancer patients receiving multiple cycles of myelosuppressive chemotherapy: an open-label, randomized, multicenter phase III study[J]. Breast Cancer Res Treat, 2018, 168(2): 389-399.
[14] Li X, Zheng H, Yu MC, et al.Is PEGylated G-CSF superior to G-CSF in patients with breast cancer receiving chemotherapy? A systematic review and meta-analysis[J]. Support Care Cancer, 2020, 28(11): 5085-5097.
[15] Park KH, Lee S, Park JH, et al.A randomized, multi-center, open-label, phase III study of once-per-cycle DA-3031, a pegylated G-CSF, in comparison with daily filgrastim in patients receiving TAC chemotherapy for breast cancer[J]. Support Care Cancer, 2017, 25(2): 505-511.
[16] Wildiers H, Reiser M.Relative dose intensity of chemotherapy and its impact on outcomes in patients with early breast cancer or aggressive lymphoma[J]. Crit Rev Oncol Hematol, 2011, 77(3): 221-240.
[17] Ashrafi F, Salmasi M.Comparison of the effects of pegylated granulocyte-colony stimulating factor and granulocyte-colony stimulating factor on cytopenia induced by dose-dense chemotherapy in breast cancer patients[J]. J Res Med Sci, 2018, 23: 73.

乳腺癌辅助化疗后预防性使用乙二醇化重组人粒细胞刺激因子的成本效果分析和对生活质量的影响

Cost-effectiveness and Qol of PEGrhGCSF prophylaxis for breast cancer patients receiving adjuvant chemotherapy

PDF

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

编辑推荐

Metrics

[1]	陈景森, 张文夏, 李欢, 熊志毅, 王恩礼. 全数字钼靶提高同时性双侧乳腺癌检出率的临床研究[J]. 岭南现代临床外科, 2022, 22(03): 223-226.
[2]	李逸林, 韩玮, 施郦媛, 陈绪, 王旸, 王康, 鲁凯. 浆细胞性乳腺炎并发导管原位癌一例报告[J]. 岭南现代临床外科, 2022, 22(03): 302-305.
[3]	池月芮, 刘丽, 刘奕琳, 徐文贵. 乳腺非肿块样病变的影像学研究现状与展望[J]. 岭南现代临床外科, 2022, 22(03): 309-314.
[4]	赵炜, 罗曼莉. Pin1相互作用的长非编码RNA lncPIL-1调控乳腺癌恶性表型的研究[J]. 岭南现代临床外科, 2022, 22(02): 126-133.
[5]	黎淑玲, 刘俊杰. 体表标记定位下内镜套扎治疗Ⅱ~Ⅲ度内痔的前瞻性研究[J]. 岭南现代临床外科, 2022, 22(02): 187-190.
[6]	曾智豪, 何深. 三阴性乳腺癌新辅助治疗现状[J]. 岭南现代临床外科, 2022, 22(02): 205-209.
[7]	欧欣瑜, 陆艺文, 刘志瀚, 苏士成. 术中导航系统在腔镜乳腺癌保乳根治术中的应用：病例报告[J]. 岭南现代临床外科, 2022, 22(01): 1-5.
[8]	林威威, 林确然, 何钻玉, 苏逢锡, 潘萍, 陈凯, 杨冬梓. 早期乳腺癌患者化疗联合促性腺激素释放激素激动剂：一项单中心、双盲、随机对照临床试验[J]. 岭南现代临床外科, 2022, 22(01): 7-13.
[9]	王敏, 魏建南, 曾圣光, 杨勇, 王媛, 石剑, 郑爱秋. 早期乳腺癌前哨淋巴结活检手术中示踪方法的临床应用研究[J]. 岭南现代临床外科, 2022, 22(01): 66-70.
[10]	曹洪涛, 王晓龙, 陈亮, 林波, 汤婷婷, 马克强, 嵇腾飞, 曹天生, 王健, 张文伟, 杨建荣, 卢卓才, 由田, 何青青, 黄敬敏, 周堤侠. SOX新辅助化疗在进展期胃癌的治疗体会[J]. 岭南现代临床外科, 2021, 21(06): 631-635.
[11]	桂秀娟, 赵健丽, 汪颖, 柴洁, 丁林潇潇, 姚和瑞. 伊尼妥单抗联合吡咯替尼治疗HER2阳性晚期乳腺癌1例[J]. 岭南现代临床外科, 2021, 21(06): 675-678.
[12]	刘钊远, 蒋小峰, 薛平. 胆管癌的光动力治疗[J]. 岭南现代临床外科, 2021, 21(05): 495-499.
[13]	陈欣欣, 章乐虹. 内源性miR103A通过抑制RGS2的表达从而影响乳腺癌的转移[J]. 岭南现代临床外科, 2021, 21(05): 541-546.
[14]	金小岩, 覃延翔, 刘淑琼, 吴畏. 31例男性乳腺癌的临床特点分析[J]. 岭南现代临床外科, 2021, 21(05): 547-550.
[15]	关健华, 温坚坤, 林启谋, 黄文俊. 手术切除联合植入缓释型5-FU在局部区域复发的乳腺癌患者中的应用分析（附27例病例数据分析）[J]. 岭南现代临床外科, 2021, 21(04): 428-431.