Economic Evaluation on Neoadjuvant Chemotherapy Combined with Surgery and Surgery Alone in the Treatment of Advanced Esophageal Cancer Based on Cost-Effectiveness Analysis

ZHOU Hui; ZHANG Yinying; LI Chaojuan; AN Yuanyuan; RUAN Yihong; HAN Yongtao; CHEN Dandi

doi:10.14009/j.issn.1672-2124.2022.02.006

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Economic Evaluation on Neoadjuvant Chemotherapy Combined with Surgery and Surgery Alone in the Treatment of Advanced Esophageal Cancer Based on Cost-Effectiveness Analysis

更新时间：2022-10-08

- Economic Evaluation on Neoadjuvant Chemotherapy Combined with Surgery and Surgery Alone in the Treatment of Advanced Esophageal Cancer Based on Cost-Effectiveness Analysis
- Vol. 22, Issue 2, Pages: 151-154(2022)
- 作者机构：
  
  1. 四川大学华西公共卫生学院/四川大学华西第四医院卫生政策与管理系
  2. 四川省肿瘤医院肿瘤科
- 作者简介：
- 基金信息：
- DOI：10.14009/j.issn.1672-2124.2022.02.006
  CLC： R735.1
- Published：2022，
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ZHOU Hui, ZHANG Yinying, LI Chaojuan, et al. Economic Evaluation on Neoadjuvant Chemotherapy Combined with Surgery and Surgery Alone in the Treatment of Advanced Esophageal Cancer Based on Cost-Effectiveness Analysis. [J]. 22(2):151-154(2022)
DOI：

ZHOU Hui, ZHANG Yinying, LI Chaojuan, et al. Economic Evaluation on Neoadjuvant Chemotherapy Combined with Surgery and Surgery Alone in the Treatment of Advanced Esophageal Cancer Based on Cost-Effectiveness Analysis. [J]. 22(2):151-154(2022) DOI： 10.14009/j.issn.1672-2124.2022.02.006.

摘要

目的：基于成本-效果分析，探讨新辅助化疗联合手术与单纯手术治疗晚期食管癌的经济性。方法：采用分层随机法将2007年6月至2014年12月四川省肿瘤医院等8家医院收治的451例临床分期为T1-4N1M0/T4N0M0的食管鳞状细胞癌患者分为研究组和对照组。对照组患者(n=227)采用单纯手术治疗，研究组患者(n=224)采用新辅助化疗联合手术治疗。根据食管癌的疾病进展过程，将疾病分为3种状态，即疾病无进展状态、复发/转移状态和死亡状态，建立马尔可夫(Markov)模型评价两种治疗方案的经济性。结果：模型运行10年显示，单纯手术方案、新辅助化疗联合手术方案治疗食管癌的成本分别为578 334.18、1 024 119.63元。新辅助化疗联合手术方案治疗食管癌的增量成本-效果比为19 209.26元/QALY。结论：新辅助化疗联合手术方案的增量成本-效果比为19 209.26元/QALY

远低于四川省2019年的意愿支付阈值55 774元/QALY。因此，新辅助化疗联合手术方案具有显著的成本-效果优势。

Abstract

OBJECTIVE: Based on cost-effectiveness analysis

to probe into the economical efficiency of neoadjuvant chemotherapy combined with surgery and surgery alone in the treatment of advanced esophageal cancer. METHODS: Totally 451 patients with esophageal squamous cell carcinoma in the clinical stages of T1-4 N1 M0/T4 N0 M0

treated in 8 hospitals including Sichuan Cancer Hospital from Jun. 2007 to Dec. 2014

were divided into research group and control group via stratified random. The control group（227 cases） was given surgery alone

while the research group（224 cases） was given neoadjuvant chemotherapy combined with surgery. According to the disease progression of esophageal cancer

the disease was divided into three states

namely disease-free state

recurrence/metastasis state and death state

so that the Markov model was established to evaluate the economical efficiency of the two treatment regimens. RESULTS: The model run for 10 years showed that the cost of regimens of surgery alone and neoadjuvant chemotherapy combined with surgery for esophageal cancer were 578 334.18 yuan and 1 024 119.63 yuan

respectively. The incremental cost-effectiveness ratio of neoadjuvant chemotherapy combined with surgical regimen for esophageal cancer was 19 209.26 yuan/QALY. CONCLUSIONS: The incremental cost-effectiveness ratio of neoadjuvant chemotherapy combined with surgery regimen was 19 209.26 yuan/QALY

which is much lower than the willingness-to-pay threshold of 55 774 yuan/QALY in Sichuan Province in 2019. Therefore

neoadjuvant chemotherapy combined with surgery regimen has a significant cost-effectiveness advantage.

关键词

食管癌新辅助化疗Markov模型成本-效果分析

Keywords

Esophageal cancerNeoadjuvant chemotherapyMarkov modelCost-effectiveness analysis

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