Economic analysis of conventional-dose chemotherapy compared with high-dose chemotherapy plus autologous hematopoietic stem-cell transplantation for metastatic breast cancer.
Economic analysis of conventional-dose chemotherapy compared with high-dose chemotherapy plus autologous hematopoietic stem-cell transplantation for metastatic breast cancer.
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常规剂量化疗与高剂量化疗联合自体造血干细胞移植治疗转移性乳腺癌的经济分析。
DOI：
10.1038/sj.bmt.1703795
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发表时间：
2003
期刊：
影响因子：
--
通讯作者：
Glick,JH
中科院分区：
文献类型：
--
作者：
Schulman,KA;Stadtmauer,EA;Reed,SD;Glick,HA;Goldstein,LJ;Pines,JM;Jackman,JA;Suzuki,S;Styler,MJ;Crilley,PA;Klumpp,TR;Mangan,KF;Glick,JH
我们对180名妇女的数据进行了经济学分析，这些妇女参加了一项临床试验，比较了常规剂量化疗与高剂量化疗加干细胞移植治疗一线化疗有效的转移性乳腺癌。从受试者的临床试验记录中提取资源使用数据，包括住院、医疗程序、药物和诊断测试。使用一个学术医疗中心的住院费用的医疗保险费用表和药物的平均批发价格对资源进行估值。计算每月费用，并按治疗组和临床阶段分层。移植组的平均随访时间为690天，常规剂量化疗组的平均随访时间为758天。移植组受试者住院天数（28.6 vs 17.8，P= 0.0041）和费用（84055 vs 28169美元）均高于常规剂量化疗组，平均差异为55886美元（95%CI，47298 - 63666美元）。敏感性分析导致治疗组之间的成本差异从36528美元到75531美元。高剂量化疗加干细胞移植导致了大量额外的发病率和费用，而生存率没有改善。无论是生存结果还是经济结果都不支持在临床试验环境之外使用该手术。
We performed an economic analysis of data from 180 women in a clinical trial of conventional-dose chemotherapy vs high-dose chemotherapy plus stem-cell transplantation for metastatic breast cancer responding to first-line chemotherapy. Data on resource use, including hospitalizations, medical procedures, medications, and diagnostic tests, were abstracted from subjects' clinical trial records. Resources were valued using the Medicare Fee Schedule for inpatient costs at one academic medical center and average wholesale prices for medications. Monthly costs were calculated and stratified by treatment group and clinical phase. Mean follow-up was 690 days in the transplantation group and 758 days in the conventional-dose chemotherapy group. Subjects in the transplantation group were hospitalized for more days (28.6 vs 17.8, P= 0.0041) and incurred higher costs ($84 055 vs $28 169) than subjects receiving conventional-dose chemotherapy, with a mean difference of $55 886 (95% CI, $47 298–$63 666). Sensitivity analyses resulted in cost differences between the treatment groups from $36 528 to $75 531. High-dose chemotherapy plus stem-cell transplantation resulted in substantial additional morbidity and costs at no improvement in survival. Neither the survival results nor the economic findings support the use of this procedure outside of the clinical trial setting.
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影响因子：
158.5
作者：
Cassileth, PA;Harrington, DP;Wiernik, PH
通讯作者：
Wiernik, PH
高剂量化疗试验中的患者选择：与高风险乳腺癌的相关性。
影响因子：
45.3
作者：
R. García;M. Hidalgo;L. Paz;J. Calzas;H. Gómez;J. Guerra;R. Hitt;J. Hornedo;R. Colomer;H. Cortés
通讯作者：
H. Cortés
对腋窝淋巴结有 10 个或以上阳性的乳腺癌女性患者进行辅助治疗前进行广泛评估的结果。
影响因子：
45.3
作者：
M. Crump;P. Goss;M. Prince;C. Girouard
通讯作者：
C. Girouard
IV 期乳腺癌的高剂量巩固治疗与自体干细胞挽救。
影响因子：
45.3
作者：
S. Williams;R. Mick;R. Desser;J. Golick;J. Beschorner;J. Bitran
通讯作者：
J. Bitran
选择过程对转移性乳腺癌患者接受标准剂量含阿霉素化疗的潜在高剂量化疗候选者的反应率和长期生存的影响。
影响因子：
45.3
作者：
Z. Rahman;D. Frye;A. U. Buzdar;T. L. Smith;Lina Asmar;R. Champlin;G. Hortobagyi
通讯作者：
G. Hortobagyi