| Part 1 Effectiveness and safety of Glycididazole Sodium on Radiotherapy for Esophageal Carcinoma-A Meta-analysisObjective: Clinical studies on Glycididazole Sodium on radiotherapy for Esophageal Carcinoma are numerous and with uneven quality.Meta analysis was used to systematically evaluate the published literatures,and explore effectiveness and safety of radiotherapy combined with Glycididazole Sodium(CMNa)in treatment of Esophageal Carcinoma,which can provide higher level evidence for clinicians and help clinical decision-making.Methods: Databases including China National Knowledge Infrastructure(CNKI),Wanfang Database,VIP and MedLine(PubMed)database were searched,and date of publication was up to May 2017.Clinical controlled trials of radiotherapy combined with CMNa and radiotherapy alone in treatment of Esophageal Carcinoma were retrieved from these datebases.Complete response rate,effective rate,survival rate and adverse drug reactions were performed by Review Manager5.3 statistical software.Results: A total of 13 articles were included,involving 1073 patients.Effective rates of test and control groups were 92.71%(496 cases/535 cases)and 77.32%(416 cases/538 cases),complete response rates of test and control groups were 43.55%(233 cases/535 cases)and 25.28%(136 cases/538 cases),both were statistically different(P<0.001,P<0.001).One-year survival rate was statistically different in test and control groups(P=0.01),with 78.92%(131 case/166case)and 53.76%(93 case/173 case)respectively;Two-year survival rate were 44.44%(40 cases /90 cases)and 34.06%(31 cases /91 cases),three-year survival rate were 35.56%(32cases/90cases)and 23.08%(21 cases /91 cases),both without statistically different(P=0.15,P=0.07).There were no serious adverse drug reactions in both groups.Total incidences of adverse drug reactions in test and control groups were 41.94%(78 cases/186 cases)and 43.00%(83 cases/193 cases)without statistically different(P>0.05).Conclusions: Effectiveness of radiotherapy combined with CMNa in treatment Esophageal Carcinoma is reliable and safe in short term.But long-term effectiveness and safety needed further clinical study.Part 2 Pharmacoeconomic evaluation of radiotherapy combined with Glycididazole Sodium in treatment of Esophagea l CarcinomaObjective: There is a lack of pharmacoeconomic evaluation of Glycididazole Sodium for Esophageal Carcinoma so far.The aim of the study was to evaluate the cost and effectiveness of radiotherapy combined with CMNa and radiotherapy alone in treatment of Esophageal Carcinoma in Chinese,and provide reference for medical insurance policy and clinicians.Methods: Study would be divided into two parts.Cost-effectiveness analysis was used to carry out radiotherapy combined with CMNa(test group)and radiotherapy alone(control group)in treatment of Esophageal Carcinoma in short term,and cost-utility analysis was carried out in long term.Data of effective ratios and adverse reactions came from published literatures.Cost data derived from the Pharmaceutical Sunshine Purchasing Platform and Beijing Municipal Development and Reform Commission in 2017.Based on cost and effectiveness data,cost and effectiveness differences between test and control group were calculated.Then incremental cost-effectiveness ratio was calculated in short term(ICER=?C/?E),and incremental cost-utility ratio was calculated in long term,quality adjusted life year(QALY)would be used for utility(ICUR=?C/?QALY).Stability of the result would be tested by one-way sensitivity analysis.Results: Cost-effectiveness analysis result in short term showed that: effective ratios of test and control group were 89.86% and 81.21%,with cost 74,273 yuan and 73,619 yuan respectively,ICER=7561yuan;cost-utility analysis result in long term showed that: compared with control group,quality adjusted life years of test group increased by 0.257 years,with 4122 yuan increase in cost.That is to say,with an increase in quality adjusted life years,cost would increase 16039 yuan.Sensitivity analysis showed that impact of radiotherapy equipment cost,chemotherapy adjuvant medication cost,CMNa cost and hospitalization cost list top of the cost,especially the radiotherapy equipment cost.Further sensitivity analysis showed that any of chemotherapy adjuvant medication cost,CMNa cost or hospitalization cost reduced by 10%,test group would be dominant.Conclusions: Based on cost-effectiveness analysis in short term,treatment of Esophageal Carcinoma with radiotherapy combined with CMNa can increase effective ratio with an increasing in cost.Radiotherapy combined with CMNa in treatment of Esophageal Carcinoma was economy in long term.Part 3 Pharmacoeconomic evaluation of radiotherapy combined with Glycididazole Sodium in the treatment of Nasop harynx CarcinomaObjective: By far,it is short of pharmacoeconomic evaluation of Glycididazole Sodium for Nasopharynx Carcinoma.The aim of the study was to evaluate the cost and effectiveness of radiotherapy combined with CMNa and radiotherapy alone in treatment of Naso pharynx Carcinoma in Chinese,and provide reference for medical insurance policy and clinicians.Methods: In short term,cost-effectiveness analysis was used to evaluate economic of radiotherapy combined with CMNa(test gr-oup)and radiotherapy alone(control group)in treatment of Nasopharyngeal Carcinoma.In long term,costutility analysis was used.Data of effective ratios were collected from published literature.Cost data derived from the Pharmaceutical Sunshine Purchasing Platform and Beijing Municipal Development and Reform Commission in 2017.Based on cost and effectiveness data,cost and effectiveness differences between test and control group were calculated.Then incremental cost-effectiveness ratio was calculated in short term,and incremental cost-utility ratio was calculated in long term.Results: Cost-effectiveness analysis results in short term showed that: effective ratios of test and control group were 90.37% and 72.86%,with cost 74127 yuan and 73772 yuan respectively,ICER=2027 yuan.Cost-utility analysis results in long term showed that: quality adjusted life year and cost in test group were 2.820 years and 42549 yuan,and 2.184 years and 50237 yuan in control group.Quality adjusted life year in test group was0.636 years higher than control group,and cost in test group was 7,688 yuan lower than control group.Conclusions: Based on cost-effectiveness analysis in short term,treatment of Nasopharyngeal Carcinoma with radiotherapy combined with CMNa can increase the effective ratio with an increasing in cost.Long term analysis results showed that treatment of Nasopharyngeal Carcinoma with radiotherapy combined with CMNa was economic. |
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