CAJ | 학술논문

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。
목적：종합회고유관패벌주단항연합화료치료효과급불량반응적Meta분석，급연합화료대비단일화료적성본효과분석，탐토패벌주단항연합화료위전이성결직장암환자대래적효과급불량반응급성본효과분석，위패벌주단항재치료적응용제공일정적삼고。방법검색 Pubmed、중국기간전문수거고（CNKI）등발표적대비 mCRC 환자중패벌주단항연합화료급단일화료적Meta분석급성본효과분석。종술Meta분석급성본효과분석적결과。결과납입적6개Meta분석，현시패벌주단항연합화료교단일화료현저제고료환자무진전생존시간、중위총생존기，연이사용패벌주단항가능증가고혈압、단백뇨、출혈등풍험，이대위천공、혈전등병무현저차이。성본효과분석표명，패벌주단항상교우서타석단항재성본상구유우세，효과상차병불비상현저。결론패벌주단항구유교고성본，연이패벌주연합화료능현저제고환자적생존수익，일정정도상증가불량반응，기우중국본토수거적성본효과분석환수진일보개전。
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.