| Summary: | 碩士 === 國立陽明大學 === 醫務管理研究所 === 105 === Objectives
The first among the top ten cancer leading cause of death in Taiwan is malignant neoplasm of trachea, bronchus and lung. The prognosis of advanced lung adenocarcinoma is the worst. The first line use of chemotherapy or target therapy for advanced lung adenocarcinoma both can improve survival rate. But, few longitudinal studies were designed for comparing efficacy between two therapies. We will evaluate characteristics, survival and its affecting factors of patients with advanced lung adenocarcinoma who first line use gefitinib or pemetrexed.
Methods
We used registry for catastrophic illness patients of National Health Insurance Research Database from 2002 to 2011 to identify patients with lung adenocarcinoma. Study population was defined as patients with lung adenocarcinoma who used gefitinib or pemetrexed without using other chemotherapeutic or target therapeutic drugs before. The analyzing variables include patient characteristics and comorbidities. We use Kaplan-meier Method to estimate survival of patients. Cox-regression was used to analyze patient characteristics and factors affecting survival.
Results
We included 800 patients with advanced lung adenocarcinoma. There were 306 (38.25%) patients in gefitinib group and 494 (61.75%) patients in pemetrexed group. In gefitinib group, there were 90 (29.4%) men and 239 (70.6%) women. 131 (42.8%) patients were 30-64 years old and 175 (57.2%) patients were 65-89 years old. In pemetrexed group , there were 255 (51.6%) men and 239 (48.4%) women. 251 (50.8%) patients were 30-64 years old and 243 (49.2%) patients were 65-89 years old. Mean survival days between two groups showed no statistically significant differences (gefitinib group vs. pemetrexed group: 78.667±15.358 vs. 65.000±12.894). Gender, age, drugs, comorbidities, and average monthly insurance salary between two groups didn’t reach statistically significant differences.
Conclusions
There is no sufficient evidence to show significant differences for survival analysis in advanced lung adenocarcinoma patients who use pemetrexed or geftinib as first line therapy. Clinicians can choose the most appropriate therapy depending on patient tolerance and income.
|
|---|
