Prophylactic Cranial Irradiation Revisited: Cost-effectiveness and Quality of Life in Small-cell Lung Cancer
| Autor: | Marlene Schmidt, Tete Ago, Jon Tonita, Glen Beck, Edward Yu, T.H.Patricia Tai, Matthew Schmid, John S.K Liem, Peter Dickof, David Skarsgard |
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| Rok vydání: | 2002 |
| Předmět: |
Male
Cancer Research medicine.medical_specialty Lung Neoplasms Cost effectiveness Epidemiology medicine.medical_treatment Cost-Benefit Analysis Small-cell carcinoma Gastroenterology Internal medicine Antineoplastic Combined Chemotherapy Protocols medicine Confidence Intervals Humans Radiology Nuclear Medicine and imaging Carcinoma Small Cell Lung cancer Survival rate Aged Retrospective Studies Radiation business.industry Brain Neoplasms Carcinoma Remission Induction Retrospective cohort study Small Cell Middle Aged medicine.disease Prognosis Surgery Radiation therapy Survival Rate Oncology Conventional PCI Quality of Life Female Prophylactic cranial irradiation Cranial Irradiation business |
| Zdroj: | Edward Yu Oncology Publications |
| Popis: | PURPOSE: To investigate the therapeutic usefulness and cost-effectiveness of prophylactic cranial irradiation (PCI) in patients with limited-stage small-cell lung cancer (SCLC) who had achieved a complete remission. METHODS: A retrospective chart review was undertaken of all patients diagnosed in Saskatchewan with SCLC between 1987 and 1998 inclusive. Patients who achieved a complete remission were divided into two groups, depending on whether they underwent PCI (PCI+ and PCI-, respectively). The quality-of-life-adjusted survival was estimated by the Q-TWiST method (quality time without symptoms and toxicity). The mean incremental costs per month of incremental OS were calculated in a cost-effectiveness analysis. RESULTS: Among the 98 complete remission patients, the median OS for PCI+ and PCI- patients was 20.0 and 19.0 months, respectively (p > 0.05, nonsignificant). The median disease-free survival was 14.7 and 10.0 months, respectively (p < 0.05). The difference in the mean Q-TWiST survival was significant (p < 0.01). The mean marginal cost was $18,834/PCI+ patient and $17,885/PCI- patient (p > 0.05, nonsignificant). The cost-effectiveness ratio was $70/mo of incremental OS if u(tox) and u(rel) (the utility coefficients to reflect the value of time in health states of toxicity and relapse) were assumed to be 1.0. CONCLUSION: PCI is a cost-effective treatment that improves the quality-of-life-adjusted survival for patients with a complete remission of SCLC. |
| Databáze: | OpenAIRE |
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