Individualised selection of left‐sided breast cancer patients for proton therapy based on cost‐effectiveness
| Autor: | Scott Penfold, Hien Le, Annabelle M. Austin, Michael Douglass, Lisa Cunningham, Yvonne Hu, Giang T. Nguyen |
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| Přispěvatelé: | Austin, Annabelle M, Douglass, Michael JJ, Nguyen, Giang T, Cunningham, Lisa, Le, Hien, Hu, Yvonne, Penfold, Scott N |
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
lcsh:Medical physics. Medical radiology. Nuclear medicine
medicine.medical_specialty Cost effectiveness Cost-Benefit Analysis lcsh:R895-920 Normal tissue Left sided 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Breast cancer breast cancer Treatment plan Unilateral Breast Neoplasms medicine proton therapy Humans Radiology Nuclear Medicine and imaging cost-effectiveness Proton therapy Selection (genetic algorithm) Radiological and Ultrasound Technology business.industry Patient Selection Radiotherapy Planning Computer-Assisted radiobiological models Original Articles cost‐effectiveness medicine.disease Markov model 030220 oncology & carcinogenesis Normal tissue toxicity Female Original Article Radiology business |
| Zdroj: | Journal of Medical Radiation Sciences, Vol 68, Iss 1, Pp 44-51 (2021) Journal of Medical Radiation Sciences |
| ISSN: | 2051-3895 2051-3909 |
| Popis: | Introduction The significantly greater cost of proton therapy compared with X‐ray therapy is frequently justified by the expected reduction in normal tissue toxicity. This is often true for indications such as paediatric and skull base cancers. However, the benefit is less clear for other more common indications such as breast cancer, and it is possible that the degree of benefit may vary widely between these patients. The aim of this work was to demonstrate a method of individualised selection of left‐sided breast cancer patients for proton therapy based on cost‐effectiveness of treatment. Methods 16 left‐sided breast cancer patients had a treatment plan generated for the delivery of intensity‐modulated proton therapy (IMPT) and of intensity‐modulated photon therapy (IMRT) with the deep inspiration breath‐hold (DIBH) technique. The resulting dosimetric data was used to predict probabilities of tumour control and toxicities for each patient. These probabilities were used in a Markov model to predict costs and the number of quality‐adjusted life years expected as a result of each of the two treatments. Results IMPT was not cost‐effective for the majority of patients but was cost‐effective where there was a greater risk reduction of second malignancies with IMPT. Conclusion The Markov model predicted that IMPT with DIBH was only cost‐effective for selected left‐sided breast cancer patients where IMRT resulted in a significantly greater dose to normal tissue. The presented model may serve as a means of evaluating the cost‐effectiveness of IMPT on an individual patient basis. The aim of this work was to demonstrate an individualised selection method for proton therapy of left‐sided breast cancer patients based on cost‐effectiveness of treatment. A Markov model is used to predict costs and the number of quality adjusted life years expected for a small cohort of patients. The presented model may serve as a means of evaluating the cost‐effectiveness of intensity modulated proton therapy on an individual patient basis. |
| Databáze: | OpenAIRE |
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