Cost-effectiveness of hypofractionated versus conventional radiotherapy in patients with intermediate-risk prostate cancer: An ancillary study of the PROstate fractionated irradiation trial – PROFIT
Autor: | Zhou, K., Renouf, M., Perrocheau, G., Magné, N., Latorzeff, I., Pommier, P., Créhange, G., Paumier, A., Bera, G., Martin, J., Catton, C., Bellanger, Martine, Supiot, S. |
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Přispěvatelé: | Institut de Cancérologie de l'Ouest [Angers/Nantes] (UNICANCER/ICO), UNICANCER, Institut de Cancérologie Lucien Neuwirth, Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne] (CHU ST-E), Centre Léon Bérard [Lyon], Institut Curie [Paris], CRLCC Paul Papin, Groupe Hospitalier Bretagne Sud (GHBS), University of Newcastle [Callaghan, Australia] (UoN), University of Toronto, École des Hautes Études en Santé Publique [EHESP] (EHESP), Centre de Recherches sur l'Action Politique en Europe (ARENES), Université de Rennes (UR)-Institut d'Études Politiques [IEP] - Rennes-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Centre National de la Recherche Scientifique (CNRS), This study received a grant from French ministry of health (Ministère des Solidarités et de la Santé, DGOS, Grant No: DGOS_2574). The funder had no role in the study design, data collection, data analysis, data interpretation, or writing of the report. |
Rok vydání: | 2022 |
Předmět: |
Male
Prostate cancer Cost-effectiveness analysis Cost-Benefit Analysis Prostate Prostatic Neoplasms Hematology Image Guided Radiation Therapy Intensity Modulated Radiation Therapy Treatment Outcome Oncology Quality of Life Hypofractionation Humans [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie Radiology Nuclear Medicine and imaging France Prospective Studies |
Zdroj: | Radiotherapy & Oncology Radiotherapy & Oncology, 2022, 173, pp.306-312. ⟨10.1016/j.radonc.2022.06.014⟩ |
ISSN: | 0167-8140 |
Popis: | International audience; Purpose: To evaluate the cost-effectiveness of moderate Hypofractionated Radiotherapy (H-RT) compared to Conventional Radiotherapy (C-RT) for intermediate-risk prostate caner (PCa).Methods: A prospective randomized clinical trial including 222 patients from six French cancer centers was conducted as an ancillary study of the international PROstate Fractionated Irradiation Trial (PROFIT). We carried-out a cost-effectiveness analysis (CEA) from the payer's perspective, with a time horizon of 48 months. Patients assigned to the H-RT arm received 6000 cGy in 20 fractions over 4 weeks, or 7800 cGy in 39 fractions over 7 to 8 weeks in the C-RT arm. Patients completed quality of life (QoL) questionnaire: Expanded Prostate Cancer Index Composite (EPIC) at baseline, 24 and 48 months, which were mapped to obtain a EuroQol five-dimensional questionnaire (EQ-5D) equivalent to generate Quality Adjusted Life Years (QALY). We assessed differences in QALYs and costs between the two arms with Generalized Linear Models (GLMs). Costs, estimated in euro (€) 2020, were combined with QALYs to estimate the Incremental Cost-effectiveness ratio (ICER) with non-parametric bootstrap.Results: Total costs per patien were lower in the H-RT arm compared to the C-RT arm €3,062 (95 % CI: 2,368 to 3,754) versus €4,285 (95 % CI: 3,355 to 5,215), (p < 0.05). QALY were marginally higher in the H-RT arm, however this difference was not significant: 0.044 (95 % CI: - 0.016 to 0.099).Conclusions: Treating localized prostate cancer with moderate H-RT could reduce national health insurance spending. Adopting such a treatment with an updated reimbursement tariff would result in improving resource allocation in RT management. |
Databáze: | OpenAIRE |
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