Long-term economic value of hypofractionated prostate radiation: Secondary analysis of a randomized trial
| Autor: | Lincy S. Lal, K. Ranh Voong, Andrew K. Lee, J. Michael Swint, Deborah A. Kuban, Joy Godby, Sean E. McGuire, Seungtaek Choi, Pamela J. Schlembach, Karen E. Hoffman, Thomas J. Pugh, Steven J. Frank |
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| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
Oncology
lcsh:Medical physics. Medical radiology. Nuclear medicine medicine.medical_specialty lcsh:R895-920 Reimbursement rates ROI Value of RT Publication Award Winner lcsh:RC254-282 030218 nuclear medicine & medical imaging law.invention Disease course 03 medical and health sciences Prostate cancer 0302 clinical medicine Randomized controlled trial law Prostate Secondary analysis Internal medicine Medicine Radiology Nuclear Medicine and imaging health care economics and organizations business.industry Intensity-modulated radiation therapy medicine.disease lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens medicine.anatomical_structure 030220 oncology & carcinogenesis Cost-minimization analysis Physical therapy business |
| Zdroj: | Advances in Radiation Oncology, Vol 2, Iss 3, Pp 249-258 (2017) Advances in Radiation Oncology |
| ISSN: | 2452-1094 |
| Popis: | Purpose: Moderately hypofractionated intensity modulated radiation therapy (HIMRT) for prostate cancer shortens the treatment course while providing outcomes comparable with those of conventional intensity modulated radiation therapy (CIMRT). To determine the long-term economic value of HIMRT, including the costs of managing long-term radiation toxicities, a cost minimization analysis compared CIMRT with dose-escalated HIMRT using patient-level data from a randomized trial. Methods and materials: Men with localized prostate cancer were randomized to CIMRT (75.6 Gy in 42 fractions over 8.4 weeks) or HIMRT (72 Gy in 30 fractions over 6 weeks). A decision tree modeled trial probabilities of maximum late bowel and urinary toxicities using patient-level data with a median follow-up of 6 years. Costs were estimated from the healthcare perspective using the 2014 national reimbursement rates for services received. Patient-level institutional costs, adjusted to 2014 dollars, verified reimbursements. A sensitivity analysis assessed model uncertainty. Results: The cost for HIMRT and toxicity management was $22,957, saving $7,000 compared with CIMRT ($30,241). CIMRT was the common factor among the 5 most influential scenarios that contributed to total costs. Toxicity represented a small part ( |
| Databáze: | OpenAIRE |
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