Kohler, R. E., Sheets, N. C., Wheeler, S. B., Nutting, C., Hall, E., Chera, B. S. (2013) Two-Year and Lifetime Cost-Effectiveness of Intensity Modulated Radiation Therapy Versus 3-Dimensional Conformal Radiation Therapy for Head-and-Neck Cancer. INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 87 (4). pp. 683-689. ISSN 0360-3016

Full text not available from this repository.

Abstract

Purpose: To assess the cost-effectiveness of intensity modulated radiation therapy (IMRT) versus 3-dimensional conformal radiation therapy (3D-CRT) in the treatment of head-and neck-cancer (HNC). Methods and Materials: We used a Markov model to simulate radiation therapy-induced xerostomia and dysphagia in a hypothetical cohort of 65-year-old HNC patients. Model input parameters were derived from PARSPORT (CRUK/03/005) patient-level trial data and quality-of-life and Medicare cost data from published literature. We calculated average incremental cost-effectiveness ratios (ICERs) from the US health care perspective as cost per quality-adjusted life-year (QALY) gained and compared our ICERs with current cost-effectiveness standards whereby treatment comparators less than $50,000 per QALY gained are considered cost-effective. Results: In the first 2 years after initial treatment, IMRT is not cost-effective compared with 3D-CRT, given an average ICER of $101,100 per QALY gained. However, over 15 years (remaining lifetime on the basis of average life expectancy of a 65-year-old), IMRT is more cost-effective at $34,523 per QALY gained. Conclusion: Although HNC patients receiving IMRT will likely experience reduced xerostomia and dysphagia symptoms, the small quality-of-life benefit associated with IMRT is not cost-effective in the short term but may be cost-effective over a patient's lifetime, assuming benefits persist over time and patients are healthy and likely to live for a sustained period. Additional data quantifying the long-term benefits of IMRT, however, are needed. (C) 2013 Elsevier Inc.

Item Type:	Article
Authors (ICR Faculty only):	Nutting, Chris and Hall, Emma
All Authors:	Kohler, R. E., Sheets, N. C., Wheeler, S. B., Nutting, C., Hall, E., Chera, B. S.
Additional Information:	ISI Document Delivery No.: 235ZS Times Cited: 0 Cited Reference Count: 25 Kohler, Racquel E. Sheets, Nathan C. Wheeler, Stephanie B. Nutting, Chris Hall, Emma Chera, Bhishamjit S. Cancer Research UK [CRUK/03/005] PARSPORT was funded by Cancer Research UK (CRUK/03/005). Elsevier science inc New york
Uncontrolled Keywords:	quality-of-life stage nasopharyngeal carcinoma late treatment-toxicity effects working group oropharyngeal cancer human-papillomavirus clinical-trial initial report united-states radiotherapy
Research teams:	ICR divisions > Clinical Studies > ICR-CTSU Urology and Head and Neck Trials Team Clinical Units > Head & Neck Cancer Unit
Depositing User:	Barry Jenkins
Date Deposited:	14 Nov 2013 15:54
Last Modified:	14 Nov 2013 15:54
URI:	http://publications.icr.ac.uk/id/eprint/12827

Actions (login required)

View Item