دورية أكاديمية
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Cost effectiveness of treatment strategies for high risk prostate cancer.

التفاصيل البيبلوغرافية
العنوان: Cost effectiveness of treatment strategies for high risk prostate cancer.
المؤلفون: Kowalchuk RO; Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota, USA., Kim H; Department of Radiation Oncology, Hillman Cancer Center, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA., Harmsen WS; Department of Statistics, Mayo Clinic, Rochester, Minnesota, USA., Jeans EB; Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota, USA., Morris LK; Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota, USA., Mullikin TC; Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota, USA., Miller RC; Mayo Clinic, Department of Radiation Oncology, Mayo Clinic, Jacksonville, Florida, USA., Wong WW; Department of Radiation Oncology, Mayo Clinic, Phoenix, Arizona, USA., Vargas CE; Department of Radiation Oncology, Mayo Clinic, Phoenix, Arizona, USA., Trifiletti DM; Mayo Clinic, Department of Radiation Oncology, Mayo Clinic, Jacksonville, Florida, USA., Phillips RM; Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota, USA., Choo CR; Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota, USA., Davis BJ; Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota, USA., Beriwal S; Allegheny Health Networks, Pittsburgh, Pennsylvania, USA.; Medical Affairs, Varian Medical Systems, Pittsburgh, Pennsylvania, USA., Tendulkar RD; Department of Radiation Oncology, Cleveland Clinic, Cleveland, Ohio, USA., Stish BJ; Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota, USA., Breen WG; Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota, USA., Waddle MR; Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota, USA.
المصدر: Cancer [Cancer] 2022 Nov 01; Vol. 128 (21), pp. 3815-3823. Date of Electronic Publication: 2022 Sep 07.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Wiley Country of Publication: United States NLM ID: 0374236 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1097-0142 (Electronic) Linking ISSN: 0008543X NLM ISO Abbreviation: Cancer Subsets: MEDLINE
أسماء مطبوعة: Publication: <2005- >: Hoboken, NJ : Wiley
Original Publication: New York [etc.] Published for the American Cancer Society by J. Wiley [etc.]
مواضيع طبية MeSH: Brachytherapy*/methods , Prostatic Neoplasms*, Cost-Benefit Analysis ; Humans ; Male ; Prostatectomy ; Quality of Life
مستخلص: Background: Patients with high-risk prostate cancer (HRPC) have multiple accepted treatment options. Because there is no overall survival benefit of one option over another, appropriate treatment must consider patient life expectancy, quality of life, and cost.
Methods: The authors compared quality-adjusted life years (QALYs) and cost effectiveness among treatment options for HRPC using a Markov model with three treatment arms: (1) external-beam radiotherapy (EBRT) delivered with 20 fractions, (2) EBRT with 23 fractions followed by low-dose-rate (LDR) brachytherapy boost, or (3) radical prostatectomy alone. An exploratory analysis considered a simultaneous integrated boost according to the FLAME trial (ClinicalTrials.gov identifier NCT01168479).
Results: Treatment strategies were compared using the incremental cost-effectiveness ratio (ICER). EBRT with LDR brachytherapy boost was a cost-effective strategy (ICER, $20,929 per QALY gained). These results were most sensitive to variations in the biochemical failure rate. However, the results still demonstrated cost effectiveness for the brachytherapy boost paradigm, regardless of any tested parameter ranges. Probabilistic sensitivity analysis demonstrated that EBRT with LDR brachytherapy was favored in 52% of 100,000 Monte Carlo iterations. In an exploratory analysis, EBRT with a simultaneous integrated boost was also a cost-effective strategy, resulting in an ICER of $62,607 per QALY gained; however, it was not cost effective compared with EBRT plus LDR brachytherapy boost.
Conclusions: EBRT with LDR brachytherapy boost may be a cost-effective treatment strategy compared with EBRT alone and radical prostatectomy for HRPC, demonstrating high-value care. The current analysis suggests that a reduction in biochemical failure alone can result in cost-effective care, despite no change in overall survival.
(© 2022 American Cancer Society.)
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فهرسة مساهمة: Keywords: brachytherapy; cost effectiveness; high-risk prostate cancer; prostatectomy; treatment strategies
سلسلة جزيئية: ClinicalTrials.gov NCT01168479
تواريخ الأحداث: Date Created: 20220907 Date Completed: 20221017 Latest Revision: 20221214
رمز التحديث: 20240628
DOI: 10.1002/cncr.34450
PMID: 36070558
قاعدة البيانات: MEDLINE
الوصف
تدمد:1097-0142
DOI:10.1002/cncr.34450