Better preservation of erectile function in localized prostate cancer patients with modern proton therapy: Is it cost‐effective?
| العنوان: | Better preservation of erectile function in localized prostate cancer patients with modern proton therapy: Is it cost‐effective? |
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| المؤلفون: | Guo Li, Yun‐Fei Xia, Yi‐Xiang Huang, Deniz Okat, Bo Qiu, Jerome Doyen, Pierre‐Yves Bondiau, Karen Benezery, Jin Gao, Chao‐Nan Qian |
| المصدر: | The Prostate. 82:1438-1446 |
| بيانات النشر: | Wiley, 2022. |
| سنة النشر: | 2022 |
| مصطلحات موضوعية: | Male, Erectile Dysfunction, Oncology, Cost-Benefit Analysis, Urology, Proton Therapy, Quality of Life, Humans, Prostatic Neoplasms, Middle Aged, Protons, Aged |
| الوصف: | Stereotactic body radiation therapy (SBRT) has gradually been recognized as favorable curative treatment for localized prostate cancer (PC). However, the high rate of erectile dysfunction (ED) after traditional photon-based SBRT remains an ongoing challenge that greatly impacts the quality of life of PC survivors. Modern proton therapy allows higher conformal SBRT delivery and has the potential to reduce ED occurrence but its cost-effectiveness remains uninvestigated.A Markov decision model was designed to evaluate the cost-effectiveness of proton SBRT versus photon SBRT in reducing irradiation-related ED. Base-case evaluation was performed on a 66-year-old (median age of PC) localized PC patient with normal pretreatment erectile function. Further, stratified analyses were performed for different age groups (50, 55, 60, 65, 70, and 75 years) and threshold analyses were conducted to estimate cost-effective scenarios. A Chinese societal willingness-to-pay (WTP) threshold (37,653 US dollars [$])/quality-adjusted life-year [QALY]) was adopted.For the base case, protons provided an additional 0.152 QALY at an additional cost of $7233.4, and the incremental cost-effectiveness ratio was $47,456.5/QALY. Protons was cost-effective for patients ≤62-year-old at the WTP of China (≤66-year-old at a WTP of $50,000/QALY; ≤73-year-old at a WTP of $100,000/QALY). For patients at median age, once the current proton cost ($18,000) was reduced to ≤$16,505.7 or the patient had a life expectancy ≥88 years, protons were cost-effective at the WTP of China.Upon assumption-based modeling, the results of current study support the use of proton SBRT in younger localized PC patients who are previously potent, for better preservation of erectile function. The findings await further validation using data from future comparative clinical trials. |
| تدمد: | 1097-0045 0270-4137 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::62b41d066e75593fecaabd5ee12f9191 https://doi.org/10.1002/pros.24417 |
| حقوق: | CLOSED |
| رقم الأكسشن: | edsair.doi.dedup.....62b41d066e75593fecaabd5ee12f9191 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 10970045 02704137 |
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