The cost-effectiveness of particle therapy in non-small cell lung cancer: exploring decision uncertainty and areas for future research.
Cancer Treat Rev
; 36(6): 468-76, 2010 Oct.
Article
em En
| MEDLINE
| ID: mdl-20303217
ABSTRACT
PURPOSE:
To review and synthesize all available evidence in order to explore the cost-effectiveness of particle therapy (carbon-ions, protons) compared to the best current treatments for non-small-cell lung cancer (NSCLC), and the value of additional research. The present study focuses on stage I NSCLC, as no data is available for more advanced stages.METHODS:
A probabilistic decision-analytic Markov model was constructed to synthesize all available evidence. Comparative treatments were carbon-ions, protons, conventional radiotherapy (CRT) and stereotactic radiotherapy (SBRT) for inoperable stage I NSCLC; and carbon-ions and SBRT for operable stage I NSCLC. The expected value of perfect information (EVPI) was calculated to support research decisions.RESULTS:
For inoperable stage I NSCLC, carbon-ion therapy costed euro 67.257 per quality-adjusted-life-year gained compared to SBRT. Both treatments dominated protons and CRT. Considerable uncertainty surrounded these results, resulting in a high EVPI. For operable stage I NSCLC SBRT dominated carbon-ion therapy.CONCLUSIONS:
Due to the considerable uncertainty in stage I NSCLC, and the lack of data on more advanced stages, it is recommended not to adopt particle therapy as standard treatment in NSCLC yet. More evidence is needed to reduce the decision uncertainty and to support evidence-based treatment decisions. It might be worthwhile to invest in a particle facility for clinical research. Future research should also weigh the investment risk, value of information and costs of delay.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Carbono
/
Carcinoma Pulmonar de Células não Pequenas
/
Terapia com Prótons
/
Neoplasias Pulmonares
Tipo de estudo:
Health_economic_evaluation
/
Prognostic_studies
Aspecto:
Patient_preference
Limite:
Humans
Idioma:
En
Revista:
Cancer Treat Rev
Ano de publicação:
2010
Tipo de documento:
Article
País de afiliação:
Holanda