Improved cost-effectiveness of short-course radiotherapy in elderly and/or frail patients with glioblastoma.
Radiotherapy and Oncology(2018)
摘要
Background and purpose: Short-course radiotherapy (25 Gy in five fractions) was recently shown in a randomized phase III trial to be non-inferior to 40 Gy in 15 fractions in elderly and/or frail patients with glioblastoma multiforme. This study compared the cost-effectiveness of the two regimens. Material and methods: The direct unit costs of imaging, radiotherapy (RT), and dexamethasone were collected from the five primary contributing countries to the trial, constituting the data of 88% of all patients. Effectiveness was measured by the restricted mean overall survival (RMOS) and progression free survival (RMPFS). The incremental cost-effectiveness ratio (ICER) was calculated. Indirect costs were also estimated for comparison. Results: The median OSs for the short-course and commonly used RTs were 8.2 (95% confidence interval [CI] 6.1-10.3) and 7.7 (95% CI 5.5-9.9) months, respectively (log rank p = 0.340). Median PFSs were also not different (p = 0.686). The differences in the RMOS and the ICER, however, were + 0.11 life-years and $ 3062 United States dollars (USD) per life-year gained, respectively. The differences in the RMPFS and the ICER were + 0.02 PFS and -$ 17,693 USD, respectively. Conclusion: The ICER of -$ 3062 per life-year gained and -$ 17,693 per PFS gained indicates that the short-course RT is less costly compared to the longer RT regimen. (C) 2018 Published by Elsevier B. V. Radiotherapy and Oncology 127 (2018) 114-120
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关键词
Cost-effectiveness,Radiotherapy,Short-course,Elderly,Frail,Glioblastoma
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