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Title: Individualized Positron Emission Tomography–Based Isotoxic Accelerated Radiation Therapy Is Cost-Effective Compared With Conventional Radiation Therapy: A Model-Based Evaluation

Purpose: To evaluate long-term health effects, costs, and cost-effectiveness of positron emission tomography (PET)-based isotoxic accelerated radiation therapy treatment (PET-ART) compared with conventional fixed-dose CT-based radiation therapy treatment (CRT) in non-small cell lung cancer (NSCLC). Methods and Materials: Our analysis uses a validated decision model, based on data of 200 NSCLC patients with inoperable stage I-IIIB. Clinical outcomes, resource use, costs, and utilities were obtained from the Maastro Clinic and the literature. Primary model outcomes were the difference in life-years (LYs), quality-adjusted life-years (QALYs), costs, and the incremental cost-effectiveness and cost/utility ratio (ICER and ICUR) of PET-ART versus CRT. Model outcomes were obtained from averaging the predictions for 50,000 simulated patients. A probabilistic sensitivity analysis and scenario analyses were carried out. Results: The average incremental costs per patient of PET-ART were €569 (95% confidence interval [CI] €−5327-€6936) for 0.42 incremental LYs (95% CI 0.19-0.61) and 0.33 QALYs gained (95% CI 0.13-0.49). The base-case scenario resulted in an ICER of €1360 per LY gained and an ICUR of €1744 per QALY gained. The probabilistic analysis gave a 36% probability that PET-ART improves health outcomes at reduced costs and a 64% probability that PET-ART is more effective at slightly higher costs. Conclusion:more » On the basis of the available data, individualized PET-ART for NSCLC seems to be cost-effective compared with CRT.« less
Authors:
 [1] ;  [1] ;  [2] ;  [3] ; ;  [4] ;  [1] ;  [3]
  1. Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam (Netherlands)
  2. Radiation Oncology University Hospitals Leuven/KU Leuven, Leuven (Belgium)
  3. (Netherlands)
  4. Department of Radiation Oncology, GROW Research Institute, Maastricht University Medical Center, Maastricht (Netherlands)
Publication Date:
OSTI Identifier:
22458660
Resource Type:
Journal Article
Resource Relation:
Journal Name: International Journal of Radiation Oncology, Biology and Physics; Journal Volume: 91; Journal Issue: 4; Other Information: Copyright (c) 2015 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; COMPARATIVE EVALUATIONS; COST; FORECASTING; LUNGS; NEOPLASMS; PATIENTS; POSITRON COMPUTED TOMOGRAPHY; PROBABILISTIC ESTIMATION; PROBABILITY; RADIATION DOSES; RADIOTHERAPY; SENSITIVITY ANALYSIS; SIMULATION