Vivek Verma1, Mark V Mishra2, Minesh P Mehta2. 1. Department of Radiation Oncology, University of Nebraska Medical Center, Omaha, Nebraska. 2. Department of Radiation Oncology, University of Maryland Medical Center, Baltimore, Maryland.
Abstract
BACKGROUND: Economic analyses of new technologies, such as proton-beam radiotherapy (PBT), are a public health priority. To date, no systematic review of the cost-effectiveness of PBT has been performed. METHODS: Systematic searches of PubMed, EMBASE, abstracts from American Society for Radiation Oncology and American Society of Clinical Oncology meetings, and the Cost-Effectiveness Analysis Registry were conducted (2000-2015) along with abstracts from the Particle Therapy Co-Operative Group of North America for both years of existence (2014-2015). Eighteen original investigations were analyzed. RESULTS: The cost-effectiveness for prostate cancer-the single most common diagnosis currently treated with PBT-was suboptimal. PBT was the most cost-effective option for several pediatric brain tumors. PBT costs for breast cancer were increased but were favorable for appropriately selected patients with left-sided cancers at high risk of cardiac toxicity and compared with brachytherapy for accelerated partial breast irradiation. For non-small cell lung cancer (NSCLC), the greatest cost-effectiveness benefits using PBT were observed for locoregionally advanced-but not early stage-tumors. PBT offered superior cost-effectiveness in selected head/neck cancer patients at higher risk of acute mucosal toxicities. Similar cost-effectiveness was observed for PBT, enucleation, and plaque brachytherapy in patients with uveal melanoma. CONCLUSIONS: With greatly limited amounts of data, PBT offers promising cost-effectiveness for pediatric brain tumors, well-selected breast cancers, locoregionally advanced NSCLC, and high-risk head/neck cancers. Heretofore, it has not been demonstrated that PBT is cost-effective for prostate cancer or early stage NSCLC. Careful patient selection is absolutely critical to assess cost-effectiveness. Together with increasing PBT availability, clinical trial evidence, and ongoing major technological improvements, cost-effectiveness data and conclusions from this analysis could change rapidly. Cancer 2016;122:1483-501.
BACKGROUND: Economic analyses of new technologies, such as proton-beam radiotherapy (PBT), are a public health priority. To date, no systematic review of the cost-effectiveness of PBT has been performed. METHODS: Systematic searches of PubMed, EMBASE, abstracts from American Society for Radiation Oncology and American Society of Clinical Oncology meetings, and the Cost-Effectiveness Analysis Registry were conducted (2000-2015) along with abstracts from the Particle Therapy Co-Operative Group of North America for both years of existence (2014-2015). Eighteen original investigations were analyzed. RESULTS: The cost-effectiveness for prostate cancer-the single most common diagnosis currently treated with PBT-was suboptimal. PBT was the most cost-effective option for several pediatric brain tumors. PBT costs for breast cancer were increased but were favorable for appropriately selected patients with left-sided cancers at high risk of cardiac toxicity and compared with brachytherapy for accelerated partial breast irradiation. For non-small cell lung cancer (NSCLC), the greatest cost-effectiveness benefits using PBT were observed for locoregionally advanced-but not early stage-tumors. PBT offered superior cost-effectiveness in selected head/neck cancerpatients at higher risk of acute mucosal toxicities. Similar cost-effectiveness was observed for PBT, enucleation, and plaque brachytherapy in patients with uveal melanoma. CONCLUSIONS: With greatly limited amounts of data, PBT offers promising cost-effectiveness for pediatric brain tumors, well-selected breast cancers, locoregionally advanced NSCLC, and high-risk head/neck cancers. Heretofore, it has not been demonstrated that PBT is cost-effective for prostate cancer or early stage NSCLC. Careful patient selection is absolutely critical to assess cost-effectiveness. Together with increasing PBT availability, clinical trial evidence, and ongoing major technological improvements, cost-effectiveness data and conclusions from this analysis could change rapidly. Cancer 2016;122:1483-501.
Authors: Steven H Lin; Brian P Hobbs; Vivek Verma; Rebecca S Tidwell; Grace L Smith; Xiudong Lei; Erin M Corsini; Isabel Mok; Xiong Wei; Luyang Yao; Xin Wang; Ritsuko U Komaki; Joe Y Chang; Stephen G Chun; Melenda D Jeter; Stephen G Swisher; Jaffer A Ajani; Mariela Blum-Murphy; Ara A Vaporciyan; Reza J Mehran; Albert C Koong; Saumil J Gandhi; Wayne L Hofstetter; Theodore S Hong; Thomas F Delaney; Zhongxing Liao; Radhe Mohan Journal: J Clin Oncol Date: 2020-03-11 Impact factor: 44.544
Authors: Scott M Glaser; Ronny Kalash; Dante R Bongiorni; Mark S Roberts; Goundappa K Balasubramani; Bruce L Jacobs; Sushil Beriwal; Dwight E Heron; Joel S Greenberger Journal: In Vivo Date: 2018 Jan-Feb Impact factor: 2.155
Authors: Joe Y Chang; Vivek Verma; Ming Li; Wencheng Zhang; Ritsuko Komaki; Charles Lu; Pamela K Allen; Zhongxing Liao; James Welsh; Steven H Lin; Daniel Gomez; Melenda Jeter; Michael O'Reilly; Ronald X Zhu; Xiaodong Zhang; Heng Li; Radhe Mohan; John V Heymach; Ara A Vaporciyan; Stephen Hahn; James D Cox Journal: JAMA Oncol Date: 2017-08-10 Impact factor: 31.777