Sunita Ghosh1, Sarah Baker1, Douglas Guedes de Castro2, Lucyna Kepka3, Narendra Kumar4, Valery Sinaika5, Juliana Matiello6, Darejan Lomidze7, Katarzyna Dyttus-Cebulok8, Eduardo Rosenblatt9, Elena Fidarova9, Wilson Roa10. 1. Cross Cancer Institute and University of Alberta, Edmonton, Canada. 2. AC Camargo Cancer Center, São Paulo, Brazil. 3. Independent Public Health Care Facility of the Ministry of the Interior and Warmian & Mazurian Oncology Centre, Olsztyn, Poland. 4. Postgraduate Institute of Medical Education and Research, Chandigarh, India. 5. N.N. Alexandrov National Cancer Centre of Belarus, Minsk, Belarus. 6. Irmandade da Santa Casa de Misericórdia de Porto Alegre, Brazil. 7. High Technology Medical Centre, University Clinic, Tbilisi, Georgia. 8. Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology, Warsaw, Poland. 9. International Atomic Energy Agency, Vienna, Austria. 10. Cross Cancer Institute and University of Alberta, Edmonton, Canada. Electronic address: wilson.roa@ahs.ca.
Abstract
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.
RCT Entities:
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.
Authors: Brandon A Sherrod; Nicholas T Gamboa; Christopher Wilkerson; Herschel Wilde; Mohammed A Azab; Michael Karsy; Randy L Jensen; Sarah T Menacho Journal: J Neurooncol Date: 2019-05-04 Impact factor: 4.130
Authors: Mirjam Renovanz; Anne-Katrin Hickmann; Minou Nadji-Ohl; Naureen Keric; Elke Weimann; Christian Rainer Wirtz; Susanne Singer; Florian Ringel; Jan Coburger Journal: Support Care Cancer Date: 2020-02-14 Impact factor: 3.603