Format

Send to

Choose Destination
Radiother Oncol. 2018 Apr;127(1):114-120. doi: 10.1016/j.radonc.2018.01.017. Epub 2018 Feb 13.

Improved cost-effectiveness of short-course radiotherapy in elderly and/or frail patients with glioblastoma.

Author information

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.

KEYWORDS:

Cost-effectiveness; Elderly; Frail; Glioblastoma; Radiotherapy; Short-course

PMID:
29452901
DOI:
10.1016/j.radonc.2018.01.017
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center