BACKGROUND: Intensity modulated radiation therapy (IMRT) is a radiation therapy technology that facilitates the delivery of an improved dose distribution with less dose to surrounding critical structures.
This study estimates the longer term effectiveness and cost-effectiveness of IMRT in patients post radical prostatectomy.
METHODS: A Markov decision model was developed to calculate the incremental quality adjusted life years (QALYs) and costs of IMRT compared with three dimensional conformal radiation therapy (3DCRT). Costs were estimated from the perspective of the Australian health care system.
RESULTS: IMRT was both more effective and less costly than 3DCRT over 20years, with an additional 20 QALYs gained and over $1.1 million saved per 1000 patients treated. This result was robust to plausible levels of uncertainty.
CONCLUSIONS: IMRT was estimated to have a modest long term advantage over 3DCRT in terms of both improved effectiveness and reduced cost. This result was reliant on clinical judgement and interpretation of the existing literature, but provides quantitative guidance on the cost effectiveness of IMRT whilst long term trial evidence is awaited.
Written by:
Carter HE, Martin A, Schofield D, Duchesne G, Haworth A, Hornby C, Sidhom M, Jackson M. Are you the author?
NHMRC Clinical Trials Centre, University of Sydney, Camperdown, Australia; Sir Peter MacCallum Dept of Oncology, University of Melbourne, Australia; Dept Physical Sciences, Peter MacCallum Cancer Centre, Melbourne, Australia; Division of Radiation Oncology, Peter MacCallum Cancer Centre, Australia; Liverpool Cancer Therapy Centre, Australia; Faculty of Medicine, University of New South Wales, Sydney, Australia.
Reference: Radiother Oncol. 2014 Jun 11. pii: S0167-8140(14)00163-7.
doi: 10.1016/j.radonc.2014.03.020
PubMed Abstract
PMID: 24929702
UroToday.com Prostate Cancer Section
