─ Background: Breast cancer is a disease that affects a large part of the Brazilian female population. Especially, those bones metastasis developed in the spinal column. This can produce potential fractures with neurological compromise or reduction of the life's quality of the patient due to chronic pain. Objective: Computational dosimetry study in vertebrae models simulating bone metastasis locating a radioactive bone cement with Sm-153, Ho-166 or Y-90 in the vertebral body. Methods: Radiological images of animal vertebrae was used to construct a model using the MCNPx code (MonteCarlo N-Particle code). Deposited doses were evaluated in the axial plane (XY) respect to implant of the radioactive bone cement into the metastasis. The nearest organ of risk (OAR) was the spinal cord and the planning target volume (PTV) was the implant itself on the vertebrae. The and Yttrium-90 (Y-90) radionuclides were considered. Results: The therapeutic deposited dose obtained in the implant plane by radioactive bone cement reaches levels above 70 Gy for specific activities close to 3 GBq•mg -1 with suitable values for the Y-90 coupled to the cement. Exposure to Ho-166 produces a dose such that cover 76,49 % and 62,77 % for two cases with metastasis respect to PTV while Y-90 covers 94,30 % and 80,91 % on the PTV. Conclusions: The radioactive cement implant may potentially to make an optimal tumor control and lower side effects in organs at risk.

medical costs (2014 purchases and price tabulators) where retrieved to adopt the national health system perspective. Information gaps related to the use and frequency of medical resources where fulfilled with the results of a Delphi panel (10 oncologists of all major public institutions). The model was populated with the results of a Network Meta-Analysis. Both probabilistic and deterministic sensitivity analysis were performed to back up the results. RESULTS: Life years in PFS and OS gave an advantage to afatinib with 1.17 and 2.21 years respectively, followed by erlotinib with 1.11 and 2.07, gefitnib with 1.02 and 2.12 and pemetrexed/cisplatin with 0.63 and 2.07. Least costly therapy was afatinib with total treatment costs until death of US$100,152, followed by erlotinib, gefitinib and pemetrexed/cisplatin with 141,040 USD, 141,176 USD and 175,889 USD respectively. Afatinib, erlotinib and gefitinib resulted dominant therapies against pemetrexed/cisplatin. A further analysis showed a dominance of afatinib versus the others TKIs. Results were robust to changes in the time horizon (1 to 5 years) and prices (±10%). CONCLUSIONS: Afatinib resulted to be a cost-saving therapy against all comparators, presenting the least costly treatment and the most life years gained in terms of both PFS and OS from a Mexican public health perspective.OBJECTIVES: To establish the incremental cost-effectiveness ratio (ICER) of tyrosinekinase inhibitors (TKIs) afatinib, erlotinib and gefitinib versus pemetrexed/cisplatin in presence of EGFR mutations from a public Mexican perspective. Main efficacy endpoint was progression free survival (PFS) and secondary endpoint overall survival (OS). METHODS: A discrete event simulation CE model was developed to assess PFS, OS and treatment related costs until death in a five year time horizon. Three relevant clinical health outcomes were assessed in one month length cycles: Progression free, disease progression and death. Public institutional direct

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Intensa pesquisa foi deslocada para integrar a nanotecnologia no tratamento do câncer, face aos resultados insatisfatórios das abordagens terapêuticas tradicionais. A nanomedicina, campo sobreposto da nanotecnologia e da medicina, traz uma série de vantagens sobre a terapêutica convencional do câncer, incluindo radiosensibilização, multifuncionalidade, eficiência na entrega de drogas e liberação controlada de agentes quimioterápicos. Dentre as várias frentes de ação que têm sido seguidas, também a terapia gênica surge como uma proposta promissora como suporte ao tratamento do câncer, podendo ainda se aliar a sistemas nanoestrutrados para trazer um efeito sinergético, proporcionando bloqueio de marcadores metastáticos para aumentar a expectativa de vida em pacientes com estadiamento mais avançados.

Objectives: UHC is the largest hospital in Crete and among the 5 largest hospitals in Greece. With the implementation of the memorandum, all operators were asked to reduce their costs, while special emphasis was placed on decreasing health care costs. In 2012, in this context, UHC made various attempts to diminish its budget. MethOds: Two events happened in 2012: 1) Pharmaceutical companies were asked to offer discounts for their products' price; 2) A central unit for the cytostatics drugs' dilution for all oncologic therapies was founded. Good management and economy of scale succeeded in quantity saving of drugs that were re-entered in pharmacy's stock. Results: The effect of these combined actions was examined in achieving the goal of reducing the pharmaceutical expenditure. In order for the data to be comparable, only the drugs used in the CU were studied. Specifically, there are 113 medications (62 prototypes, 31 generics and 20 orphan drugs), which derived from 23 companies. In 2012, 100.000 units were consumed in hospital that worth 10 M€ . The combined results were impressive as a budget reduction of 21.4% was achieved (15.4% due to discounts and 6% due to the CU). As per the discounts, 82% of cytostatics' value represents prototypes and expensive drugs, which were limited to the legal rebate of 5% discount, while 17% is mostly generics whose discounts varied from 29.5 to 92.9%. Thus, 73.4% of the value benefit was due to generic and 26.6% due to the prototype drugs. As for the CU's savings, 6000 pieces were returned to the pharmacy. A total of 91.7% of the value benefit derived from the prototypes and the remaining 8.3% from the generic and orphan drugs. cOnclusiOns: Taking into consideration that cytostatic drugs' cost equals 1/3 of the total pharmaceutical expenditure, even if only these two events were taking place, a 7.1% budget decrease was achieved.