A decision model to estimate the cost-effectiveness of intensity modulated radiation therapy (IMRT) compared to three dimensional conformal radiation therapy (3DCRT) in patients receiving radiotherapy to the prostate bed

Carter, Hannah; Martin, Andrew; Schofield, Deborah; Duchesne, Gillian; Haworth, Annette; Hornby, Colin; Sidhom, Mark; Jackson, Michael

doi:10.1016/j.radonc.2014.03.020

Cited by 26 publications

(40 citation statements)

References 25 publications

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“…6 The article illustrates how the Framework stages were followed to produce the diverse pieces of evidence successfully, supporting the health-economic assessment of a radiation oncology technique. Review of the results across the four clinical protocols demonstrated consistency from one to another, supporting the robustness of both the process of the Framework and the indicators chosen as predictors.…”

Section: Gm Duchesne Et Almentioning

confidence: 99%

Trans Tasman Radiation Oncology Group: Development of the Assessment of New Radiation Oncology Technology and Treatments (ANROTAT) Framework

et al. 2014

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Introduction: The study aim was to develop a generic framework to derive the parameters to populate health-economic models for the rapid evaluation of new techniques and technologies in radiation oncology. Methods: A draft framework was developed through horizon scanning for relevant technologies, literature review to identify framework models, and a workshop program with radiation oncology professionals, biostatisticians, health economists and consumers to establish the Framework's structure. It was tested using four clinical protocols, comparing intensity modulated with 3D conformal therapy (post-prostatectomy, anal canal and nasopharynx) and image-guided radiation therapy techniques with off-line review of portal imaging (in the intact prostate). Results: The draft generic research framework consisted of five sequential stages, each with a number of components, and was assessed as to its suitability for deriving the evidence needed to populate the decision-analytic models required for the health-economic evaluations. A final Framework was established from this experience for use by future researchers to provide evidence of clinical efficacy and cost-utility for other novel techniques. The four clinical treatment sites tested during the project were considered suitable to use in future evaluations. Conclusions: Development of a generic research framework to predict early and long-term clinical outcomes, combined with health-economic data, produced a generally applicable method for the rapid evaluation of new techniques and technologies in radiation oncology. Its application to further health technology assessments in the radiation oncology sector will allow further refinement and support its generalisability.

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Section: Gm Duchesne Et Almentioning

confidence: 99%

Trans Tasman Radiation Oncology Group: Development of the Assessment of New Radiation Oncology Technology and Treatments (ANROTAT) Framework

et al. 2014

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“…There are many publications which demonstrate the benefits of IMRT in radiotherapy for patients with prostate cancer [1][2][3][4][5][6][7][8][9]. However, only a few of them have evaluated the feasibility of this technique for patients after prostatectomy [10][11][12]. These studies show that IMRT, together with a helical tomotherapy (HT), allow for better local tumour control and spare organs at risk (OARs).…”

Section: Introductionmentioning

confidence: 99%

Comparison of 3D-CRT and IMRT techniques in radiotherapy for post-prostatectomy patients with a higher risk of nodal involvement

Poncyljusz

Kukołowicz

Chorąży

et al. 2017

Nowotwory. Journal of Oncology

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Background. Irradiation of a larger volume of the target may lead to an increase of the doses delivered to the surrounding organs at risk (OAR) for post-prostatectomy patients with a higher risk of nodal involvement. It was anticipated that IMRT significantly improved OAR sparing. The aim of this study was to provide a dosimetric comparison between conformal radiotherapy (3D-CRT) and intensity-modulated radiotherapy (IMRT) treatment plans for patients with prostate cancer irradiated to the prostate bed and pelvic lymph-nodal area. Materials and methods. The 3D-CRT and IMRT plans were created for ten patients after prostatectomy. The treatment plans were generated for the prostate bed (PTV1) and the pelvic lymph nodes (PTV2). The sum of PTV1 and PTV2 was irradiated to a mean dose of 46 Gy in 23 fractions, and additionally PTV1 was irradiated to a mean dose of 18 Gy in 9 fractions. Target coverage and the doses delivered to the pelvic bones, the rectum, the bladder, the bowel bag, and the femurs, were compared between techniques. The Wilcoxon signed-rank test was used to compare the dosimetric parameters. Results. The dosimetric quality of 3D-CRT and IMRT plans were comparable for target coverage (the mean value of PTV1 V95%, the mean value of PTV2 V95% all > 99%). The IMRT plans resulted in significant reductions in the pelvic bones Conclusions. The analysis presented in this paper demonstrates that the IMRT technique reduces the delivered dose to the OARs. Most interesting was the possibility of reducing the delivered dose to the pelvic bones and the bowel bag. This allowed us to expect a decreased risk of acute hematologic toxicity and acute gastrointestinal toxicity. NOWOTWORY J Oncol 2016; 66, 6: 440-444

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“…That trend persisted in ceas of imrt and 3D-crt published during 2012-2015 that looked at prostate, anal, gynecologic, and head-and-neck cancers [8][9][10][11][12] . However, the included cost components varied and omitted capital costs, with one Australian analysis of imrt in prostate cancer specifically excluding them based on the recommendations of their national Medical Services Advisory Committee 13 . The integration of components such as gynecologic toxicities 8 , concurrent chemotherapy 9 , hormonal therapy, and palliative care 10 , in addition to no expressed intention for the costing approach to be transferable, demonstrates the challenge of comparability between ceas.…”

Section: Introductionmentioning

confidence: 99%

Estimating the Costs of Intensity-Modulated and 3-Dimensional Conformal Radiotherapy in Ontario

et al. 2016

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A decision model to estimate the cost-effectiveness of intensity modulated radiation therapy (IMRT) compared to three dimensional conformal radiation therapy (3DCRT) in patients receiving radiotherapy to the prostate bed

Cited by 26 publications

References 25 publications

Trans Tasman Radiation Oncology Group: Development of the Assessment of New Radiation Oncology Technology and Treatments (ANROTAT) Framework

Trans Tasman Radiation Oncology Group: Development of the Assessment of New Radiation Oncology Technology and Treatments (ANROTAT) Framework

Comparison of 3D-CRT and IMRT techniques in radiotherapy for post-prostatectomy patients with a higher risk of nodal involvement

Estimating the Costs of Intensity-Modulated and 3-Dimensional Conformal Radiotherapy in Ontario

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