Comparison of health utility weights among elderly patients receiving breast-conserving surgery plus hormonal therapy with or without radiotherapy

Ali, Askal Ayalew; Xiao, Hong; Tawk, Rima; Campbell, Ellen; Montero, Alberto J.; Diaby, Vakaramoko

doi:10.1080/03007995.2016.1257983

Cited by 11 publications

(21 citation statements)

References 19 publications

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“…Moreover, patients who received postoperative radiotherapy, on average, tended to have a higher OS. This is consistent with the research conducted by Ali et al 13. As the average life expectancy in the United States continues to increase, the standard for “elderly” care may continue to rise.…”

Section: Discussionsupporting

confidence: 91%

Effects of Postoperative Radiotherapy in Early Breast Cancer Patients Older than 75 Years: A Propensity-Matched Analysis

et al. 2019

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Background: Currently, there is still some controversy regarding whether early breast cancer patients with a tumor size of ≤5 cm and 1-3 positive lymph nodes should undergo postoperative radiotherapy (PRT). Materials and Methods: We obtained data from the Surveillance, Epidemiology, and End Results (SEER) 18 database. Then, we conducted propensity score matching (PSM), according to the radiotherapy record. The Kaplan-Meier and Cox regression analysis were conducted to explore prognostic factors in breast cancer. Results: A total of 6,777 patients aged 75+ years old were eligible and 2,361 patients were included after PSM. We found PRT could improve patient overall survival (OS) (P = 0.01, hazard ratio [HR] = 0.88, 95% confidence interval [CI], 0.80-0.97). Subgroup analysis revealed PRT could improve OS in patients with hormone receptor positive (HR+) (P = 0.001, HR = 0.84, 95% CI, 0.76-0.94) or white patients (P =0.004, HR = 0.86, 95% CI, 0.77-0.95). Conclusions: PRT may benefit for elderly women with early breast cancer, especially in HR+ patients or white patients. These findings may inform future optimized options whether elderly female patients with early breast cancer should undergo postoperative radiotherapy.

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Section: Discussionsupporting

confidence: 91%

Effects of Postoperative Radiotherapy in Early Breast Cancer Patients Older than 75 Years: A Propensity-Matched Analysis

et al. 2019

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“…Several authors have already attempted to develop such a reference model for MBC treatments. These models were however limited to a specific setting or patient population [ 19 , 20 ].…”

Section: Discussionmentioning

confidence: 99%

“…Because model design influences cost-effectiveness results, researchers and the European network for health technology assessment (Eunethta) have argued for increased consistency between cost-effectiveness assessments [ 14 – 17 ]. Eunethta consequently encourages adherence to the HTA Core model ® [ 18 ] and researchers have argued for the development of disease-specific reference models; a unique model which would be used for all economic evaluations in a specific disease area [ 19 , 20 ].…”

Section: Introductionmentioning

confidence: 99%

Reviewing the quality, health benefit and value for money of chemotherapy and targeted therapy for metastatic breast cancer

Pouwels

Ramaekers

Joore

2017

Breast Cancer Res Treat

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PurposeTo provide an overview of model characteristics and outcomes of model-based economic evaluations concerning chemotherapy and targeted therapy (TT) for metastatic breast cancer (MBC); to assess the quality of the studies; to analyse the association between model characteristics and study quality and outcomes.MethodsPubMED and NHS EED were systematically searched. Inclusion criteria were as follows: English or Dutch language, model-based economic evaluation, chemotherapy or TT as intervention, population diagnosed with MBC, published between 2000 and 2014, reporting life years (LY) or quality-adjusted life-year (QALY) and an incremental cost-effectiveness ratio. General characteristics, model characteristics and outcomes of the studies were extracted. Quality of the studies was assessed through a checklist.Results24 studies were included, considering 50 comparisons (20 concerning chemotherapy and 30 TT). Seven comparisons were represented in multiple studies. A health state-transition model including the following health states: stable/progression-free disease, progression and death was used in 18 studies. Studies fulfilled on average 14 out of the 26 items of the quality checklist, mostly due to a lack of transparency in reporting. Thirty-one per cent of the incremental net monetary benefit was positive. TT led to higher iQALY gained, and industry-sponsored studies reported more favourable cost-effectiveness outcomes.ConclusionsThe development of a disease-specific reference model would improve the transparency and quality of model-based cost-effectiveness assessments for MBC treatments. Incremental health benefits increased over time, but were outweighed by the increased treatment costs. Consequently, increased health benefits led to lower value for money.Electronic supplementary materialThe online version of this article (doi:10.1007/s10549-017-4374-6) contains supplementary material, which is available to authorized users.

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“…Moreover, in the absence of clear literature data, the generalization of evidenced-based medical practice may be tenuous, making decisions more susceptible to physician biases and marketbased influences [1][2][3] . Over the last years, we have witnessed a growing interest in the treatment of elderly cancer patients, and various studies have shown that they can well tolerate multimodality treatments, including high dose radiotherapy with curative intent [1][2][3][4][5] . An increasing number of studies showed that also stereotactic body radiotherapy, i.e.…”

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confidence: 99%

“…On the other hand, there is a potential benefit from adjuvant radiotherapy in patients with predicted 10-year cancer specific survival rates lower than 80% 18 . The concept of health utility weight was recently introduced by Ali et al 1 , who estimated and compared the health utility of breast-conserving surgery followed by hormone therapy and associated or not with post-operative radiotherapy. The authors used an algorithm to determine the health utility weight by using health-related quality-of-life questionnaires.…”

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confidence: 99%

Could radiotherapy be omitted in elderly patients receiving breast conserving surgery?

Krengli

Pisani

2017

Current Medical Research and Opinion

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Comparison of health utility weights among elderly patients receiving breast-conserving surgery plus hormonal therapy with or without radiotherapy

Abstract: Background-The selection of the most appropriate treatment combinations requires the balancing of benefits and harms of these treatment options as well as the patients' preferences for the resulting outcomes.

Cited by 11 publications

References 19 publications

Effects of Postoperative Radiotherapy in Early Breast Cancer Patients Older than 75 Years: A Propensity-Matched Analysis

Effects of Postoperative Radiotherapy in Early Breast Cancer Patients Older than 75 Years: A Propensity-Matched Analysis

Reviewing the quality, health benefit and value for money of chemotherapy and targeted therapy for metastatic breast cancer

Could radiotherapy be omitted in elderly patients receiving breast conserving surgery?

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