Cost-effectiveness analysis of intraoperative radiation therapy versus external beam radiation therapy for the adjuvant treatment of early breast cancer: A systematic review

Eisavi, Mahmoud; Rezapour, Aziz; Alipour, Vahid; Arabloo, Jalal

doi:10.47176/mjiri.34.167

Cited by 4 publications

(4 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…For the IORT technology, a systematic review of articles comparing IORT with external beam radiation therapy (EBRT) was done by Eisavi et al, who found 8 cost-effectiveness articles that met the selection criteria. Inconsistent results regarding IORT cost-effectiveness were reported: 4 articles show that IORT costs were lower with more benefits compared to EBRT, while in 3, despite IORT costs being also lower than EBRT, the benefits were lower too and it was dominated by EBRT [ 23 ]. Some of the studies that reported more benefits for IORT extrapolated local recurrence rate at years from 5 years data reported in the TARGIT-A trial, which lead to estimation errors.…”

Section: Discussionmentioning

confidence: 99%

Cost-effectiveness of intraoperative radiation therapy versus intensity-modulated radiation therapy for the treatment of early breast cancer: a disinvestment analysis

Muñoz-Montecinos,

González-Browne,

Maza

et al. 2024

BMC Health Serv Res

View full text Add to dashboard Cite

Background Adjuvant radiotherapy represents a key component in curative-intent treatment for early-stage breast cancer patients. In recent years, two accelerated partial breast irradiation (APBI) techniques are preferred for this population in our organization: electron-based Intraoperative radiation therapy (IORT) and Linac-based External Beam Radiotherapy, particularly Intensity-modulated radiation therapy (IMRT). Recently published long-term follow-up data evaluating these technologies have motivated a health technology reassessment of IORT compared to IMRT. Methods We developed a Markov model to simulate health-state transitions from a cohort of women with early-stage breast cancer, after lumpectomy and adjuvant APBI using either IORT or IMRT techniques. The cost-effectiveness from a private health provider perspective was assessed from a disinvestment point of view, using life-years (LYs) and recurrence-free life-years (RFLYs) as measure of benefits, along with their respective quality adjustments. Expected costs and benefits, and the incremental cost-effectiveness ratio (ICER) were reported. Finally, a sensitivity and scenario analyses were performed to evaluate the cost-effectiveness using lower IORT local recurrence and metastasis rates in IORT patients, and if equipment maintenance costs are removed. Results IORT technology was dominated by IMRT in all cases (i.e., fewer benefits with greater costs). Despite small differences were found regarding benefits, especially for LYs, costs were considerably higher for IORT. For sensitivity analyses with lower recurrence and metastasis rates for IORT, and scenario analyses without equipment maintenance costs, IORT was still dominated by IMRT. Conclusions For this cohort of patients, IMRT was, at least, non-inferior to IORT in terms of expected benefits, with considerably lower costs. As a result, IORT disinvestment should be considered, favoring the use of IMRT in these patients.

show abstract

Section: Discussionmentioning

confidence: 99%

Cost-effectiveness of intraoperative radiation therapy versus intensity-modulated radiation therapy for the treatment of early breast cancer: a disinvestment analysis

Muñoz-Montecinos,

González-Browne,

Maza

et al. 2024

BMC Health Serv Res

View full text Add to dashboard Cite

show abstract

“…On the other hand, Eisavi et al reported their results of systematic review based on current evidence, showing that IORT was associated with lower costs compared with external beam RT. 40 …”

Section: Discussionmentioning

confidence: 99%

Long-Term Results of Intraoperative Radiation Therapy for Early Breast Cancer Using a Nondedicated Linear Accelerator

Hanna¹,

Bevilacqua²,

Barros³

et al. 2023

Advances in Radiation Oncology

View full text Add to dashboard Cite

“…For the IORT technology, a systematic review of articles comparing IORT with external beam radiation therapy (EBRT) was done by Eisavi et al, who found 8 cost-effectiveness articles that met the selection criteria. Inconsistent results regarding IORT cost-effectiveness were reported: 4 articles show that IORT costs were lower with more bene ts compared to EBRT, while in 3, despite IORT costs being also lower than EBRT, the bene ts were lower too and it was dominated by EBRT (20). Some of the studies that reported more bene ts for IORT extrapolated local recurrence rate at 10 years from 5 years data reported in the TARGIT-A trial, which lead to estimation errors.…”

Section: Discussionmentioning

confidence: 99%

Cost-effectiveness of intraoperative radiation therapy versus intensity-modulated radiation therapy for the treatment of early breast cancer: A disinvestment analysis

Muñoz-Montecinos

González-Browne

Maza

et al. 2022

Preprint

View full text Add to dashboard Cite

Background Adjuvant radiotherapy represents a key component in curative-intent treatment for early-stage breast cancer patients. In last years, two accelerated partial breast irradiation (APBI) techniques are preferred for this population in our organization: electron-based Intraoperative radiation therapy (IORT) and Linac based External Beam Radiotherapy, particularly Intensity-modulated radiation therapy (IMRT-APBI). Recently published long-term follow-up data evaluating these technologies have motivated a health technology reassessment of IORT compared to IMRT. Methods We developed a Markov model to simulate health-state transitions from a cohort of women with early-stage breast cancer, after lumpectomy and adjuvant APBI using either IORT or IMRT techniques. The cost-effectiveness from a private health provider perspective was assessed from a disinvestment point of view, using life-years (LYs) and recurrence-free life-years (RFLYs) as measure of benefits, along with their respective quality adjustments. Expected costs and benefits, and the incremental cost-effectiveness ratio (ICER) were reported. Finally, a scenario analysis was performed to evaluate the cost-effectiveness if equipment maintenance costs are removed. Results IORT technology was dominated by IMRT in all cases (i.e., less benefits with greater costs), except when benefits were estimated as LYs, where no differences were found and therefore the ICER was undefined. Despite small differences were found regarding benefits, costs were considerably higher for IORT. In the scenario analysis without equipment maintenance costs, IORT was still dominated by IMRT. Conclusions For this cohort of patients, IMRT was, at least, non-inferior to IORT in terms of expected benefits, with considerably lower costs. As a result, IORT disinvestment should be considered, favoring the use of IMRT in these patients.

show abstract

Cost-effectiveness analysis of intraoperative radiation therapy versus external beam radiation therapy for the adjuvant treatment of early breast cancer: A systematic review

Cited by 4 publications

References 28 publications

Cost-effectiveness of intraoperative radiation therapy versus intensity-modulated radiation therapy for the treatment of early breast cancer: a disinvestment analysis

Cost-effectiveness of intraoperative radiation therapy versus intensity-modulated radiation therapy for the treatment of early breast cancer: a disinvestment analysis

Long-Term Results of Intraoperative Radiation Therapy for Early Breast Cancer Using a Nondedicated Linear Accelerator

Cost-effectiveness of intraoperative radiation therapy versus intensity-modulated radiation therapy for the treatment of early breast cancer: A disinvestment analysis

Contact Info

Product

Resources

About