Quantifying the Optimum Number of Proton Fields in Treatment of Midline Tumors Using a Marginal Cost Analysis

Estabrook, Neil C.; Hoene, Ted A.; McDonald, Mark W.

doi:10.1016/j.ijrobp.2014.05.1086

Cited by 1 publication

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“…The use of cyclotrons versus synchrotrons also has been related to cost‐effectiveness along with postulation that, one day, 4‐dimensional proton treatment may be the standard of care for some tumors . Recent advances in optimizing treatment times, proton units, beam energies, and field design can improve cost‐effectiveness, as can achieving a balance of PBT‐indicated cases and “nonessential” cases . None of these factors were taken into account by any study in this review.…”

Section: Discussionmentioning

confidence: 99%

A systematic review of the cost and cost‐effectiveness studies of proton radiotherapy

Verma

Mishra

Mehta

2016

Cancer

190

145

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Group of North America for both years of existence (2014)(2015). Eighteen original investigations were analyzed. RESULTS: The costeffectiveness for prostate cancer-the single most common diagnosis currently treated with PBT-was suboptimal. PBT was the most cost-effective option for several pediatric brain tumors. PBT costs for breast cancer were increased but were favorable for appropriately selected patients with left-sided cancers at high risk of cardiac toxicity and compared with brachytherapy for accelerated partial breast irradiation. For non-small cell lung cancer (NSCLC), the greatest cost-effectiveness benefits using PBT were observed for locoregionally advanced-but not early stage-tumors. PBT offered superior cost-effectiveness in selected head/neck cancer patients at higher risk of acute mucosal toxicities. Similar cost-effectiveness was observed for PBT, enucleation, and plaque brachytherapy in patients with uveal melanoma. CONCLUSIONS: With greatly limited amounts of data, PBT offers promising cost-effectiveness for pediatric brain tumors, well-selected breast cancers, locoregionally advanced NSCLC, and high-risk head/neck cancers. Heretofore, it has not been demonstrated that PBT is cost-effective for prostate cancer or early stage NSCLC. Careful patient selection is absolutely critical to assess cost-effectiveness. Together with increasing PBT availability, clinical trial evidence, and ongoing major technological improvements, cost-effectiveness data and conclusions from this analysis could change rapidly. Cancer 2016;122:1483

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