PMID- 24457241
OWN - NLM
STAT- MEDLINE
DCOM- 20140918
LR  - 20181203
IS  - 1556-1380 (Electronic)
IS  - 1556-0864 (Linking)
VI  - 8
IP  - 10
DP  - 2013 Oct
TI  - Cost effectiveness of modified fractionation radiotherapy versus conventional 
      radiotherapy for unresected non-small-cell lung cancer patients.
PG  - 1295-307
LID - 10.1097/JTO.0b013e31829f6c55 [doi]
AB  - INTRODUCTION: Modified fractionation radiotherapy (RT), delivering multiple 
      fractions per day or shortening the overall treatment time, improves overall 
      survival for non -small-cell lung cancer (NSCLC) patients compared with 
      conventional fractionation RT (CRT). However, its cost effectiveness is unknown. 
      Therefore, we aimed to examine and compare the cost effectiveness of different 
      modified RT schemes and CRT in the curative treatment of unresected NSCLC 
      patients. METHODS: A probabilistic Markov model was developed based on individual 
      patient data from the meta-analysis of radiotherapy in lung cancer (N = 2000). 
      Dutch health care costs, quality-adjusted life years (QALYs), and net monetary 
      benefits (NMBs) were compared between two accelerated schemes (very accelerated 
      RT [VART] and moderately accelerated RT [MART]), two hyperfractionated schemes 
      (using an identical (HRT) or higher (HRT) total treatment dose than CRT) and CRT. 
      RESULTS: All modified fractionations were more effective and costlier than CRT 
      (1.12 QALYs, &OV0556;24,360). VART and MART were most effective (1.30 and 1.32 
      QALYs) and cost &OV0556;25,746 and &OV0556;26,208, respectively. HRT and HRT 
      yielded less QALYs than the accelerated schemes (1.27 and 1.14 QALYs), and cost 
      &OV0556;26,199 and &OV0556;29,683, respectively. MART had the highest NMB 
      (&OV0556;79,322; 95% confidence interval [CI], &OV0556;35,478-&OV0556;133,648) 
      and was the most cost-effective treatment followed by VART (&OV0556;78,347; 95% 
      CI, &OV0556;64,635-&OV0556;92,526). CRT had an NMB of &OV0556;65,125 (95% CI, 
      &OV0556;54,663-&OV0556;75,537). MART had the highest probability of being cost 
      effective (43%), followed by VART (31%), HRT (24%), HRT (2%), and CRT (0%). 
      CONCLUSION: Implementing accelerated RT is almost certainly more efficient than 
      current practice CRT and should be recommended as standard RT for the curative 
      treatment of unresected NSCLC patients not receiving concurrent 
      chemo-radiotherapy.
FAU - Ramaekers, Bram L T
AU  - Ramaekers BL
AD  - *Department of Health Services Research, CAPHRI-School for Public Health and 
      Primary Care, Maastricht University, Maastricht, The Netherlands; daggerDepartment of 
      Clinical Epidemiology and Medical Technology Assessment (KEMTA), Maastricht 
      University Medical Center, Maastricht, The Netherlands; double daggerService Biostatistique 
      et Epidemiologie, and  section signDepartement d'Oncologie et de Radiotherapie, Gustave 
      Roussy, Villejuif, France;  ||Department of Radiation Oncology (MAASTRO), 
      GROW-School for Oncology and Developmental Biology, Maastricht University Medical 
      Center, Maastricht, The Netherlands;  paragraph signDepartment of Radiation Oncology, 
      University Hospital Leuven/KU Leuven, Leuven, Belgium; #List of the members of 
      Meta-Analysis of Radiotherapy in Lung Cancer Collaborative Group is given at the 
      end of the acknowledgments; and **Department of Epidemiology, Biostatistics and 
      HTA, University Medical Center, St. Radboud, Nijmegen, The Netherlands. Institut 
      Gustave-Roussy/Karolinska Institutet Radiation Therapy Oncology Group Peter 
      MacCallum Cancer Centre and the University of Melbourne University of Dresden 
      Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology Penn 
      State Hershey Cancer Institute Peter MacCallum Cancer Centre Victorian 
      Comprehensive Cancer Centre University of Alabama-Birmingham The University of 
      Texas Southwestern Dana-Farber Cancer Institute University Hospital Leuven and 
      University Hospital Maastricht Mount Vernon Hospital Institut de Cancerologie de 
      la Loire University of Dresden Institut Gustave-Roussy Mayo Clinic Institut 
      Gustave-Roussy Centre Hospitalier Lyon Sud MRC Clinical Trials Unit Mayo Clinic 
      MRC Clinical Trials Unit Radiation Therapy Oncology Group Institut Gustave-Roussy 
      Mount Vernon Hospital Intermountain Medical Center Mayo Clinic Sinai Grace 
      Hospital Maria Sklodowska -Curie Memorial Cancer Center and Institute of 
      Oncology.
FAU - Joore, Manuela A
AU  - Joore MA
FAU - Lueza, Beranger
AU  - Lueza B
FAU - Bonastre, Julia
AU  - Bonastre J
FAU - Mauguen, Audrey
AU  - Mauguen A
FAU - Pignon, Jean-Pierre
AU  - Pignon JP
FAU - Le Pechoux, Cecile
AU  - Le Pechoux C
FAU - De Ruysscher, Dirk K M
AU  - De Ruysscher DK
CN  - MAR-LC Collaborative group
FAU - Grutters, Janneke P C
AU  - Grutters JP
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - J Thorac Oncol
JT  - Journal of thoracic oncology : official publication of the International 
      Association for the Study of Lung Cancer
JID - 101274235
SB  - IM
MH  - Aged
MH  - Carcinoma, Non-Small-Cell Lung/*economics/mortality/pathology/radiotherapy
MH  - Carcinoma, Squamous Cell/*economics/mortality/pathology/radiotherapy
MH  - *Cost-Benefit Analysis
MH  - *Dose Fractionation, Radiation
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Lung Neoplasms/*economics/mortality/pathology/radiotherapy
MH  - Male
MH  - Markov Chains
MH  - Meta-Analysis as Topic
MH  - Middle Aged
MH  - Neoplasm Recurrence, Local/*economics/mortality/pathology/radiotherapy
MH  - Neoplasm Staging
MH  - Prognosis
MH  - Quality of Life
MH  - Quality-Adjusted Life Years
MH  - Randomized Controlled Trials as Topic
MH  - Survival Rate
FIR - Arriagada, R
IR  - Arriagada R
FIR - Bae, K
IR  - Bae K
FIR - Ball, D
IR  - Ball D
FIR - Baumann, M
IR  - Baumann M
FIR - Behrendt, K
IR  - Behrendt K
FIR - Belani, C P
IR  - Belani CP
FIR - Beresford, J
IR  - Beresford J
FIR - Bishop, J
IR  - Bishop J
FIR - Bonner, J A
IR  - Bonner JA
FIR - Choy, H
IR  - Choy H
FIR - Dahlberg, S E
IR  - Dahlberg SE
FIR - De Ruysscher, D
IR  - De Ruysscher D
FIR - Dische, S
IR  - Dische S
FIR - Fournel, P
IR  - Fournel P
FIR - Koch, R
IR  - Koch R
FIR - Le Pechoux, C
IR  - Le Pechoux C
FIR - Mandrekar, S J
IR  - Mandrekar SJ
FIR - Mauguen, A
IR  - Mauguen A
FIR - Mornex, F
IR  - Mornex F
FIR - Nankivell, M
IR  - Nankivell M
FIR - Nelson, G
IR  - Nelson G
FIR - Parmar, M K
IR  - Parmar MK
FIR - Paulus, R
IR  - Paulus R
FIR - Pignon, J P
IR  - Pignon JP
FIR - Saunders, M I
IR  - Saunders MI
FIR - Sause, W
IR  - Sause W
FIR - Schild, S E
IR  - Schild SE
FIR - Turrisi, A T
IR  - Turrisi AT
FIR - Zajusz, A
IR  - Zajusz A
EDAT- 2014/01/25 06:00
MHDA- 2014/09/19 06:00
CRDT- 2014/01/25 06:00
PHST- 2014/01/25 06:00 [entrez]
PHST- 2014/01/25 06:00 [pubmed]
PHST- 2014/09/19 06:00 [medline]
AID - S1556-0864(15)33022-7 [pii]
AID - 10.1097/JTO.0b013e31829f6c55 [doi]
PST - ppublish
SO  - J Thorac Oncol. 2013 Oct;8(10):1295-307. doi: 10.1097/JTO.0b013e31829f6c55.