Spacers in radiotherapy treatment of prostate cancer: Is reduction of toxicity cost-effective? - Abstract

BACKGROUND AND PURPOSE: To compare the cost-effectiveness of treating prostate cancer patients with intensity-modulated radiation therapy and a spacer (IMRT+S) versus IMRT-only without a spacer (IMRT-O).

MATERIALS AND METHODS: A decision-analytic Markov model was constructed to examine the effect of late rectal toxicity and compare the costs and quality-adjusted Life Years (QALYs) of IMRT-O and IMRT+S. The main assumption of this modeling study was that disease progression, genito-urinary toxicity and survival were equal for both comparators.

RESULTS: For all patients, IMRT+S revealed a lower toxicity than IMRT-O. Treatment follow-up and toxicity costs for IMRT-O and IMRT+S amounted to €1604 and €1444, respectively, thus saving €160 on the complication costs at an extra charge of €1700 for the spacer in IMRT+S. The QALYs yielded for IMRT-O and IMRT+S were 3.542 and 3.570, respectively. This results in an incremental cost-effectiveness ratio (ICER) of €55,880 per QALY gained. For a ceiling ratio of €80,000, IMRT+S had a 77% probability of being cost-effective.

CONCLUSION: IMRT+S is cost-effective compared to IMRT-O based on its potential to reduce radiotherapy-related toxicity.

Written by:
Vanneste BG, Pijls-Johannesma M, Van De Voorde L, van Lin EN, van de Beek K, van Loon J, Ramaekers BL, Lambin P.   Are you the author?
Department of Radiation Oncology (MAASTRO), GROW - School for Oncology and Developmental Biology, Maastricht University Medical Center+, The Netherlands; Health insurance company CZ, Tilburg, The Netherlands; Westdeutsches Protonentherapiezentrum Essen (WPE), Germany; Department of Urology, Maastricht University Medical Center+, The Netherlands; Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Center+, The Netherlands.  

Reference: Radiother Oncol. 2015 Feb;114(2):276-81.
doi: 10.1016/j.radonc.2015.01.005

PubMed Abstract
PMID: 25616537

Go "Beyond the Abstract" - Read an article written by the authors for Prostate Cancer Section


Newsletter subscription

Free Daily and Weekly newsletters offered by content of interest

The fields of GU Oncology and Urology are rapidly advancing. Sign up today for articles, videos, conference highlights and abstracts from peer-review publications by disease and condition delivered to your inbox and read on the go.