Brachytherapy provides comparable outcomes and improved cost-effectiveness in the treatment of low/intermediate prostate cancer

Shah, Chirag; Lanni, Thomas B.; Ghilezan, M.; Gustafson, Gary; Marvin, K.; Ye, Hong; Vicini, Frank A.; Martínez, Álvaro

doi:10.1016/j.brachy.2012.04.002

Cited by 98 publications

(62 citation statements)

References 17 publications

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“…The disease site most often evaluated in rt costing studies was prostate cancer (39%) 7,9,10,[15][16][17][18]24,27,29,31,32,34 , followed by breast cancer (18%) 8,19,22,25,26,28 , non-smallcell lung cancer (12%) 20,23,37,39 , head-and-neck cancer (9%) 14,33,38 , cervical cancer (6%) 13,21 , and other sites [bone metastases (6%) 12,30 , metastatic epidural spinal cord (3%) 36 , oropharyngeal cancer (3%) 35 , and squamous cell cancer of the anus (3%) 11 ]. Thirteen studies used original costing data to conduct the costing analysis 8,19,20,[24][25][26]28,[29][30][31][32][33]37 ; the remaining twenty studies modelled outcomes using hypothetical patient cohorts 7,…”

Section: Methods In the Included Studiesmentioning

confidence: 99%

“…All studies included treatment and planning costs, per the objective of the studies. Only 33% of the studies incorporated institution or facility costs into their costing model, which most often included inpatient, outpatient, and technical costs of the hospital 7,16,18,22,24,26,[33][34][35][36][37] . Only five studies (15%) included equipment costs in their cost analyses (that is, computed tomography scanner and planning system, capital cost, specialized construction cost, and maintenance and operating costs of the radiation equipment) 22,24,34,35,37 .…”

Section: Methods In the Included Studiesmentioning

confidence: 99%

“…Only 33% of the studies incorporated institution or facility costs into their costing model, which most often included inpatient, outpatient, and technical costs of the hospital 7,16,18,22,24,26,[33][34][35][36][37] . Only five studies (15%) included equipment costs in their cost analyses (that is, computed tomography scanner and planning system, capital cost, specialized construction cost, and maintenance and operating costs of the radiation equipment) 22,24,34,35,37 . Most studies (70%) accounted for other costs (overhead, administration, and so on), which included minor equipment such as port films, immobilization devices, multileaf collimator, and other complex treatment devices; however, ten studies did not account for such items in their costing method 13,16,18,21,23,26,28,30,34,37 .…”

Section: Methods In the Included Studiesmentioning

confidence: 99%

“…As shown in Figure 2, twenty-two studies provided costs for imrt 7,[9][10][11]14,[16][17][18][19][20][21][22][23][24]27,28,29,[31][32][33][34][35] ; sixteen, for 3D-c rt 11,14,15,17,19,20,22,23,28,[31][32][33][34][35]37,39 ; six, for bt 9,13,22,24,31,32 ; and six, for sbrt 7,10,20,23,27,37 . A number of studies also costed other modalities of rt (rt in general, whole-breast radiation, external-beam partial-breast irradiation, etc.…”

Section: Methods In the Included Studiesmentioning

confidence: 99%

“…The cost for imrt ranged from US$2,687.87 to US$111,900.60 per treatment, followed by 3D-crt at US$5,583.28 to US$90,055, bt at US$10,544.22 to US$78,667.40, and sbrt at US$6,520.58 to US$19,602.68. Studies by Lanni et al 20 and Shah et al 24 included institutional costs in addition to the hospital-specific reimbursement for rt treatment.…”

Section: Methods In the Included Studiesmentioning

confidence: 99%

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Radiation Costing Methods: A Systematic Review

et al. 2016

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Objective Costs for radiation therapy (rt) and the methods used to cost rt are highly diverse across the literature.To date, no study has compared various costing methods in detail. Our objective was to perform a thorough review of the radiation costing literature to identify sources of costs and methods used.Methods A systematic review of Ovid medline, Ovid oldmedline, embase, Ovid HealthStar, and EconLit from 2005 to 23 March 2015 used search terms such as "radiation," "radiotherapy," "neoplasm," "cost," " cost analysis," and "cost benefit analysis" to locate relevant articles. Original papers were reviewed for detailed costing methods. Cost sources and methods were extracted for papers investigating rt modalities, including three-dimensional conformal rt (3D-crt), intensity-modulated rt (imrt), stereotactic body rt (sbrt), and brachytherapy (bt). All costs were translated into 2014 U.S. dollars. ResultsMost of the studies (91%) reported in the 33 articles retrieved provided rt costs from the health system perspective. The cost of rt ranged from US$2,687.87 to US$111,900.60 per treatment for imrt, followed by US$5,583.28 to US$90,055 for 3D-crt, US$10,544.22 to US$78,667.40 for bt, and US$6,520.58 to US$19,602.68 for sbrt. Cost drivers were professional or personnel costs and the cost of rt treatment. Most studies did not address the cost of rt equipment (85%) and institutional or facility costs (66%). ConclusionsCosting methods and sources were widely variable across studies, highlighting the need for consistency in the reporting of rt costs. More work to promote comparability and consistency across studies is needed.

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Section: Methods In the Included Studiesmentioning

confidence: 99%

Section: Methods In the Included Studiesmentioning

confidence: 99%

Section: Methods In the Included Studiesmentioning

confidence: 99%

Section: Methods In the Included Studiesmentioning

confidence: 99%

Section: Methods In the Included Studiesmentioning

confidence: 99%

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Radiation Costing Methods: A Systematic Review

et al. 2016

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Image‐guided Prostate Brachytherapy

Folkert

Desai

Yamada

2018

Smith's Textbook of Endourology

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Impact of national guidelines on brachytherapy monotherapy practice patterns for prostate cancer

Tseng¹,

Paciorek

Martin

et al. 2013

Cancer

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BACKGROUND In 1999 and 2000, 2 national guidelines recommended brachytherapy monotherapy (BT) primarily for treatment of low‐risk prostate cancer but not high‐risk prostate cancer. This study examined rates of BT use before and after publication of these guidelines, as compared with 4 other treatment options. METHODS From 1990 to 2011, 8128 men with localized prostate cancer (≤ T3cN0M0) were treated definitively within the Cancer of the Prostate Strategic Urologic Research Endeavor (CaPSURE) registry with 1 of 5 primary treatments: BT, external beam radiotherapy (EBRT), EBRT with androgen deprivation therapy, EBRT+BT, or radical prostatectomy. Men were categorized into low‐, intermediate‐, and high‐risk groups based on the guidelines' risk‐group definitions. Within each risk group, logistic regression was used to estimate odds ratios (OR) comparing BT with other treatment options between the 1990‐1998 and 1999‐2011 periods, adjusting for age, disease characteristics, and clinic type. RESULTS In total, 1117 men received BT alone for low‐ (n = 658), intermediate‐ (n = 244), or high‐risk disease (n = 215). BT comprised 6.1% of all treatments in 1990‐1998 versus 16.6% in 1999‐2011 (P < .01). The odds of BT use remained increased after adjusting for potential confounders (OR = 3.06; P < .001) and was seen among low‐ (OR = 4.52; P < .001), intermediate‐ (OR = 2.67; P < .001), and even high‐risk groups (OR = 2.11; P < .001). CONCLUSIONS National guidelines did not appear to influence practice patterns, as BT monotherapy use increased relative to other treatments from the 1990‐1998 to 1999‐2011 periods in unfavorable risk groups including men with high‐risk prostate cancer. Cancer 2014;120:824–832. © 2013 American Cancer Society.

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Brachytherapy provides comparable outcomes and improved cost-effectiveness in the treatment of low/intermediate prostate cancer

Cited by 98 publications

References 17 publications

Radiation Costing Methods: A Systematic Review

Radiation Costing Methods: A Systematic Review

Image‐guided Prostate Brachytherapy

Impact of national guidelines on brachytherapy monotherapy practice patterns for prostate cancer

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