Chemotherapy and high–dose-rate brachytherapy in the management of advanced cancers of the nasopharynx

Levendag, Peter C.; Nijdam, Wideke; Agthoven, Michel van; Groot, Carin A. Uyl–de

doi:10.1016/s1538-4721(02)00005-3

Cited by 10 publications

(6 citation statements)

References 37 publications

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“…We, for instance, did not include the laboratory and pathology costs associated with the prevented operations and hospitalizations. During the last decade, the costs for radiotherapy in HNSCC have increased because of the implementation of 3-dimensional conformal radiotherapy, intensity-modulated radiation techniques, stereotactic radiotherapy, and combination with chemotherapy (17,18). The introduction of these new techniques implies that the savings with 18 F-FDG PET could be higher.…”

Section: Discussionmentioning

confidence: 99%

Chest CT and Whole-Body¹⁸F-FDG PET Are Cost-Effective in Screening for Distant Metastases in Head and Neck Cancer Patients

Groot

Senft²,

Bree

et al. 2010

J Nucl Med

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The aim of the study was to define the cost-effectiveness of whole-body 18 F-FDG PET, as compared with chest CT, in screening for distant metastases in patients with head and neck squamous cell carcinoma (HNSCC). Methods: In a multicenter prospective study, 145 consecutive patients with high risk factors for distant metastases and scheduled for extensive treatment underwent chest CT and whole-body 18 F-FDG PET for screening of distant metastases. The cost data of 80 patients in whom distant metastases developed or who had a follow-up of at least 12 mo were analyzed. Cost-effectiveness analysis, including sensitivity analysis, was performed to compare the results of 18 F-FDG PET, CT, and a combination of CT and 18 F-FDG PET (CT 1 18 F-FDG PET). Results: Pretreatment screening identified distant metastases in 21% of patients. 18 F-FDG PET had a higher sensitivity (53% vs. 37%) and positive predictive value (80% vs. 75%) than did CT. CT 1 18 F-FDG PET had the highest sensitivity (63%). The average costs in the CT, 18 F-FDG PET, and CT 1 18 F-FDG PET groups amounted to e38,558 ($57,705), e38,355 ($57,402), and e37,954 ($56,801), respectively, in the first year after screening. CT 1 18 F-FDG PET resulted in savings between e203 ($303) and e604 ($903). Sensitivity analysis showed that the dominance of CT 1 18 F-FDG PET was robust. Conclusion: In HNSCC patients with risk factors, pretreatment screening for distant metastases by chest CT is improved by 18 F-FDG PET. The combination of 18 F-FDG PET with CT is the most effective, without leading to additional costs.

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Section: Discussionmentioning

confidence: 99%

Chest CT and Whole-Body¹⁸F-FDG PET Are Cost-Effective in Screening for Distant Metastases in Head and Neck Cancer Patients

Groot

Senft²,

Bree

et al. 2010

J Nucl Med

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“…Chemotherapy as well as high- technology treatment techniques for advanced NPC obviously increases the treatment costs. However, the costs generated by conventional treatment schemes and modalities in other head and neck tumor sites are in a similar range [ 99 ]. Most of the publications represent results of descriptive statistical evaluations of monoinstitutional patient cohorts.…”

Section: Nasopharynx Cancermentioning

confidence: 99%

Modern head and neck brachytherapy: from radium towards intensity modulated interventional brachytherapy

Kovács¹

2014

jcb

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Intensity modulated brachytherapy (IMBT) is a modern development of classical interventional radiation therapy (brachytherapy), which allows the application of a high radiation dose sparing severe adverse events, thereby further improving the treatment outcome. Classical indications in head and neck (H&N) cancers are the face, the oral cavity, the naso- and oropharynx, the paranasal sinuses including base of skull, incomplete resections on important structures, and palliation. The application type can be curative, adjuvant or perioperative, as a boost to external beam radiation as well as without external beam radiation and with palliative intention. Due to the frequently used perioperative application method (intraoperative implantation of inactive applicators and postoperative performance of radiation), close interdisciplinary cooperation between surgical specialists (ENT-, dento-maxillary-facial-, neuro- and orbital surgeons), as well interventional radiotherapy (brachytherapy) experts are obligatory. Published results encourage the integration of IMBT into H&N therapy, thereby improving the prognosis and quality of life of patients.

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“…However, given the fact that both patient groups have right, almost similar, local control rates (80e90%) and most of the patients can be treated by organ preservation, we feel comfortable to date with this protocol. In previous articles by Levendag et al (2,9), Nijdam et al (10,12), and Wijers et al (20) tumors of the TF and/or SP and BOT were analyzed for clinical outcome comparing BT with surgery: basically no difference was observed between the two treatment groups. Additionally, full hospital costs (including associated costs of locoregional relapses and/or treatment-related RTOG Grade III/IV complications) were calculated for primary cancers originating from the oropharynx, and treated by BT, surgery, or EBRT (with or without chemotherapy).…”

Section: Discussionmentioning

confidence: 99%

“…RT has been instituted as a sole treatment modality, using different fractionation regimes (1) or combined with a neck dissection (ND) and neoadjuvant and/or concomitant chemotherapy (8). Also, RT has been effectively applied by means of a linear accelerator only (external beam radiation therapy [EBRT]) or by EBRT in combination with brachytherapy (BT), that is interstitial radiation therapy (IRT) (2,3,9).…”

Section: Introductionmentioning

confidence: 99%

Longitudinal changes in quality of life and costs in long-term survivors of tumors of the oropharynx treated with brachytherapy or surgery

et al. 2008

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Chemotherapy and high–dose-rate brachytherapy in the management of advanced cancers of the nasopharynx

Cited by 10 publications

References 37 publications

Chest CT and Whole-Body¹⁸F-FDG PET Are Cost-Effective in Screening for Distant Metastases in Head and Neck Cancer Patients

Chest CT and Whole-Body¹⁸F-FDG PET Are Cost-Effective in Screening for Distant Metastases in Head and Neck Cancer Patients

Modern head and neck brachytherapy: from radium towards intensity modulated interventional brachytherapy

Longitudinal changes in quality of life and costs in long-term survivors of tumors of the oropharynx treated with brachytherapy or surgery

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Chemotherapy and high–dose-rate brachytherapy in the management of advanced cancers of the nasopharynx

Cited by 10 publications

References 37 publications

Chest CT and Whole-Body18F-FDG PET Are Cost-Effective in Screening for Distant Metastases in Head and Neck Cancer Patients

Chest CT and Whole-Body18F-FDG PET Are Cost-Effective in Screening for Distant Metastases in Head and Neck Cancer Patients

Modern head and neck brachytherapy: from radium towards intensity modulated interventional brachytherapy

Longitudinal changes in quality of life and costs in long-term survivors of tumors of the oropharynx treated with brachytherapy or surgery

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Product

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Chest CT and Whole-Body¹⁸F-FDG PET Are Cost-Effective in Screening for Distant Metastases in Head and Neck Cancer Patients

Chest CT and Whole-Body¹⁸F-FDG PET Are Cost-Effective in Screening for Distant Metastases in Head and Neck Cancer Patients