Cost-effectiveness analysis of cochlear dose reduction by proton beam therapy for medulloblastoma in childhood

Hirano, Emi; Fuji, Hiroshi; Onoe, Tsuyoshi; Kumar, Vinay; Shirato, Hiroki; Kawabuchi, Koichi

doi:10.1093/jrr/rrt112

Cited by 29 publications

(20 citation statements)

References 18 publications

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“…In PBT, the tumor control rate is similar to that in photon radiotherapy [9][10][11][12][13][14][15][16][17][18][19][20], but late toxicity and the secondary cancer risk should be much lower due to the dose distribution [21]. For this reason, PBT has potential as a treatment for pediatric tumors, but fewer institutions have proton beam centers compared to those with normal photon radiotherapy.…”

Section: Introductionmentioning

confidence: 99%

Proton beam therapy for pediatric malignancies: a retrospective observational multicenter study in Japan

et al. 2016

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Recent progress in the treatment for pediatric malignancies using a combination of surgery, chemotherapy, and radiotherapy has improved survival. However, late toxicities of radiotherapy are a concern in long‐term survivors. A recent study suggested reduced secondary cancer and other late toxicities after proton beam therapy (PBT) due to dosimetric advantages. In this study, we evaluated the safety and efficacy of PBT for pediatric patients treated in Japan. A retrospective observational study in pediatric patients who received PBT was performed. All patients aged <20 years old who underwent PBT from January 1983 to August 2014 at four sites in Japan were enrolled in the study. There were 343 patients in the study. The median follow‐up periods were 22.6 months (0.4–374.3 months) for all patients and 30.6 months (0.6–374.3 months) for survivors. The estimated 1‐, 3‐, 5‐, and 10‐year survival rates were 82.7% (95% CI: 78.5–87.0%), 67.4% (61.7–73.2%), 61.4% (54.8–67.9%), and 58.7% (51.5–65.9%), respectively. Fifty‐two events of toxicity ≥ grade 2 occurred in 43 patients. Grade 4 toxicities of myelitis, visual loss (two cases), cerebral vascular disease, and tissue necrosis occurred in five patients. This study provides preliminary results for PBT in pediatric patients in Japan. More experience and follow‐up with this technique are required to establish the efficacy of PBT in this patient population.

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Section: Introductionmentioning

confidence: 99%

Proton beam therapy for pediatric malignancies: a retrospective observational multicenter study in Japan

et al. 2016

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“…The improvement in QOL and late effects with proton therapy may be more cost-effective than photon therapy in pediatric patients who are expected to be cured of their disease, particularly when the management of potential second malignancies and late toxicities are evaluated [48]. In a Monte Carlo simulation model of survivors of pediatric medulloblastoma treated at 5 years of age with proton and photon therapy, LAR was estimated from previous studies, and model-valued health effects and costs were estimated per the US Panel on Cost Effectiveness in Health and Medicine.…”

Section: • • the Economics Of Proton Therapymentioning

confidence: 99%

Proton therapy for the treatment of children with CNS malignancies

Sreeraman¹,

Indelicato

2014

CNS Oncol.

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Proton therapy is a novel technique for treating pediatric malignancies. As a tool to reduce normal-tissue dose, it has the potential to decrease late toxicity. Although proton therapy has been used for over five decades, most pediatric dosimetry studies and clinical series have been published over the last 10 years. The purpose of this article is to review the physical, radiobiological and economic rationales for proton therapy in pediatric CNS malignancies, and provide an overview of the current challenges and future direction of research and utilization of this approach.

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“…All radiotherapy requires expensive equipment and highly qualified staff, but in itself, it is not an expensive treatment and consumes only about 5% of a running oncology budget [2]. A Swiss study has found that the cost of proton radiotherapy is 2.4 times higher than IMRT [48].…”

mentioning

confidence: 99%

“…It can be expected that over time, this can be reduced to 2.1 or even 1.7 times, however proton radiotherapy will probably always remain more expensive that photon therapy [48]. There are two vital economic measures used for analysing the efficiency of medical procedure outcomes: the cost of obtaining an extra 'Quality-Adjusted Life Year' (QALY) or an extra 'Life Year Gained' (LYG).…”

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confidence: 99%

Proton radiotherapy should be further developed in Poland

Maciejczyk¹,

Sztuder²

2017

Nowotwory. Journal of Oncology

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Proton radiation therapy needs to be further developed in Poland by virtue of both epidemiological considerations and because this type of radiation exhibits very advantageous biological and physical properties. The underlying benefit of such therapy is to make lower integral radiation dose delivered to structures beyond a given target area, including critical organs, resulting in reduced toxicities for patients. Of somewhat less import is the improvement in dose distributions for target areas (vs photons), which can potentially bring about a better local control. As a result, proton radiotherapy is mainly indicated for paediatric cases, where any development of complications is most likely because of the long lifetimes and the heightened radiosensitivity of healthy tissues. The most recent studies also show that certain subpopulations of patients can benefit from proton beam radiotherapy in cases of widespread cancers such as from the lung or breast. A further advantage is found after conducting a cost-effectiveness analysis whereby proton beam radiotherapy was demonstrated as a cost-effective procedure, with both lowered costs for treating complications and indirect costs. By the term 'development' as used herein, it is understood that there is a need to open another proton therapy centre in Poland; this question however being left open in the presented article. Nevertheless, before taking such a high-level decision, the following requires consideration: the working experience garnered by the existing Cyclotron Centre at Bronowice (CCB), outcomes from current prospective clinical trials and, above all, delivering appropriately managed and coordinated oncological care for cancer patients in Poland regarding multi-centre collaboration between specialists. NOWOTWORY J Oncol 2017; 67, 1: 65-70

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Cost-effectiveness analysis of cochlear dose reduction by proton beam therapy for medulloblastoma in childhood

Cited by 29 publications

References 18 publications

Proton beam therapy for pediatric malignancies: a retrospective observational multicenter study in Japan

Proton beam therapy for pediatric malignancies: a retrospective observational multicenter study in Japan

Proton therapy for the treatment of children with CNS malignancies

Proton radiotherapy should be further developed in Poland

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