Costs of treatment intensification for head and neck cancer: Concomitant chemoradiation randomised for radioprotection with amifostine

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

doi:10.1016/j.ejca.2005.05.012

Cited by 24 publications

(28 citation statements)

References 30 publications

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“…These aspects relate to the general condition of the patient, the patient's preferences, the cost implications of the clinical approach, and the possible use of second-line diagnostics to confirm or reject an initial test outcome. In addition, 18 F-FDG PET has proven its value in previous studies, and it would, therefore, be unethical to leave its test outcome out of the clinical decision. This decision to include 18 F-FDG PET resulted in several additional test outcome treatment combinations that had to be adjusted for in the cost analysis to be able to judge the added value of 18 F-FDG PET in screening for distant metastasis and synchronous primary tumors in HNSCC patients.…”

Section: Allocation Of Resource Use and Details Of Cost Analysismentioning

confidence: 99%

“…Spiral CT scans were obtained with a fourth-generation Somaton Plus (Siemens AG) after the intravenous administration of contrast medium (Ultravist; Schering AG). 18 F-FDG PET was performed after patients had fasted for 6 h with ample access to water. At 60-90 min after the intravenous administration of 250-370 MBq of 18 F-FDG, the imaging of trajectory knee-skull base was performed using dedicated full-ring bismuth germinate PET scanners (in Amsterdam/Groningen, ECAT HR1 [CTI/Siemens]; in Nijmegen, ECAT EXACT [CTI/Siemens]).…”

Section: Imaging Techniquesmentioning

confidence: 99%

“…PET with 18 F-FDG is able to detect tumor deposits in the whole body. 18 F-FDG PET detects more distant metastases than does CT, but the combination of both techniques (CT 1 18 F-FDG PET), as currently provided with hybrid PET/CT scanners, appears to be superior (11,12). 18 F-FDG PET is a costly technique, and there are various clinical applications.…”

mentioning

confidence: 99%

“…18 F-FDG PET detects more distant metastases than does CT, but the combination of both techniques (CT 1 18 F-FDG PET), as currently provided with hybrid PET/CT scanners, appears to be superior (11,12). 18 F-FDG PET is a costly technique, and there are various clinical applications. Therefore, there is a need to use it for the most valuable applications to have the most efficient use of resources.…”

mentioning

confidence: 99%

“…Therefore, there is a need to use it for the most valuable applications to have the most efficient use of resources. We have performed a prospective, multicenter clinical trial determining the potential added value of wholebody 18 F-FDG PET in screening for distant metastases in HNSCC patients with risk factors to the best conventional imaging with CT. The clinical results are presented elsewhere (11).…”

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confidence: 99%

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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

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: Allocation Of Resource Use and Details Of Cost Analysismentioning

confidence: 99%

Section: Imaging Techniquesmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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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

Groot

Senft²,

Bree

et al. 2010

J Nucl Med

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Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy

Riley

Glenny

Hua

et al. 2017

Cochrane Database of Systematic Reviews

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There is some low-quality evidence to suggest that amifostine prevents the feeling of dry mouth in people receiving radiotherapy to the head and neck (with or without chemotherapy) in the short- (end of radiotherapy) to medium-term (three months postradiotherapy). However, it is less clear whether or not this effect is sustained to 12 months postradiotherapy. The benefits of amifostine should be weighed against its high cost and side effects. There was insufficient evidence to show that any other intervention is beneficial.

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NOD2 agonist murabutide alleviates radiation‐induced injury through DNA damage response pathway mediated by ATR

Liu

Qin

et al. 2019

Journal Cellular Physiology

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Injury-induced by ionizing radiation (IR) severely reduces the quality of life of victims. The development of radiation protectors is regarded as one of the most resultful strategies to alleviate damages caused by IR exposure. In the present study, we investigated the radioprotective effects of the agonist of nucleotide-binding-oligomerization-domaincontaining proteins 2 called murabutide (MBD) and clarified the potential mechanisms.Our results showed that the pretreatment with MBD effectively protected cultured cells and mice against IR-induced toxicity and the pretreatment with MBD in vitro and in vitro also inhibited apoptosis caused by IR exposure. The downregulation of γ-H2AX and the upregulation of ATR signaling pathways by MBD treatment indicated that the radioprotective effects of MBD were due to the stimulation of DNA damage response (DDR) pathway to repair DNA double-strand breaks caused by IR exposure. As the radioprotective effects of MBD were diminished by the ATR selective inhibitor rather than the ATM inhibitor, ATR pathway was confirmed to be a more crucial checkpoint pathway in mediating the stimulation of DDR pathway by MBD. Taken together, our data provide a novel and effective protector to relieve the injury induced by IR exposure. K E Y W O R D SATR, DNA damage response, ionizing radiation, murabutide, NOD2

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Costs of treatment intensification for head and neck cancer: Concomitant chemoradiation randomised for radioprotection with amifostine

Cited by 24 publications

References 30 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

Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy

NOD2 agonist murabutide alleviates radiation‐induced injury through DNA damage response pathway mediated by ATR

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Costs of treatment intensification for head and neck cancer: Concomitant chemoradiation randomised for radioprotection with amifostine

Cited by 24 publications

References 30 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

Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy

NOD2 agonist murabutide alleviates radiation‐induced injury through DNA damage response pathway mediated by ATR

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Product

Resources

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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