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

Nijdam, Wideke; Levendag, Peter C.; Noever, Inge; Schmitz, Paul; Groot, Carin A. Uyl–de

doi:10.1016/j.brachy.2008.05.001

Cited by 15 publications

(4 citation statements)

References 23 publications

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“…The median score on this scale remained worse than baseline levels and was 38. However, the score on the EORTC QLQ‐H&N35 Dry mouth scale was significantly improved by using IMRT, compared to the median score of 67 reported Nijdam et al on patients treated by 46 Gy of 3DCRT followed by brachytherapy boost. The addition of neck dissection to this multimodality approach did not result in significant deterioration in QOL scores over time, compared with the scores of patients who did not undergo neck dissection (Figure ).…”

Section: Discussionmentioning

confidence: 68%

Intensity‐modulated radiotherapy followed by a brachytherapy boost for oropharyngeal cancer

et al. 2013

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Section: Discussionmentioning

confidence: 68%

Intensity‐modulated radiotherapy followed by a brachytherapy boost for oropharyngeal cancer

et al. 2013

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“…Whether a programme such as INTERCOM would be included in this package is unclear. Other healthcare interventions with comparable, but also much higher cost-effectiveness ratios [30][31][32][33] are currently reimbursed, providing an indication that a ratio of around J30,000 as found in the current study was previously considered acceptable for reimbursement. It is obvious, however, that other criteria, such as budget impact, necessity of care, own responsibility and affordability by the patient also play a role in the decision whether a healthcare service should be covered by social healthcare insurance.…”

Section: Discussionmentioning

confidence: 99%

Is INTERdisciplinary COMmunity-based COPD management (INTERCOM) cost-effective?

Hoogendoorn¹,

Wetering²,

Schols³

et al. 2009

European Respiratory Journal

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The study aimed to estimate the cost-effectiveness of interdisciplinary communitybased chronic obstructive pulmonary disease (COPD) management in patients with COPD.We conducted a cost-effectiveness analysis alongside a 2-yr randomised controlled trial, in which 199 patients with less advanced airflow obstruction and impaired exercise capacity were assigned to the INTERCOM programme or usual care. The INTERCOM programme consisted of exercise training, education, nutritional therapy and smoking cessation counselling offered by community-based physiotherapists and dieticians and hospital-based respiratory nurses. Allcause resource use during 2 yrs was obtained by self-report and from hospital and pharmacy records. Health outcomes were the St George's Respiratory Questionnaire (SGRQ), exacerbations and quality-adjusted life years (QALYs).The INTERCOM group had 30% (95% CI 3-56%) more patients with a clinically relevant improvement in SGRQ total score, 0.08 (95% CI -0.01-0.18) more QALYs per patient, but a higher mean number of exacerbations, 0.84 (95% CI -0.07-1.78). Mean total 2-yr costs were J2,751 (95% CI -J632-J6,372) higher for INTERCOM than for usual care, which resulted in an incremental cost-effectiveness ratio of J9,078 per additional patient with a relevant improvement in SGRQ or J32,425 per QALY.INTERCOM significantly improved disease-specific quality of life, but did not affect exacerbation rate. The cost per QALY ratio was moderate, but within the range of that generally considered to be acceptable.

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“…Three Dimensional Conformal radiotherapy (3D CRT) and Intensity Modulated Radiotherapy (IMRT) have made possible higher dose delivery with curative intent to the tumor, with acceptably lower doses to normal organs and critical structures in its neighborhood (Studer et al 2007 ). However, higher costs and complexity in planning and treatment delivery have precluded their widespread adoption, especially in third world nations, where cost effectiveness and ease of implementation are the need of the hour (Nijdam et al 2008 ).…”

Section: Discussionmentioning

confidence: 99%

Role of high dose rate interstitial brachytherapy in early and locally advanced squamous cell carcinoma of buccal mucosa

et al. 2014

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BackgroundThe study aimed to assess the effect of High Dose Rate (HDR) Interstitial Brachytherapy when used alone or in combination with External Beam Radiotherapy (EBRT), in early and locally advanced squamous cell carcinoma of buccal mucosa.Materials and methodsThirty three patients with histologically proven squamous cell carcinoma of the buccal mucosa received high dose rate interstitial brachytherapy either as primary treatment or as a boost from November 2008 to April 2013. Stage I patients received interstitial brachytherapy alone to a dose of 38.50 Gy, 3.5 Gy per fraction, twice daily at six hours apart for 11 fractions. Stage II patients received EBRT to a dose of 50 Gy in 25 fractions of two Gy each followed by brachytherapy boost to 21 Gy, 3.5 Gy per fraction, twice daily at six hours apart for six fractions. Stage III patients received the same radiotherapy schedule (i.e., same EBRT & Brachytherapy schedule) and with addition of Injection Cisplatin 70 mg/m2 in three divided doses every three weeks along with EBRT.ResultsFollow up ranged from 12 to 60 months, median follow up was 26 months. Complete response was observed in 28 patients. Five patients had residual disease and were referred for surgical salvage. One patient died of disease progression. Stage I patients had 100% local control, whereas Stage II and Stage III patients had 84.6% and 80% local control respectively.ConclusionHDR Interstitial Brachytherapy used either as a primary treatment modality or as a boost in buccal mucosal cancers provides results comparable to that of surgery, with the advantages of organ preservation, better cosmetic and functional outcomes.

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

Cited by 15 publications

References 23 publications

Intensity‐modulated radiotherapy followed by a brachytherapy boost for oropharyngeal cancer

Intensity‐modulated radiotherapy followed by a brachytherapy boost for oropharyngeal cancer

Is INTERdisciplinary COMmunity-based COPD management (INTERCOM) cost-effective?

Role of high dose rate interstitial brachytherapy in early and locally advanced squamous cell carcinoma of buccal mucosa

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