Treatments and costs for recurrent and/or metastatic squamous cell carcinoma of the head and neck in the Netherlands

Abstract

For patients with recurrent and/or metastatic squamous cell carcinoma of the head and neck (R/M SCCHN), chemotherapy can prolong life and alleviate symptoms. However, expected gains may be small, not necessarily outweighing considerable toxicity and high costs. Treatment choice is to a large extent dependent on preferences of doctors and patients and data on these choices are scarce. The purpose of this study is to obtain real-world information on palliative systemic treatment and costs of R/M SCCHN in the Netherlands. In six Dutch head and neck treatment centers, data were collected on patient and tumor characteristics, treatment patterns, disease progression, survival, adverse events, and resource use for R/M SCCHN, between 2006 and 2013. 125 (14 %) out of 893 R/M SCCHN patients received palliative, non-trial first-line systemic treatment, mainly platinum + 5FU + cetuximab (32 %), other platinum-based combination therapy (13 %), methotrexate monotherapy (27 %) and capecitabine monotherapy (14 %). Median progression-free survival and overall survival were 3.4 and 6.0 months, respectively. 34 (27 %) patients experienced severe adverse events. Mean total hospital costs ranged from €10,075 (±€9,891) (methotrexate monotherapy) to €39,459 (±€21,149) (platinum + 5FU + cetuximab). Primary cost drivers were hospital stays and anticancer drug treatments. Major health care utilization and costs are involved in systemically treating R/M SCCHN patients with a limited survival.

Thermal photodynamic therapy increases apoptosis and reactive oxygen species generation in cutaneous and mucosal squamous cell carcinoma cells

“…From 2007 to 2011, over 4.5 billion US dollars were spent treating non-melanoma skin cancers (a classification which includes SCC and BCC), a 74% increase in spending from the previous 4-year period 19 . In the Netherlands, the total cost for treatment of recurrent/metastatic SCC of the head and neck was 10,000 to 40,000 Euros with the primary drivers of cost being hospital stays and cancer drugs 20 . It is estimated by 2025, non-melanoma skin cancer will cost the United Kingdom 338 to 465 million pounds per year 21 .…”

Utility of Surgery/Radiotherapy in Distant Metastatic Head and Neck Squamous Cell Carcinoma

“…Squamous cell carcinoma (SCC) of the head and neck (HN) is the sixth-most common neoplasm worldwide and accounts for roughly 3% of cancers in the United States. 1 Among HN cancers, SCC makes up about 95% of cases. Locations of SCC in the HN include the oral cavity, nasal cavity, pharynx, and the larynx.…”

Economic burden of chemotherapy-treated recurrent and/or metastatic squamous cell carcinoma of the head and neck in France: real-world data from the permanent sample of national health insurance beneficiaries

“…In our study, only patients who received chemotherapy for R/M SCCHN were included. Indeed, due to possible side effects and limited clinical benefit of systemic treatment in R/M SCCHN, treatment choice is, to a large extent, dependent on individual preferences of doctors and their patients 21 . Also, some SCCHN patients with R/M do not receive chemotherapy.…”