scholarly journals Evaluation of a mixed beam therapy for postmastectomy breast cancer patients: Bolus electron conformal therapy combined with intensity modulated photon radiotherapy and volumetric modulated photon arc therapy

2018 ◽  
Vol 45 (7) ◽  
pp. 2912-2924 ◽  
Author(s):  
Rui Zhang ◽  
David Heins ◽  
Mary Sanders ◽  
Beibei Guo ◽  
Kenneth Hogstrom
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Breast Cancer Patients ◽  
Intensity Modulated ◽  
Conformal Therapy ◽  
Mixed Beam ◽  
Arc Therapy ◽  
Photon Radiotherapy

scholarly journals Cost-Effectiveness Analysis of Advanced Radiotherapy Techniques for Post-Mastectomy Breast Cancer Patients

2020 ◽  
Author(s):  
Yibo Xie ◽  
Beibei Guo ◽  
Rui Zhang
Keyword(s):  
Breast Cancer ◽  
Cost Effectiveness ◽  
Cancer Patients ◽  
Cost Effective ◽  
Sensitivity Analyses ◽  
Tumor Control ◽  
Breast Cancer Patients ◽  
Intensity Modulated ◽  
Life Years ◽  
Mixed Beam

Abstract Background: Prior cost-effectiveness studies of post-mastectomy radiotherapy (PMRT) only compared conventional radiotherapy versus no radiotherapy and only considered tumor control. The goal of this study was to perform cost-effectiveness analyses of standard of care (SOC) and advanced PMRT techniques including intensity-modulated radiotherapy (IMRT), standard volumetric modulated arc therapy (STD-VMAT), non-coplanar VMAT (NC-VMAT), multiple arc VMAT (MA-VMAT), Tomotherapy (TOMO), mixed beam therapy (MIXED), and intensity-modulated proton therapy (IMPT).Methods: Using a Markov model, we estimated the cost-effectiveness of various techniques over 15 years. A cohort of women (55-year-old) was simulated in the model, and radiogenic side effects were considered. Transition probabilities, utilities, and costs for each health state were obtained from literature and Medicare data. Model outcomes include quality-adjusted life-years (QALYs) and incremental cost-effectiveness ratio (ICER), and SOC was used as the reference.Results: For the patient cohort, IMRT is the most cost-effective technique with an ICER value of 27,310 $/QALY, and IMPT has the highest ICER of 74,564 $/QALY. One-way analysis shows that the probability of cardiac toxicity has the most significant impact on the model outcomes. The probability sensitivity analyses show that all advanced PMRT techniques are more cost-effective than SOC at a willingness-to-pay (WTP) threshold of 100,000 $/QALY, while almost none of the advanced techniques is more cost-effective than SOC at a WTP threshold of $50,000/QALY.Conclusion: Advanced PMRT techniques are more cost-effective for breast cancer patients at a WTP threshold of 100,000 $/QALY, and IMRT might be the most cost-effective option for PMRT patients.

scholarly journals Cost-Effectiveness Analysis of Advanced Radiotherapy Techniques for Post-Mastectomy Breast Cancer Patients

2020 ◽  
Author(s):  
Yibo Xie ◽  
Beibei Guo ◽  
Rui Zhang
Keyword(s):  
Breast Cancer ◽  
Cost Effectiveness ◽  
Cancer Patients ◽  
Cost Effective ◽  
Sensitivity Analyses ◽  
Breast Cancer Patients ◽  
Intensity Modulated ◽  
Life Years ◽  
Mixed Beam ◽  
Effective Option

Abstract Background: Prior cost-effectiveness studies of post-mastectomy radiotherapy (PMRT) only compared conventional radiotherapy versus no radiotherapy and only considered tumor control. The goal of this study was to perform cost-effectiveness analyses of standard of care (SOC) and advanced PMRT techniques including intensity-modulated radiotherapy (IMRT), standard volumetric modulated arc therapy (STD-VMAT), non-coplanar VMAT (NC-VMAT), multiple arc VMAT (MA-VMAT), Tomotherapy (TOMO), mixed beam therapy (MIXED), and intensity-modulated proton therapy (IMPT). Methods: Using a Markov model, we estimated the cost-effectiveness of various techniques over 15 years. A cohort of women (55-year-old) was simulated in the model, and radiogenic side effects were considered. Transition probabilities, utilities, and costs for each health state were obtained from literature and Medicare data. Model outcomes include quality-adjusted life-years (QALYs) and incremental cost-effectiveness ratio (ICER), and SOC was used as the reference. Results: For the patient cohort, IMRT is the most cost-effective technique as it dominates NC-VMAT, MA-VMAT, MIXED, and has ICER of 27,310 $/QALY, 19,081 $/QALY and 3,067 $/QALY compared with SOC, STD-VMAT and TOMO, respectively. IMPT has the highest ICER of 74,564 $/QALY and 151,741 $/QALY compared with SOC and IMRT, which shows IMPT is the least cost-effective option. One-way analysis shows that the probability of cardiac toxicity has the most significant impact on the model outcomes. The probability sensitivity analyses show that all advanced PMRT techniques are more cost-effective than SOC at a willingness-to-pay (WTP) threshold of 100,000 $/QALY, while almost none of the advanced techniques is more cost-effective than SOC at a WTP threshold of $50,000/QALY. Conclusion: Advanced PMRT techniques are more cost-effective for breast cancer patients at a WTP threshold of 100,000 $/QALY, and IMRT might be the most cost-effective option for PMRT patients.

scholarly journals Cost-Effectiveness Analysis of Advanced Radiotherapy Techniques for Post-Mastectomy Breast Cancer Patients

2020 ◽  
Author(s):  
Yibo Xie ◽  
Beibei Guo ◽  
Rui Zhang
Keyword(s):  
Breast Cancer ◽  
Cost Effectiveness ◽  
Cancer Patients ◽  
Cost Effective ◽  
Sensitivity Analyses ◽  
Tumor Control ◽  
Breast Cancer Patients ◽  
Intensity Modulated ◽  
Life Years ◽  
Mixed Beam

Abstract Background: Prior cost-effectiveness studies of post-mastectomy radiotherapy (PMRT) only compared conventional radiotherapy versus no radiotherapy and only considered tumor control. The goal of this study was to perform cost-effectiveness analyses of standard of care (SOC) and advanced PMRT techniques including intensity-modulated radiotherapy (IMRT), standard volumetric modulated arc therapy (STD-VMAT), non-coplanar VMAT (NC-VMAT), multiple arc VMAT (MA-VMAT), Tomotherapy (TOMO), mixed beam therapy (MIXED), and intensity-modulated proton therapy (IMPT). Methods: Using a Markov model, we estimated the cost-effectiveness of various techniques over 15 years. A cohort of women (55-year-old) was simulated in the model, and radiogenic side effects were considered. Transition probabilities, utilities, and costs for each health state were obtained from literature and Medicare data. Model outcomes include quality-adjusted life-years (QALYs) and incremental cost-effectiveness ratio (ICER). Results: For the patient cohort, STD-VMAT has ICER of $32,617 relative to SOC; TOMO is dominated by STD-VMAT; IMRT has ICER of 19,081 $/QALY relative to STD-VMAT; NC-VMAT, MA-VMAT, MIXED are dominated by IMRT; IMPT has ICER of 151,741 $/QALY relative to IMRT. One-way analysis shows that the probability of cardiac toxicity has the most significant impact on the model outcomes. The probability sensitivity analyses show that all advanced PMRT techniques are more cost-effective than SOC at a willingness-to-pay (WTP) threshold of 100,000 $/QALY, while almost none of the advanced techniques is more cost-effective than SOC at a WTP threshold of $50,000/QALY. Conclusion: Advanced PMRT techniques are more cost-effective for breast cancer patients at a WTP threshold of 100,000 $/QALY, and IMRT might be a cost-effective option for PMRT patients.

Electron arc therapy: Chest wall irradiation of breast cancer patients

1986 ◽  
Vol 12 ◽  
pp. 153
Author(s):  
Geraldine M. Jacobson ◽  
Lee K. McNeely ◽  
Dennis D. Leavitt ◽  
J. Robert Stewart
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Chest Wall ◽  
Breast Cancer Patients ◽  
Arc Therapy
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