- Title
- Cost-effectiveness of hypofractionated versus conventional radiotherapy in patients with intermediate-risk prostate cancer: An ancillary study of the PROstate fractionated irradiation trial – PROFIT
- Creator
- Zhou, K.; Renouf, M.; Catton, C.; Bellanger, M.; Supiot, S.; Perrocheau, G.; Magné, N.; Latorzeff, I.; Pommier, P.; Créhange, G.; Paumier, A.; Bera, G.; Martin, J.
- Relation
- Radiotherapy and Oncology Vol. 173, p. 306-312
- Publisher Link
- http://dx.doi.org/10.1016/j.radonc.2022.06.014
- Publisher
- Elsevier
- Resource Type
- journal article
- Date
- 2022
- Description
- PURPOSE: To evaluate the cost-effectiveness of moderate Hypofractionated Radiotherapy (H-RT) compared to Conventional Radiotherapy (C-RT) for intermediate-risk prostate caner (PCa). METHODS: A prospective randomized clinical trial including 222 patients from six French cancer centers was conducted as an ancillary study of the international PROstate Fractionated Irradiation Trial (PROFIT). We carried-out a cost-effectiveness analysis (CEA) from the payer's perspective, with a time horizon of 48 months. Patients assigned to the H-RT arm received 6000 cGy in 20 fractions over 4 weeks, or 7800 cGy in 39 fractions over 7 to 8 weeks in the C-RT arm. Patients completed quality of life (QoL) questionnaire: Expanded Prostate Cancer Index Composite (EPIC) at baseline, 24 and 48 months, which were mapped to obtain a EuroQol five-dimensional questionnaire (EQ-5D) equivalent to generate Quality Adjusted Life Years (QALY). We assessed differences in QALYs and costs between the two arms with Generalized Linear Models (GLMs). Costs, estimated in euro (€) 2020, were combined with QALYs to estimate the Incremental Cost-effectiveness ratio (ICER) with non-parametric bootstrap. RESULTS: Total costs per patien were lower in the H-RT arm compared to the C-RT arm €3,062 (95 % CI: 2,368 to 3,754) versus €4,285 (95 % CI: 3,355 to 5,215), (p < 0.05). QALY were marginally higher in the H-RT arm, however this difference was not significant: 0.044 (95 % CI: - 0.016 to 0.099). CONCLUSIONS: Treating localized prostate cancer with moderate H-RT could reduce national health insurance spending. Adopting such a treatment with an updated reimbursement tariff would result in improving resource allocation in RT management.
- Subject
- cost-effectiveness analysis; France; hypofractionation; image guided radiation therapy; intensity modulated radiation therapy; prostate cancer
- Identifier
- http://hdl.handle.net/1959.13/1486421
- Identifier
- uon:51846
- Identifier
- ISSN:0167-8140
- Language
- eng
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