Brachytherapy provides comparable outcomes and improved cost-effectiveness in the treatment of low/intermediate prostate cancer
Brachytherapy provides comparable outcomes and improved cost-effectiveness in the treatment of low/intermediate prostate cancer
复制标题
DOI：
10.1016/j.brachy.2012.04.002
复制
发表时间：
2012-11-01
期刊：
影响因子：
1.9
通讯作者：
Martinez, Alvaro A.
中科院分区：
文献类型：
--
作者：
Shah, Chirag;Lanni, Thomas B., Jr.;Martinez, Alvaro A.
目的：评估低剂量率 (LDR) 和高剂量率 (HDR) 近距离放射治疗与调强放射治疗 (IMRT) 相比，在低/中风险前列腺癌患者中的成本效益和结果。 方法和材料：1328 名低或中风险前列腺癌患者接受 LDR (n = 207)、四次 HDR (n = 252），或 1992 年 1 月至 2008 年 12 月之间的 IMRT（n = 869）。LDR 患者接受中位剂量为 120 Gy 的钯粒子治疗，而 HDR 患者接受中位剂量 38.0 Gy 的治疗（四次）。 IMRT 患者接受 42-44 次分次治疗，中位剂量为 75.6 Gy。比较临床结果，包括生化失败、特定原因生存率和总生存率。结果：总体而言，治疗方式之间的 5 年生化控制 (BC) 或特定原因生存率没有差异。 LDR 近距离放射治疗、四次 HDR 近距离放射治疗和 IMRT 的计算报销金额为 9,938 美元； 17,514 美元；和 29,356 美元。从统计数据来看，HDR 和 LDR 近距离放射治疗对 Medicare 和机构的成本低于 IMRT (p
PURPOSE: To evaluate the cost-effectiveness and outcomes of low-dose-rate (LDR) and high-dose-rate (HDR) brachytherapy compared with intensity-modulated radiation therapy (IMRT) in patients with low/intermediate risk of prostate cancer.METHODS AND MATERIALS: One thousand three hundred twenty-eight patients with low or intermediate risk of prostate cancer were treated with LDR (n = 207), HDR with four fractions (n = 252), or IMRT (n = 869) between January 1992 and December 2008. LDR patients were treated with palladium seeds to a median dose of 120 Gy, whereas HDR patients were treated to a median dose 38.0 Gy (four fractions). IMRT patients received 42-44 fractions with a median dose of 75.6 Gy. Clinical outcomes were compared, including biochemical failure, cause-specific survival, and overall survival.RESULTS: Overall, no differences in 5-year biochemical control (BC) or cause-specific survival were noted among treatment modalities. The calculated reimbursement for LDR brachytherapy, HDR brachytherapy with four fractions, and IMRT was $9,938; $17,514; and $29,356, respectively. HDR and LDR brachytherapy were statistically less costly to Medicare and the institution than IMRT (p