Economic evaluation of radiotherapy for early breast cancer after breast-conserving surgery in a health resource-limited setting
Economic evaluation of radiotherapy for early breast cancer after breast-conserving surgery in a health resource-limited setting
复制标题
DOI：
10.1007/s10549-012-2268-1
复制
发表时间：
2012-11-01
影响因子：
3.8
通讯作者：
Wu, Bin
中科院分区：
文献类型：
--
作者：
Bai, Yongrui;Ye, Ming;Wu, Bin
本研究的主要目的是从中国社会的角度评估保乳手术（BCS）后早期乳腺癌患者接受额外放疗的成本效益。根据乳腺癌的临床病程（无复发、局部或远处复发、死亡）和治疗策略（放疗与非放疗），构建马尔可夫模型来模拟女性在不同健康状态下的转变。临床和效用数据是根据已发表的研究估计的。从中国社会的角度估算成本。测定质量调整寿命年（QALYs）和增量成本效益比（ICERs）。进行了概率和单向敏感性分析。BCS后增加放疗与改善总生存期（22.20年vs. 19.51年）和qaly（13.25年vs. 11.75年）以及降低终生成本（24,518.9美元vs. 25,147.0美元）相关。放疗与非放疗的ICER为- 420.56美元/QALY。敏感性、亚组和情景分析表明，这些结果对合理的假设和变化是稳健的。在卫生资源有限的情况下，与早期乳腺癌妇女不进行放射治疗相比，增加放射治疗是一种非常具有成本效益的策略。
The primary objective was to assess the cost-effectiveness, from the Chinese societal perspective, of additional radiotherapy for women with early breast cancer after breast-conserving surgery (BCS). The Markov model was constructed to simulate women's transitions across various health states based on the clinical course of breast cancer (no recurrence, local or distant recurrence, and death) and treatment strategy (radiotherapy vs. no-radiotherapy). The clinical and utility data were estimated from published studies. Costs were estimated from the perspective of Chinese society. Quality-adjusted life-years (QALYs) and incremental cost-effective ratios (ICERs) were determined. Probabilistic and one-way sensitivity analyses were performed. The addition of radiotherapy following BCS was associated with improved overall survival (22.20 vs. 19.51 years) and QALYs (13.25 vs. 11.75) and reduced lifetime costs ($24,518.9 vs. $25,147.0). The ICER of radiotherapy vs. no-radiotherapy was -$420.56/QALY gained. Sensitivity, subgroup and scenario analyses indicated that these results were robust against plausible assumptions and variations. In health resource-limited settings, the addition of radiotherapy is a very cost-effective strategy in comparison to no-radiotherapy in women with early breast cancer.