Proton therapy is a cost-effective treatment for pediatric brain tumor
patients
Atlanta, September 22, 2013
Due to decreased side effects, it may also be cost-saving
Proton therapy, an external beam radiotherapy in which protons deliver
precise radiation doses to a tumor and spare healthy organs and tissues, is
cost-effective in treating medulloblastomas, fast-growing brain tumors that
mainly affect children, when compared to standard photon radiation therapy,
according to research presented today at the American Society for Radiation
Oncology’s (ASTRO’s) 55th Annual Meeting.
The study used a first-order Monte Carlo simulation model to examine a
population of 18-year old survivors of medulloblastoma brain tumors who were
assumed to have been diagnosed at age 5 and at risk of developing 10 adverse
health events, including various hormone deficiencies, coronary artery disease,
congestive heart failure, ototoxicity, secondary malignant neoplasm and death.
Primary institutional information on the cost of investment and Medicare data
regarding the cost of management of the various adverse health conditions, in
addition to peer-reviewed publications analyzing incidence of side effects were
used in the simulation model to perform a cost-effectiveness analysis comparing
proton and photon therapy from the societal perspective. Outcomes were measured
in incremental cost-effectiveness ratios, with costs measured in 2012 U.S.
dollars (USD), and effectiveness measured in quality-adjusted life years
(QALYs). A societal willingness-to-pay (WTP) threshold of $50,000/QALY was the
benchmark.
The clinical benefits of proton therapy have been recognized in reducing side
effects when compared to photon therapy, but the significant expense of building
and maintaining proton facilities and the high treatment costs have been areas
of concern. The study’s results demonstrate that by avoiding years of costly
side effects, proton therapy can be cost-effective for children with
medulloblastoma. Using current risk estimates and data on required capital
investments, proton therapy for pediatric medulloblastoma treatment was not only
cost-effective compared to standard photon radiation, but also found to be
cost-saving in many simulations.
Results from the base case analysis showed that due to the prevention of side
effects, proton therapy was cost-saving. In sensitivity analyses, proton therapy
strongly remained the more appealing treatment, in part due to decreased risks
of hearing loss, secondary malignancy and heart failure, resulting in
cost-savings in more than 95 percent of simulations.
“We believed that proton therapy might prove to be cost-effective in treating
pediatric brain tumors, and we were intrigued that it also proved to be
cost-saving in the base case and in almost all of the sensitivity analysis
simulations,” said Raymond Mailhot Vega, MD, MPH, the presenting author of the
study; a resident at Mount Auburn Hospital, the teaching hospital of Harvard
Medical School; and a 2014 radiation oncology resident at New York University’s
Langone Medical Center. “Proton therapy might prove to be both cost-effective
and cost-saving for other malignancies, too, and consequently, more cancer
patients may benefit from proton therapy.”
The abstract, “Cost-Effectiveness of Proton Therapy
Compared to Photon Therapy in the Management of Pediatric Medulloblastoma,” will
be presented in detail during a scientific session at ASTRO’s 55th Annual
Meeting at 1:45 p.m. Eastern time on Sunday, September 23, 2013. To speak with
Dr. MailhotVega, please call Michelle Kirkwood on September 22-25, 2013, in the
ASTRO Press Office at the Georgia World Congress Center at 404-222-5303 or
404-222-5304, or email
Michelle
Kirkwood.
ASTRO’s 55th Annual Meeting, held in Atlanta, September 22-25, 2013, is the
premier scientific meeting in radiation oncology and brings together more than
11,000 attendees including oncologists from all disciplines, medical physicists,
dosimetrists, radiation therapists, radiation oncology nurses and nurse
practitioners, biologists, physician assistants, practice administrators,
industry representatives and other health care professionals from around the
world. The theme of the 2013 meeting is “Patients: Hope • Guide • Heal” and will
focus on patient-centered care and the importance of the physician’s role in
improving patient-reported outcomes and the quality and safety of patient care.
The four-day scientific meeting includes presentation of four plenary papers,
363 oral presentations, 1,460 posters and 144 digital posters in 70 educational
sessions and scientific panels for 19 disease sites/tracks. Keynote speakers
include: William B. Munier, MD, Director of the Center for Quality Improvement
and Patient Safety at the Agency for Healthcare Research and Quality; Darrell G.
Kirch, MD, President and CEO of the Association of American Medical Colleges;
James Cosgrove, PhD, Director, the U.S. Government Accountability Office; Otis
W. Brawley, MD, Chief Medical Officer of the American Cancer Society; and Peter
Friedl, MD, PhD, of St. Radboud University Nijmegen Medical Centre at the
University of Nijmegen and MD Anderson Cancer Center.
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