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Konski A , James J , Hartsell W , Leibenhaut MH , Janjan N , Curran W , Roach M , Watkins-Bruner D
Economic Analysis of Radiation Therapy Oncology Group 97-14 Multiple Versus Single Fraction Radiation Treatment of Patients With Bone Metastases
American Journal of Clinical Oncology-Cancer Clinical Trials. 2009 Aug;32(4) :423-428
PMID: ISI:000268761600017    PMCID: PMC2628953   
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Introduction: Radiation Therapy Oncology Group 97-14 concluded that a single fraction of radiation was as effective in relieving pain as multiple fractions in the treatment of patients with bone metastases. A statistically significant higher retreatment rate, however, was noted in patients undergoing a single fraction treatment. The purpose of the analysis was to determine whether multiple fraction treatment is cost-effective in treating patients with bone metastasis, by preventing further retreatment. Methods and Material: A Markov model was used to evaluate the cost-effectiveness of 30 Gy in 10 fractions in comparison with 8 Gy in I fraction, Transition probabilities, cost, and utilities were obtained from the clinical trial. Costs and outcomes were not discounted because of the short time line for the study. Results: The expected mean cost and quality-adjusted survival in months for patients receiving 8 Gy in 1 fraction and 30 Gy in 10 fractions was $998 and 7.26 months and $2316 and 9.53 months, respectively, The incremental cost-effectiveness ratio was $6973/quality-adjusted life year. The results were sensitive to the utility of the posttreatment state for both single and multiple fraction treatments. Conclusion: Single fraction treatment was the less expensive treatment in the treatment of patients with bone metastasis treated on Radiation Therapy Oncology Group 97-14.
Konski, Andre James, Jennifer Hartsell, William Leibenhaut, Mark H. Janjan, Nora Curran, Walter Roach, Mack Watkins-Bruner, Deborah 12 Lippincott williams & wilkins; 530 walnut st, philadelphia, pa 19106-3621 usa 480uf