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Titolo:
Costs and effectiveness of staging and treatment options in early-stage Hodgkin's disease
Autore:
Ng, AK; Kuntz, KM; Mauch, PM; Weeks, JC;
Indirizzi:
Harvard Univ, Sch Publ Hlth, Dana Farber Canc Inst, Dept Radiat Oncol, Boston, MA 02115 USA Harvard Univ Boston MA USA 02115 Dept Radiat Oncol, Boston, MA 02115 USA Harvard Univ, Sch Publ Hlth, Dana Farber Canc Inst, Dept Adult Oncol, Boston, MA 02115 USA Harvard Univ Boston MA USA 02115 , Dept Adult Oncol, Boston, MA 02115 USA Harvard Univ, Sch Publ Hlth, Dept Hlth Policy & Management, Boston, MA 02115 USA Harvard Univ Boston MA USA 02115 olicy & Management, Boston, MA 02115 USA
Titolo Testata:
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS
fascicolo: 4, volume: 50, anno: 2001,
pagine: 979 - 989
SICI:
0360-3016(20010715)50:4<979:CAEOSA>2.0.ZU;2-5
Fonte:
ISI
Lingua:
ENG
Soggetto:
BONE-MARROW TRANSPLANTATION; EXTENDED-FIELD RADIOTHERAPY; RADIATION-THERAPY SALVAGE; SOUTHWEST-ONCOLOGY-GROUP; HIGH-DOSE THERAPY; COMBINATION CHEMOTHERAPY; PROGNOSTIC FACTORS; FOLLOW-UP; TREATMENT STRATEGIES; FAVORABLE-PROGNOSIS;
Keywords:
Hodgkin's disease; cost-effectiveness analysis; costs; patient preferences; utilities;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
65
Recensione:
Indirizzi per estratti:
Indirizzo: Weeks, JC Harvard Univ, Sch Med, Dana Farber Canc Inst, 454 Brookline Ave,Boston, MA 02115 USA Harvard Univ 454 Brookline Ave Boston MA USA 02115 MA 02115 USA
Citazione:
A.K. Ng et al., "Costs and effectiveness of staging and treatment options in early-stage Hodgkin's disease", INT J RAD O, 50(4), 2001, pp. 979-989

Abstract

Purpose: Using a cost-effectiveness analysis, to weigh the costs and benefits of the different staging and treatment options in early-stage Hodgkin'sdisease. Methods: We constructed a decision-analytic model for a hypothetical cohort of 25-year-old patients with early-stage Hodgkin's disease. Markov modelswere used to simulate the lifetime costs and prognosis of each staging andtreatment strategy. Baseline probabilities and cost estimates were derivedfrom published studies and bills of relevant patient cohorts. Results: Among the six management strategies considered, the incremental cost-effectiveness ratio of laparotomy and tailored treatment compared with mantle and para-aortic-splenic radiation therapy in all clinical stage I-IIpatients was $24,100/quality-adjusted life year, while that of the strategy of combined modality therapy in all clinical stage I-II patients comparedwith laparotomy was $61,700/quality-adjusted life year. All the remaining strategies were dominated by one of these three strategies. Sensitivity analysis showed that the cost-effectiveness ratios were driven predominantly by the effectiveness rather than the cost of each strategy. In particular, the analysis was heavily influenced by the utility of the post-laparotomy health state. Conclusions: In considering the various alternative management strategies in early-stage Hodgkin's disease, even very small gains in effectiveness were enough to justify the additional costs of more expensive treatment options. (C) 2001 Elsevier Science Inc.

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Documento generato il 20/01/21 alle ore 11:39:08