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Table 4 Main findings of Cost-effectiveness studies comparing IMRT, SBRT and PBT for localized prostate cancer

From: Model-based cost-effectiveness analysis of external beam radiation therapy for the treatment of localized prostate cancer: a systematic review

Study (authors, year) Result Conclusions
Mean cost QALYs ICER
Hodges et al. (2012) [19] SBRT: $22,152 IMRT: $35,431 SBRT = 7.9 IMRT = 7.9 NA “Compared with IMRT, SBRT for low- to intermediate-risk prostate cancer has great potential cost savings”
Sher et al. (2014) [20] IMRT: $27,564 Non-robotic SBRT: $10,108 Cyber-knife SBRT: $19,275 IMRT: 9.96 SBRT: 9.93 IMRT vs robotic SBRT: $285,000/QALY IMRT vs Non- robotic: US$591,100/QALY “SBRT clearly contained more value than IMRT for external-beam treatment”
Parthan et al. (2012) [18] Payer perspective IMRT: $33,068 PBT: $69,412 SBRT: $24,873 Societal perspective SBRT: $25,097, IMRT: $35,088 PBT: $71,657 SBRT: 8.11 IMRT: 8.05 PBT: 8.06 SBRT was dominating over RT and IMRT (less costly and more QALYs) “Based on the assumption that each treatment modality results in equivalent long-term efficacy, SBRT is a cost-effective strategy resulting in improved quality-adjusted survival compared to IMRT and PT for the treatment of localized prostate cancer”
Lundkvist, et al. (2005) [21] Proton: €13,491 IMRT: €5477 Cost Standard case result: 7952.6 High proton radiation cost estimate: 10,485.2 Low proton radiation cost estimate: 7343.9 QALY Standard case result: 0.297 High proton radiation cost estimate: 0.297 Low proton radiation cost estimate: 0.297 “Investment in a proton facility may thus be cost-effective. The results must be interpreted with caution, since there is a lack of data, and consequently large uncertainties in the assumptions used”
Konski et al. (2007) [22] 70-year-old man PBT: $63,511 IMRT: $36,808 60-year-old man PBT: $64,989 IMRT: $39,355 70-year-old man PBT: 8.54 IMRT: 8.12 60-year-old man PBT: 9.91 IMRT: 9.45 70-year-old man $63,578/QALY 60-year-old man $55,726/QALY “Even when based on the unproven assumption that protons will permit a 10-Gy escalation of prostate dose compared with IMRT photons, proton beam therapy is not cost effective for most patients with prostate cancer using the commonly accepted standard of $50,000/QALY”