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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”