Can we afford to add chemotherapy to radiotherapy for glioblastoma multiforme? Cost-identification analysis of concomitant and adjuvant treatment with temozolomide until patient death.

Détails

ID Serval
serval:BIB_752F8C3A497E
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Can we afford to add chemotherapy to radiotherapy for glioblastoma multiforme? Cost-identification analysis of concomitant and adjuvant treatment with temozolomide until patient death.
Périodique
Cancer
Auteur(s)
Wasserfallen J.B., Ostermann S., Pica A., Mirimanoff R.O., Leyvraz S., Villemure J.G., Stupp R.
ISSN
0008-543X
Statut éditorial
Publié
Date de publication
2004
Peer-reviewed
Oui
Volume
101
Numéro
9
Pages
2098-2105
Langue
anglais
Notes
Publication types: Journal Article - Publication Status: ppublish
Résumé
BACKGROUND: Adding temozolomide (TMZ) to standard radiotherapy as a first-line therapy for glioma may increase costs to a disproportionate degree compared with the resulting survival benefits. METHODS: Forty-six consecutive patients (28 males and 18 females; median age, 52 years; age range, 24-70 years) received concomitant TMZ with radiotherapy for 6 weeks followed by adjuvant TMZ for 6 cycles, and they were followed until disease recurrence and then until death. The authors assessed the costs associated with the four phases of treatment from a hospital-centered perspective. RESULTS: Treatment was discontinued early in 3 patients, 9 patients, and 15 patients during concomitant TMZ, before adjuvant TMZ, and during adjuvant TMZ, respectively. Karnofsky index values varied between 85% (at the beginning of treatment) and 76% (at the end of treatment). The nature of care after disease recurrence was diverse. Overall survival ranged from 1.4 months to 64.3 months (median, 15.8 months) and was better if surgical debulking could be carried out before treatment. Global costs amounted to Euros 39,092 +/- Euros 21,948 (concomitant TMZ, Euros 14,539 +/- Euros 4998; adjuvant TMZ, Euros 13,651 +/- Euros 4320; follow-up, Euros 6363 +/- Euros 6917; and recurrence, Euros 12,344 +/- Euros 18,327), with 53% of these costs being related to the acquisition of TMZ; this represented an eightfold increase in cost compared with radiotherapy alone. CONCLUSIONS: TMZ may be an effective but costly adjuvant outpatient therapy for patients with glioblastoma multiforme. Definite cost-effectiveness/utility must be assessed in a randomized Phase III trial.
Mots-clé
Adult, Aged, Antineoplastic Agents, Alkylating, Brain Neoplasms, Combined Modality Therapy, Cost-Benefit Analysis, Dacarbazine, Europe, Female, Glioblastoma, Health Care Costs, Humans, Male, Middle Aged, Neoplasm Recurrence, Local, O(6)-Methylguanine-DNA Methyltransferase
Pubmed
Web of science
Création de la notice
14/03/2008 11:21
Dernière modification de la notice
03/03/2018 18:23
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