UCLA researchers are seeking cost-effective methods to treat patients with locally advanced rectal cancer according to a recent report from UCLA newsroom. The researchers compared two common treatments including 1) long-course chemoradiotherapy and 2) short-course radiotherapy.
The American advanced rectal cancer standard of care is presently long-course chemotherapy. It requires 28 radiation treatments with chemotherapy. However outside of America, such as nations in Europe, short-course radiotherapy involving five treatments is most common.
The UCLA team generated a mathematical model to evaluate the cost-effectiveness of two treatments. Simulating 10-year outcomes for hypothetical 65 year-old patients, the hypothetical patients had locally advanced rectal cancer and were treated with one of the two therapies. They also underwent chemotherapy and surgery. For the two treatment approaches the UCLA team leveraged the Healthcare Bluebook and Medicare Fee schedules—providing typical costs for medical treatments in the U.S.
The findings: The incremental cost-effectiveness ratio of $133,495 per quality-adjusted life year left short-course radiotherapy the most cost-effective treatment as compared to long-course.
On the other hand, patients with distal tumors (tumors close to the anus), long-course chemoradiotherapy was more cost effective with an incremental cost effectiveness ratio of $61,123 per quality-adjusted life year. In this case, the long-course chemoradiotherapy can shrink tumors away from the sphincter muscles, helping to potentially avoid surgery that results in a life-long colostomy bag. Follow the link for the entire story.
Dr. Ann Raldow, UCLA Jonsson Comprehensive Cancer Center