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Pryor, David I., Porceddu, Sandro V., Scuffham, Paul A., Whitty, Jennifer A. 
ORCID: https://orcid.org/0000-0002-5886-1933, Thomas, Paul A. and Burmeister, Bryan H.
(2013)
Economic analysis of FDG-PET-guided management of the neck after primary chemoradiotherapy for node-positive head and neck squamous cell carcinoma.
Head & Neck, 35 (9).
pp. 1287-1294.
ISSN 1043-3074
Abstract
Background: The aim of this economic analysis was to model different strategies using pre-treatment nodal stage or nodal response assessment with CT or positron emission tomography (PET)/CT to determine the need for neck dissection. Methods: A cost-minimization analysis was developed on the basis of probability data from a prospective study of PET-guided management of the neck in patients achieving a complete response at the primary site. Costs were derived from our institution's activity-based clinical costing system. The effect of uncertainty was tested with sensitivity and scenario analyses including nationally representative cost data. Results: Strategies incorporating PET had a 7% rate for neck dissection compared with 44% for CT-guided and 90% for planned neck dissection. The cost per patient was A$16,502 for planned neck dissection, A$8014 for CT-guided, and A$2573 for PET-guided. A policy with PET used only for incomplete response on CT was the least-cost strategy (A$2111). Policies incorporating PET remained the most efficient for all sensitivity/scenario analyses. Conclusion: The incorporation of PET/CT into nodal response assessment significantly reduced the number of unnecessary neck dissections and generated considerable cost savings in our cohort.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | cost,head and neck,pet,radiotherapy,response |
| Faculty \ School: | Faculty of Medicine and Health Sciences > Norwich Medical School |
| Depositing User: | Pure Connector |
| Date Deposited: | 27 Apr 2016 14:00 |
| Last Modified: | 31 Oct 2022 12:31 |
| URI: | https://ueaeprints.uea.ac.uk/id/eprint/58437 |
| DOI: | 10.1002/hed.v35.9 |
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