Economic analysis of FDG-PET-guided management of the neck after primary chemoradiotherapy for node-positive head and neck squamous cell carcinoma

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

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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. © 2012 Wiley Periodicals, Inc. Head Neck, 2013

Item Type: Article
Uncontrolled Keywords: cost,head and neck,pet,radiotherapy,response
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
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Depositing User: Pure Connector
Date Deposited: 27 Apr 2016 14:00
Last Modified: 01 Oct 2022 01:05
URI: https://ueaeprints.uea.ac.uk/id/eprint/58437
DOI: 10.1002/hed.v35.9

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