ArticleRadiation oncology (London, England)2021
Individualized quality of life benefit and cost-effectiveness estimates of proton therapy for patients with oropharyngeal cancer.
Article in Radiation oncology (London, England), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 2 of them syntheses that pooled it.
What it found
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
9 citing papers in PubMed, 2 syntheses or guidelines pooled it, 11 citations in OpenAlex.
- Proton Radiation Therapy: A Systematic Review of Treatment-Related Side Effects and Toxicities.International journal of molecular sciences · 2024Pooled it
- A Systematic Review of the Economic Burden of Proton Therapy in Head and Neck Cancer.Asian Pacific journal of cancer prevention : APJCP · 2023Pooled it
- [Proton versus photon radiotherapy for patients with oropharyngeal cancer].Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2026Article
- Envisioning an Italian Head and Neck Proton Therapy Model-Based Selection: Challenge and Opportunity.International journal of particle therapy · 2025Article
- Cost-effectiveness analysis for multi adverse events of proton beam therapy for pediatric medulloblastoma in Japan.Journal of radiation research · 2025Article
- Proton Beam Radiation Therapy for Oropharyngeal Squamous Cell Carcinoma.International journal of particle therapy · 2023Review
- It is beneficial to invest resources to implement proton intracranial SRS.Journal of applied clinical medical physics · 2022Article
- A Review of Proton Therapy - Current Status and Future Directions.Precision radiation oncology · 2022Article
- Proton therapy needs further technological development to fulfill the promise of becoming a superior treatment modality (compared to photon therapy).Journal of applied clinical medical physics · 2021Article
Corrections and comments
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Authors and funding
8 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundProton therapy is a promising advancement in radiation oncology especially in terms of reducing normal tissue toxicity, although it is currently expensive and of limited availability. Here we estimated the individual quality of life benefit and cost-effectiveness of proton therapy in patients with oropharyngeal cancer treated with definitive radiation therapy (RT), as a decision-making tool for treatment individualization. METHODS AND MATERIALS: Normal tissue complication probability models were used to estimate the risk of dysphagia, esophagitis, hypothyroidism, xerostomia and oral mucositis for 33 patients, comparing delivered photon intensity-modulated RT (IMRT) plans to intensity-modulated proton therapy (IMPT) plans. Quality-adjusted life years (QALYs) lost were calculated for each complication while accounting for patient-specific conditional survival probability and assigning quality-adjustment factors based on complication severity. Cost-effectiveness was modeled based on upfront costs of IMPT and IMRT, and the cost of acute and/or long-term management of treatment complications. Uncertainties in all model parameters and sensitivity analyses were included through Monte Carlo sampling.
resultsThe incremental cost-effectiveness ratios (ICERs) showed considerable variability in the cost of QALYs spared between patients, with median $361,405/QALY for all patients, varying from $54,477/QALY to $1,508,845/QALY between individual patients. Proton therapy was more likely to be cost-effective for patients with p16-positive tumors ($234,201/QALY), compared to p16-negative tumors ($516,297/QALY). For patients with p16-positive tumors treated with comprehensive nodal irradiation, proton therapy is estimated to be cost-effective in ≥ 50% of sampled cases for 8/9 patients at $500,000/QALY, compared to 6/24 patients who either have p16-negative tumors or receive unilateral neck irradiation.
conclusionsProton therapy cost-effectiveness varies greatly among oropharyngeal cancer patients, and highlights the importance of individualized decision-making. Although the upfront cost, societal willingness to pay and healthcare administration can vary greatly among different countries, identifying patients for whom proton therapy will have the greatest benefit can optimize resource allocation and inform prospective clinical trial design.
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