Evidence map›Paper›PMID 39574140›Full record

ArticleRadiation oncology (London, England)2024

Cost-effectiveness analysis of additional local prostate radio therapy in metastatic prostate cancer from a medicare perspective.

Kristina K M Kramer, Nina-Sophie Schmidt-Hegemann, Thilo Westhofen, Marco Foglar, Jens Ricke, C Benedikt Westphalen, Marcus Unterrainer, Wolfgang G Kunz, Dirk Mehrens

Abstract read
In one paragraph

Article in Radiation oncology (London, England), 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Review
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Kristina K M KramerDepartment of Radiology, LMU University Hospital, LMU Munich, Munich, Germany.
Nina-Sophie Schmidt-HegemannDepartment of Radiation Oncology, University Hospital, LMU Munich, Munich, Germany.
Thilo WesthofenDepartment of Urology, Ludwig-Maximilians-University of Munich, Munich, Germany.
Marco FoglarDepartment of Urology, Ludwig-Maximilians-University of Munich, Munich, Germany.
Jens RickeDepartment of Radiology, LMU University Hospital, LMU Munich, Munich, Germany.
C Benedikt WestphalenComprehensive Cancer Center and Department of Medicine III, Ludwig Maximilian University of Munich, Munich, Germany.
Marcus UnterrainerDepartment of Nuclear Medicine, LMU University Hospital, LMU Munich, Munich, Germany.
Wolfgang G KunzDepartment of Radiology, LMU University Hospital, LMU Munich, Munich, Germany.
Dirk MehrensDepartment of Radiology, LMU University Hospital, LMU Munich, Munich, Germany. dirk.mehrens@med.uni-muenchen.de.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMetastatic prostate cancer remains a therapeutic challenge. Based on data of the STAMPEDE trial, patients with a low metastatic burden showed prolonged failure-free and overall survival when treated with prostate radio therapy (RT) in addition to standard of care (SOC). The objective of this study was to determine the cost-effectiveness of additional prostate RT compared to SOC alone for following subgroups: non-regional lymph node (NRLN) metastases, up to three bone metastases and four or more bone metastases.

methodsA partitioned survival model was implemented with clinical data from STAMPEDE trial. Analyses were performed from a United States healthcare system perspective. Costs for treatment and adverse events were derived from Medicare coverage. Utilities for health states were derived from public databases and literature. Outcome measurements included incremental costs, effectiveness, and cost-effectiveness ratio. The willingness-to-pay threshold was set to USD 100,000 per quality-adjusted life year (QALY).

resultsAdditional RT led to 0.92 incremental QALYs with increased costs of USD 26,098 with an incremental cost-effectiveness ratio (ICER) of USD 28,452/QALY for patients with only NRLN metastases and 3.83 incremental QALYs with increased costs of USD 153,490 with an ICER of USD 40,032/QALY for patients with up to three bone metastases. Sensitivity analysis showed robustness of the model regarding various parameters. In probabilistic sensitivity analysis using Monte Carlo simulation with 10,000 iterations, additional RT was found as the cost-effective strategy in over 96% for both subgroups iterations at a willingness-to-pay threshold of USD 100,000/QALYs.

conclusionsAdditional RT is cost-effective in patients with only NRLN metastases and up to three metastases compared to SOC.

Indexed as

Bone NeoplasmsCost-Benefit AnalysisMedicareProstatic NeoplasmsQuality-Adjusted Life YearsAgedCost-Effectiveness AnalysisHumansMaleUnited StatesBone metastasesCost-effectivenessNRLN metastasesProstate cancerRadiotherapy

Identifiers

PMID39574140
PMCPMC11580356

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.