Hayman J A, Hillner B E
Department of Radiation Oncology, University of Michigan Health System, Ann Arbor, MI 48109, USA.
Semin Radiat Oncol. 1999 Jul;9(3):287-91. doi: 10.1016/s1053-4296(99)80021-6.
With the publication of two randomized trials showing an improvement in overall survival after the use of postmastectomy radiation therapy, interest in the use of radiation therapy in this setting has been rekindled. These results are in contrast to those reported in the most recent meta-analysis of the Early Breast Cancer Trialists' Collaborative Group, in which a statistically significant survival benefit was not detected. Although evidence of a survival benefit was sufficient in the past for an intervention to gain acceptance, payers are increasingly interested in knowing whether its use is also cost-effective. This article briefly reviews the methods used in performing cost-effectiveness analyses, summarizes the results of one published and a second preliminary cost-effectiveness analysis of postmastectomy radiation therapy, and highlights several areas for future research.
两项随机试验表明，乳房切除术后放疗可改善总生存期，随着这两项试验结果的发表，人们对在这种情况下使用放疗的兴趣再次被点燃。这些结果与早期乳腺癌试验者协作组最近的荟萃分析结果形成对比，在该荟萃分析中未检测到具有统计学意义的生存获益。尽管过去有足够的生存获益证据使一种干预措施获得认可，但支付方越来越关注其使用是否也具有成本效益。本文简要回顾了进行成本效益分析所使用的方法，总结了一项已发表的以及另一项关于乳房切除术后放疗的初步成本效益分析的结果，并强调了未来研究的几个领域。
