Department of Radiation Oncology, Gunma University Graduate School of Medicine, Maebashi, Japan.
Gunma University Heavy Ion Medical Center, Gunma University, Maebashi, Japan.
Cancer Sci. 2022 Feb;113(2):674-683. doi: 10.1111/cas.15216. Epub 2021 Dec 6.
Carbon-ion radiotherapy (CIRT) for clinical stage I non-small-cell lung cancer (NSCLC) is used as an advanced medical treatment regimen in Japan. Carbon-ion radiotherapy reportedly aids in achieving excellent treatment outcomes, despite its high medical cost. We aimed to compare CIRT with stereotactic body radiotherapy (SBRT) in terms of cost-effectiveness for treating clinical stage I NSCLC. Data of patients with clinical stage I NSCLC treated with CIRT or SBRT at Gunma University between 2010 and 2015 were analyzed. The CIRT and SBRT groups included 62 and 27 patients, respectively. After propensity-score matching, both groups comprised 15 patients. Life year (LY) was used as an indicator of outcome. The CIRT technical fee was 3 140 000 JPY. There was no technical fee for the second CIRT carried out on the same organ within 2 years. The incremental cost-effectiveness ratio (ICER) was calculated by dividing the incremental cost by the incremental LY for 5 years after treatment. Sensitivity analysis was applied to evaluate the impact of LY or costs of each group on ICER. The ICERs were 7 491 017 JPY/LY and 3 708 330 JPY/LY for all patients and matched patients, respectively. Hospitalization and examination costs were significantly higher in the CIRT group, and the impact of the CIRT technical costs was smaller than other costs and LY. Carbon-ion radiotherapy is a cost-effective treatment approach. However, our findings suggest that reducing excessive costs by considering the validity and necessity of examinations and hospitalizations would make CIRT a more cost-effective approach.
碳离子放疗（CIRT）被用于治疗临床 I 期非小细胞肺癌（NSCLC），是日本先进的医疗方案之一。尽管 CIRT 的医疗费用高昂，但据报道，它有助于获得出色的治疗效果。我们旨在比较 CIRT 和立体定向体部放疗（SBRT）在治疗临床 I 期 NSCLC 的成本效益方面的差异。分析了 2010 年至 2015 年在群马大学接受 CIRT 或 SBRT 治疗的临床 I 期 NSCLC 患者的数据。CIRT 组和 SBRT 组分别包括 62 例和 27 例患者。在进行倾向评分匹配后，两组各有 15 例患者。采用寿命年（LY）作为结果指标。CIRT 的技术费用为 314 万日元。同一器官在 2 年内进行第二次 CIRT 时不收取技术费用。通过将治疗后 5 年的增量成本除以增量 LY，计算出增量成本效益比（ICER）。采用敏感性分析评估每组 LY 或成本对 ICER 的影响。所有患者和匹配患者的 ICER 分别为 7491017 日元/LY 和 3708330 日元/LY。CIRT 组的住院和检查费用明显较高，CIRT 技术费用对 ICER 的影响小于其他费用和 LY。碳离子放疗是一种具有成本效益的治疗方法。然而，我们的研究结果表明，通过考虑检查和住院的有效性和必要性来降低过高的成本，将使 CIRT 成为一种更具成本效益的治疗方法。
