Department of Neurosurgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Japan.
JCOG Data Center/Operations Office, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, Japan.
Jpn J Clin Oncol. 2024 Oct 3;54(10):1123-1131. doi: 10.1093/jjco/hyae116.
This study aimed to investigate what treatment are selected for malignant brain tumors, particularly glioblastoma (GBM) and primary central nervous system lymphoma (PCNSL), in real-world Japan and the costs involved.
We conducted a questionnaire survey regarding treatment selections for newly diagnosed GBM and PCNSL treated between July 2021 and June 2022 among 47 institutions in the Japan Clinical Oncology Group-Brain Tumor Study Group. We calculated the total cost and cost per month of the initial therapy for newly diagnosed GBM or PCNSL.
The most used regimen (46.8%) for GBM in patients aged ≤74 years was 'Surgery + radiotherapy concomitant with temozolomide'. This regimen's total cost was 7.50 million JPY (Japanese yen). Adding carmustine wafer implantation (used in 15.0%), TTFields (used in 14.1%), and bevacizumab (BEV) (used in 14.5%) to the standard treatment of GBM increased the cost by 1.24 million JPY for initial treatment, and 1.44 and 0.22 million JPY per month, respectively. Regarding PCNSL, 'Surgery (biopsy) + rituximab, methotrexate, procarbazine, and vincristine (R-MPV) therapy' was the most used regimen (42.5%) for patients of all ages. This regimen incurred 1.07 million JPY per month. The three PCNSL regimens based on R-MPV therapy were in ultra-high-cost medical care (exceeding 1 million JPY per month).
Treatment of malignant brain tumors is generally expensive, and cost-ineffective treatments such as BEV are frequently used. We believe that the results of this study can be used to design future economic health studies examining the cost-effectiveness of malignant brain tumors.
本研究旨在调查在真实世界的日本，针对恶性脑肿瘤，特别是胶质母细胞瘤（GBM）和原发性中枢神经系统淋巴瘤（PCNSL），选择了哪些治疗方法，以及涉及的费用。
我们针对 2021 年 7 月至 2022 年 6 月期间，日本临床肿瘤学组-脑瘤研究组的 47 家机构新诊断的 GBM 和 PCNSL 患者的治疗选择进行了问卷调查。我们计算了新诊断的 GBM 或 PCNSL 初始治疗的总费用和每月费用。
≤74 岁患者中 GBM 最常用的治疗方案（46.8%）为“手术+放疗联合替莫唑胺”。该方案的总费用为 750 万日元。在 GBM 的标准治疗中添加卡莫司汀植入剂（15.0%）、TTFields（14.1%）和贝伐珠单抗（BEV）（14.5%），初始治疗费用增加 124 万日元，每月增加 144 万日元和 22 万日元。对于 PCNSL，所有年龄段患者最常用的治疗方案（42.5%）为“手术（活检）+利妥昔单抗、甲氨蝶呤、丙卡巴肼和长春新碱（R-MPV）治疗”。该方案每月费用为 107 万日元。三种基于 R-MPV 治疗的 PCNSL 方案均属于超高费用医疗（每月超过 100 万日元）。
恶性脑肿瘤的治疗通常费用较高，且经常使用贝伐珠单抗等无成本效益的治疗方法。我们认为，本研究的结果可用于设计未来关于恶性脑肿瘤成本效益的经济健康研究。
