Efficacy and cost of high-frequency IGRT in elderly stage III non-small-cell lung cancer patients

Samuel P Heilbroner, Eric P Xanthopoulos, Donna Buono, Daniel Carrier, Ben Y Durkee, Michael Corradetti, Tony J C Wang, Alfred I Neugut, Dawn L Hershman and Simon K Cheng

PLOS ONE, 2021, vol. 16, issue 5, 1-14

Abstract: Background: High-frequency image-guided radiotherapy (hfIGRT) is ubiquitous but its benefits are unproven. We examined the cost effectiveness of hfIGRT in stage III non-small-cell lung cancer (NSCLC). Methods: We selected stage III NSCLC patients ≥66 years old who received definitive radiation therapy from the Surveillance, Epidemiology, and End-Results-Medicare database. Patients were stratified by use of hfIGRT using Medicare claims. Predictors for hfIGRT were calculated using a logistic model. The impact of hfIGRT on lung toxicity free survival (LTFS), esophageal toxicity free survival (ETFS), cancer-specific survival (CSS), overall survival (OS), and cost of treatment was calculated using Cox regressions, propensity score matching, and bootstrap methods. Results: Of the 4,430 patients in our cohort, 963 (22%) received hfIGRT and 3,468 (78%) did not. By 2011, 49% of patients were receiving hfIGRT. Predictors of hfIGRT use included treatment with intensity-modulated radiotherapy (IMRT) (OR = 7.5, p

Date: 2021
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Persistent link: https://EconPapers.repec.org/RePEc:plo:pone00:0252053

DOI: 10.1371/journal.pone.0252053

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