Surgical Treatment Of Nasopharyngeal Carcinoma
Cost-effectiveness of endoscopic nasopharyngectomy in locally recurrent rT1-rT3 nasopharyngeal carcinoma: a study based on Markov model
Chen Mengyu, Wen Weiping, Li Jian, Liu Youping, Chen Mingyuan, Tang Jun, Wen Yihui
Published 2022-11-07
Cite as Chin J Otorhinolaryngol Head Neck Surg, 2022, 57(11): 1304-1310. DOI: 10.3760/cma.j.cn115330-20211231-00838
Abstract
ObjectiveTo perform a cost-effectiveness analysis of endoscopic surgery versus intensity-modulated radiotherapy in the treatment of locally recurrent nasopharyngeal carcinoma (rNPC) from a health-economic perspective.
MethodsFrom September 30, 2011 to January 16, 2017, a total of 200 patients were enrolled in the First Affiliated Hospital of Sun Yat-sen University, the First People′s Hospital of Foshan, and Sun Yat-sen University Cancer Center. These patients were diagnosed as locally rT1-rT3 stage rNPC and were randomly assigned 1︰1 to the endoscopic surgery group (ENPG) and the intensity-modulated radiotherapy group (IMRT). There were 69 males and 31 females in ENPG, aging from 38 to 55 years. There were 72 males and 28 females in IMRT aging from 41 to 54 years. A retrospective cost-effectiveness analysis of the cohort was conducted using a Markov model. For each modality, data on survival and quality-adjusted life year (QALY) were sourced from relevant articles, and cost prices were included regarding treatment. Weibull distribution was used to estimate time-dependent transition probability. Beta-regression was used to convert the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) to utility.
ResultsThe total cost of ENPG was 29 611.88 yuan, and the total cost of IMRT was 110 082.51 yuan. The incremental cost-effectiveness ratio (ICER) of ENPG versus radiotherapy for locally rNPC was -85 555.88 yuan/QALY, which was less than 3 times of Chinese gross domestic product (GDP) per capita. Sensitivity analysis showed that the cost of IMRT had the greatest impact on ICER. ICER was stable within 10% fluctuation of all the parameters.
ConclusionIt is economical cost-effective to treat locally rNPC with ENGP versus IMRT.
Key words:
Endoscopic surgery; Recurrent nasopharyngeal carcinoma; Health economics; Markov model; Cost-effectiveness analysis
Contributor Information
Chen Mengyu
Department of Otorhinolaryngology, Otorhinolaryngology Institute, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China
Wen Weiping
Department of Otorhinolaryngology, Otorhinolaryngology Institute, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China
Li Jian
Department of Otorhinolaryngology, Otorhinolaryngology Institute, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China
Liu Youping
Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, Guangzhou 510060, China
Chen Mingyuan
Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, Guangzhou 510060, China
Tang Jun
Department of Otorhinolaryngology, the First People′s Hospital of Foshan, Foshan 528000, China
Wen Yihui
Department of Otorhinolaryngology, Otorhinolaryngology Institute, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China
