Effectiveness and cost-effectiveness analysis of nimotuzumab for the radiotherapy of locoregionally advanced nasopharyng
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RESEARCH
Effectiveness and cost‑effectiveness analysis of nimotuzumab for the radiotherapy of locoregionally advanced nasopharyngeal carcinoma Zhaodong Fei1†, Ting Xu2†, Mengying Li2, Taojun Chen1, Li Li1, Xiufang Qiu2 and Chuanben Chen1,3*
Abstract Background: This study aimed to assess the effectiveness and cost-effectiveness of nimotuzumab in patients with locoregionally advanced nasopharyngeal carcinoma (LA-NPC). Methods: LA-NPC patients treated between October 2013 and December 2016 were retrospectively reviewed. A well-balanced cohort of patients who received nimotuzumab in addition to standard treatment (n = 50) and patients who did not receive nimotuzumab (n = 100) was selected using propensity score-matching method (1:2 ratio) for the cost-effectiveness analysis. Results: Compared with concurrent chemoradiotherapy (CCRT) alone, addition of nimotuzumab to CCRT significantly improved the 3-year overall survival (OS) (98.00% vs. 91.00%, P = 0.032). On multivariate analysis, nimotuzumab (hazard ratio = 0.124, 95% confidence interval: 0.017–0.902, P = 0.039) showed prognostic significance for OS. No serious treatment-related adverse events were observed in the nimotuzumab group (P > 0.05). Cost-effectiveness analysis revealed that addition of nimotuzumab increased the average treatment costs by $14,364.63. The additional cost for every one percent increase in OS rate was $ 2,052.09. Conclusion: Addition of nimotuzumab to CCRT for LA-NPC confers significant survival benefits; however, it is not cost-effective. Keyword: Nasopharyngeal carcinoma, Nimotuzumab, Cost-effectiveness analysis, Intensity-modulated radiotherapy, Concurrent chemoradiotherapy Introduction Nasopharyngeal carcinoma (NPC) is a highly aggressive malignant tumor derived from nasopharyngeal epithelial cells. The disease is endemic in South China, Southeastern Asia, Middle East and North Africa [1, 2].
*Correspondence: [email protected] † Zhaodong Fei and Ting Xu contributed equally to this work. 3 Department of Radiation Oncology, Fujian Medical University Cancer Hospital and Fujian Cancer Hospital, Fuma Road, Fuzhou 350014, Fujian, People’s Republic of China Full list of author information is available at the end of the article
For anatomic constrain, up to 70% of newly diagnosed patients with nasopharyngeal cancer have locoregionally advanced disease [3] with an unfavorable prognosis. Platinum-based concurrent chemoradiotherapy (CCRT) with or without induction chemotherapy (IC) is the standard treatment for patients with locoregionally advanced nasopharyngeal carcinoma (LA-NPC) [4]. Application of intensity-modulated radiotherapy (IMRT) has helped improved locoregional control and survival [5, 6]. However, approximately 20% of patients with locoregionally advanced disease tend to develop recurrent disease and/ or metastasis [7]. Therefore, optimizing the systemic
© The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, di
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