Back to Search
Start Over
Treatment burden and cost-effectiveness analysis of the neoadjuvant CROSS regimen in esophageal squamous cell carcinoma: a multicenter retrospective study.
- Source :
-
Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus [Dis Esophagus] 2023 Oct 27; Vol. 36 (11). - Publication Year :
- 2023
-
Abstract
- High-quality evidence indicated that both neoadjuvant carboplatin/paclitaxel (CROSS) and cisplatin/5-fluorouracil (PF) regimens in combination with radiotherapy improve survival outcomes compared to surgery alone in patients with esophageal cancer. It is not yet known whether they may differ in terms of treatment burden and healthcare costs. A total of 232 Taiwanese patients with esophageal squamous cell carcinoma who had undergone neoadjuvant chemoradiotherapy (nCRT) with either the CROSS (n = 153) or the PF (n = 79) regimens were included. Hospital encounters and adverse events were assessed for determining treatment burden. Cost-effectiveness analysis was undertaken using the total costs incurred over 3 years in relation to overall survival (OS) and progression-free survival (PFS). Compared with PF, the CROSS regimen was associated with a lower treatment burden: shorter inpatient days on average (4.65 ± 10.05 vs. 15.14 ± 17.63 days; P < 0.001) and fewer admission requirements (70% of the patients were never admitted vs. 20% in the PF group; P < 0.001). Patients in the CROSS group experienced significantly less nausea, vomiting, and diarrhea. While the benefits observed in the CROSS group were associated with additional nCRT-related expenditures (1388 United States dollars [USD] of added cost per patient), this regimen remained cost-effective. At a willingness-to-pay threshold of 50,000 USD per life-year, the probability of the CROSS regimen to be more cost-effective than PF was 94.1% for PFS but decreased to 68.9% for OS. The use of the CROSS regimen for nCRT in patients with ESCC was associated with a lower treatment burden and was more cost-effective than PF.<br /> (© The Author(s) 2023. Published by Oxford University Press on behalf of International Society for Diseases of the Esophagus. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
- Subjects :
- Humans
Neoadjuvant Therapy
Cost-Effectiveness Analysis
Retrospective Studies
Fluorouracil
Cisplatin
Paclitaxel
Chemoradiotherapy
Antineoplastic Combined Chemotherapy Protocols therapeutic use
Esophageal Squamous Cell Carcinoma therapy
Esophageal Neoplasms drug therapy
Esophageal Neoplasms pathology
Subjects
Details
- Language :
- English
- ISSN :
- 1442-2050
- Volume :
- 36
- Issue :
- 11
- Database :
- MEDLINE
- Journal :
- Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus
- Publication Type :
- Academic Journal
- Accession number :
- 37236810
- Full Text :
- https://doi.org/10.1093/dote/doad031