On the cost-effectiveness of Carbon ion radiation therapy for skull base chordoma.
OBJECTIVE
The cost-effectiveness of Carbon ion radiotherapy (RT) for patients with skull base chordoma is analyzed.


METHODS
Primary treatment costs and costs for recurrent tumors are estimated. The costs for treatment of recurrent tumors were estimated using a sample of 10 patients presenting with recurrent chordoma at the base of skull at DKFZ. Using various scenarios for the local control rate and reimbursements of Carbon ion therapy the cost-effectiveness of ion therapy for these tumors is analyzed.


RESULTS
If local control rate for skull base chordoma achieved with carbon ion therapy exceeds 70.3%, the overall treatment costs for carbon RT are lower than for conventional RTI. The cost-effectiveness ratio for carbon RT is 2539 Euro per 1% increase in survival, or 7692 Euro per additional life year.


CONCLUSIONS
Current results support the thesis that Carbon ion RT, although more expensive, is at least as cost-effective as advanced photon therapies for these patients. Ion RT, however, offers substantial benefits for the patients such as improved control rates and less severe side effects.
Jäkel
Oliver
O
Department of Medical Physics in Radiation Oncology, Heidelberg, Germany. o.jaekel@dkfz.de
Land
Beate
B
Combs
Stephanie Elisabeth
SE
Schulz-Ertner
Daniela
D
Debus
Jürgen
J
D002250:Carbon Radioisotopes / Q000627:therapeutic use*; D002817:Chordoma / Q000532:radiotherapy*; D003362:Cost-Benefit Analysis; D004307:Dose-Response Relationship, Radiation; D063193:Heavy Ion Radiotherapy; D006801:Humans; D009364:Neoplasm Recurrence, Local; D018365:Neoplasm, Residual; D011879:Radiotherapy Dosage; D011882:Radiotherapy, High-Energy / Q000191:economics* / Q000379:methods*; D019292:Skull Base Neoplasms / Q000532:radiotherapy*
D002250:Carbon Radioisotopes