title: Cost-effectiveness analysis of cisplatin-based chemoradiation to treat patients with unresectable, nonmetastatic head and neck cancer in Brazil.
abstract: BACKGROUND
  The purpose of this study was to analyze the cost-effectiveness of cisplatin-based chemoradiation compared to radiation therapy (RT) alone to treat patients with advanced head and neck cancer in Brazil.
  
  
  METHODS
  Data were collected retrospectively from the medical records of 33 patients treated with RT alone (strategy 1) and from 29 patients treated with cisplatin-based chemoradiation (strategy 2). The Brazilian National Health System (Sistema Único de Saúde [SUS]) reimbursement parameters perspective was considered, and the effectiveness was measured in years of disease-free life gained. One-way sensitivity analysis was performed to determine robustness of this study.
  
  
  RESULTS
  In strategy 1, there were 31% of the patients who lived without disease progression for more than 13 months after treatment, compared to 58% of patients in strategy 2. According to SUS parameters, the total cost per patient in strategy 1 was $1,167.00 U.S. dollars and in strategy 2, it was $2,058.00 U.S. dollars. Incremental cost-effectiveness ratio (ICER) was $3,303.00 U.S. dollars per life-year gained.
  
  
  CONCLUSIONS
  Cisplatin-based chemoradiation proved to be more cost-effective than RT alone.
authors.affiliation: Department of Radiology, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil. alexandra@diretoria.fm.usp.br
authors.forename: Alexandra
authors.initials: A
authors.lastname: Brentani
authors.forename: Gilberto
authors.initials: G
authors.lastname: de Castro
authors.forename: Miriam H
authors.initials: MH
authors.lastname: Federico
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001938:Brazil; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D059248:Chemoradiotherapy / Q000191:economics*; D002945:Cisplatin / Q000191:economics / Q000627:therapeutic use; D015331:Cohort Studies; D016001:Confidence Intervals; D017281:Cost of Illness; D003362:Cost-Benefit Analysis; D005260:Female; D006258:Head and Neck Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D018803:Models, Economic; D009361:Neoplasm Invasiveness / Q000473:pathology; D009367:Neoplasm Staging; D011379:Prognosis; D011878:Radiotherapy / Q000191:economics* / Q000379:methods; D012189:Retrospective Studies; D018570:Risk Assessment; D018709:Statistics, Nonparametric; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D002945:Cisplatin