King's College London

Research portal

Cost-effectiveness analysis of stereotactic body radiation therapy compared with surgery and radiofrequency ablation in two patient cohorts: metastatic liver cancer and hepatocellular carcinoma

Research output: Contribution to journalArticlepeer-review

Huajie Jin, Anastasia Chalkidou, Maria Hawkins, Jennifer Summers, Saskia Eddy, Janet Peacock, Bola Coker, James Good, Mark Pennington, SABR data working group

Original languageEnglish
JournalClinical Oncology
Accepted/In press29 Aug 2020
Published17 Sep 2020

Documents

  • Manuscript - Accepted version

    Manuscript_Accepted_version.docx, 83.4 KB, application/vnd.openxmlformats-officedocument.wordprocessingml.document

    Uploaded date:01 Sep 2020

    Version:Accepted author manuscript

King's Authors

Abstract

Purpose: To compare the cost-effectiveness of stereotactic body radiation therapy (SABR) with radiofrequency ablation (RFA) and surgery in adult patients with metastatic liver cancer and hepatocellular carcinoma (HCC).
Materials and methods: Two patient cohorts were assessed: liver oligometastases and HCC. For each patient cohort, a decision analytic model was constructed to assess the cost-effectiveness of interventions over a 5-year horizon. A Markov process was embedded in the decision model to simulate the possible prognosis of cancer. Data on transition probabilities, survival, side-effects, quality of life, and costs were obtained from published sources and the Commissioning through Evaluation (CtE) scheme. The primary outcome was the incremental cost-effectiveness ratio (ICER) with respect to quality adjusted life-years. The robustness of the results was examined in sensitivity analysis. Analyses were conducted from an NHS and Personal Social Services perspective.
Results: In the base case analysis, which assumes that all three interventions are associated with the same cancer progression rates and mortality rates, SABR is the most cost-effective intervention for both patient cohorts. This conclusion is sensitive to the cancer progression rate, mortality rate and cost of interventions. Assuming a willingness-to-pay threshold of £20,000 per QALY, the probability that SABR is cost-effective is 57% and 50% in liver oligometastases and HCC, respectively.
Conclusions: Our results indicate a potential for SABR to be cost-effective for patients with liver oligometastases and HCC. This finding supports further investigation in clinical trials directly comparing SABR with surgery and RFA.

Download statistics

No data available

View graph of relations

© 2020 King's College London | Strand | London WC2R 2LS | England | United Kingdom | Tel +44 (0)20 7836 5454