Radiology and Oncology

Background & Aim: Incidence of head and neck cancer accounts for 3700 new cases every year with a range of 4-14% of all cancer cases seen in Egypt. The objective of this research is to determine how to use Cetuximab for enhancing patient outcome including (quality of life– economic value–clinical effectiveness) and better resources utilization as line of treatment for head and neck cancer.

 

Method: Cost utility study was conducted using Markov chain model with three health states. Quality of life data were incorporated. Cetuximab plus radiotherapy was compared to radio therapy alone for patients with LA-SCCHN. Only study patients with Karnofsky Performance Status (90–100) were included in the model for costs and outcomes. Cost utility analyses were conducted. Results presented in term of (Quality-Adjusted Life Years) QALYs. Robustness of our findings was checked by one-dimensional sensitivity analyses were employed. Time horizon was determined to be 10 years.

 

Results: After ten years, total QALYs for Cetuximab plus radiotherapy group was estimated to be 3.99 QALYs compared with 2.95 QALYs for radiotherapy alone, a difference of 1.04 QALYs. This yields of increased QALY gained for (Cetuximab plus radiotherapy) comparing with radiotherapy alone. Incremental Cost-Effectiveness Ratio (ICER) is still below the local accepted threshold of paying.

 

Conclusion: The addition of Cetuximab to radiotherapy for patients of LA-SCCHN with Karnofsky performance status (90–100) will enhance patient outcome (quality of life– economic value–clinical effectiveness). Through increasing number of QALY gained and better resource utilization through Incremental Cost-Effectiveness Ratio (ICER) is still below the local accepted threshold of paying which lead to efficient management for health care resources.