Abstract：
OBJECTIVE: Prostate cancer is a common form of cancer among men worldwide. The objective of this study was to conduct a systematic review of the economic evaluations of prostate cancer treatment strategies.
METHODS: This systematic review was conducted using multiple electronic databases up to May 2021. English-language economic evaluation studies that compared intensity-modulated radiation therapy (IMRT), 3-dimensional conformal radiation therapy (3DCRT), and radical prostatectomy (RP) were included. The studies were evaluated using the Consolidated Health Economic Evaluation Reporting Standards checklist. The search yielded 1151 potentially relevant publications, which were screened based on the title and abstract. After the removal of duplicates, 55 studies remained, and 9 studies were screened in full text. Finally, textual data were analyzed manually using by-content analysis method.
RESULTS: All studies were cost-effective and evaluated quality-adjusted life year as the efficacy indicator. The studies were conducted from either payers\' or health systems\' perspectives, and the time horizon varied from 5 to 20 years. We included only full economic evaluation studies. The use of IMRT in comparison with 3DCRT was evaluated in 6 studies, based on which IMRT increased health and reduced side effects of treatment. According to incremental cost-effectiveness ratio (ICER) results, IMRT was more cost-effective than 3DCRT. Three studies evaluated the use of RP in comparison with radiotherapy. Based on these studies, radiotherapy was more effective than RP.
CONCLUSIONS: IMRT was found to be more cost-effective than 3DCRT in all 6 studies compared with the threshold. Radiotherapy was found to be more effective than RP. However, long-term clinical trial studies are needed to confirm these findings and to provide more definitive conclusions.
METHODS: This systematic review was conducted using multiple electronic databases up to May 2021. English-language economic evaluation studies that compared intensity-modulated radiation therapy (IMRT), 3-dimensional conformal radiation therapy (3DCRT), and radical prostatectomy (RP) were included. The studies were evaluated using the Consolidated Health Economic Evaluation Reporting Standards checklist. The search yielded 1151 potentially relevant publications, which were screened based on the title and abstract. After the removal of duplicates, 55 studies remained, and 9 studies were screened in full text. Finally, textual data were analyzed manually using by-content analysis method.
RESULTS: All studies were cost-effective and evaluated quality-adjusted life year as the efficacy indicator. The studies were conducted from either payers\' or health systems\' perspectives, and the time horizon varied from 5 to 20 years. We included only full economic evaluation studies. The use of IMRT in comparison with 3DCRT was evaluated in 6 studies, based on which IMRT increased health and reduced side effects of treatment. According to incremental cost-effectiveness ratio (ICER) results, IMRT was more cost-effective than 3DCRT. Three studies evaluated the use of RP in comparison with radiotherapy. Based on these studies, radiotherapy was more effective than RP.
CONCLUSIONS: IMRT was found to be more cost-effective than 3DCRT in all 6 studies compared with the threshold. Radiotherapy was found to be more effective than RP. However, long-term clinical trial studies are needed to confirm these findings and to provide more definitive conclusions.
摘要：
目的：前列腺癌是全球男性常见的癌症。这项研究的目的是对前列腺癌治疗策略的经济学评估进行系统评价。
方法：这项系统评价是使用多个电子数据库进行的，截至2021年5月。比较调强放射治疗（IMRT）的英语经济评估研究，三维适形放射治疗（3DCRT），和根治性前列腺切除术（RP）。使用综合卫生经济评估报告标准清单对研究进行评估。搜索产生了1151种潜在相关出版物，根据标题和摘要进行筛选。删除副本后，还有55项研究，全文筛选了9项研究。最后,文本数据采用按内容分析方法手动分析。
结果：所有研究均具有成本效益，并评估了质量调整生命年作为疗效指标。这些研究是从付款人或卫生系统的角度进行的，时间范围从5年到20年不等。我们只包括全面的经济评估研究。在6项研究中评估了IMRT与3DCRT的使用情况，在此基础上，IMRT增加了健康，减少了治疗的副作用。根据增量成本效益比(ICER)结果，IMRT比3DCRT更具成本效益。三项研究评估了RP与放疗的比较。基于这些研究,放疗比RP更有效。
结论：在所有6项研究中，与阈值相比，IMRT比3DCRT更具成本效益。发现放射疗法比RP更有效。然而,需要长期临床试验研究来证实这些发现,并提供更明确的结论.
方法：这项系统评价是使用多个电子数据库进行的，截至2021年5月。比较调强放射治疗（IMRT）的英语经济评估研究，三维适形放射治疗（3DCRT），和根治性前列腺切除术（RP）。使用综合卫生经济评估报告标准清单对研究进行评估。搜索产生了1151种潜在相关出版物，根据标题和摘要进行筛选。删除副本后，还有55项研究，全文筛选了9项研究。最后,文本数据采用按内容分析方法手动分析。
结果：所有研究均具有成本效益，并评估了质量调整生命年作为疗效指标。这些研究是从付款人或卫生系统的角度进行的，时间范围从5年到20年不等。我们只包括全面的经济评估研究。在6项研究中评估了IMRT与3DCRT的使用情况，在此基础上，IMRT增加了健康，减少了治疗的副作用。根据增量成本效益比(ICER)结果，IMRT比3DCRT更具成本效益。三项研究评估了RP与放疗的比较。基于这些研究,放疗比RP更有效。
结论：在所有6项研究中，与阈值相比，IMRT比3DCRT更具成本效益。发现放射疗法比RP更有效。然而,需要长期临床试验研究来证实这些发现,并提供更明确的结论.
