这篇综述系统地总结了磁共振图像引导RT(MRIgRT)的经济影响的证据。
我们系统地搜索了INAHTA,MEDLINE,和Scopus直到2022年3月检索健康经济研究。提取了研究类型的相关数据,模型输入,建模方法和经济结果。
纳入了5项研究。两项研究进行了全面的经济评估,以比较MRIgRT与其他形式的图像引导放射治疗的成本效益。一项研究进行了成本最小化分析,两项研究进行了基于活动的成本核算,所有比较MRIgRT与X线计算机断层扫描图像引导放射治疗(CTigRT)。前列腺癌是四项研究的目标条件,肝细胞癌是其中一项。考虑到具有全面经济评估的研究,发现MR引导的立体定向身体放射治疗相对于CTigRT或常规或中度低分割RT具有成本效益,即使毒性降低很低。相反,在没有MR指导的情况下,要与极低分割的RT竞争,需要更大的毒性降低.
这篇综述强调了MRIgRT的巨大潜力,但也需要进一步的证据,尤其是晚期毒性,其减少预计将是这项技术的真正附加值。
This
review systematically summarizes the evidence on the economic impact of magnetic resonance image-guided RT (MRIgRT).
We systematically searched INAHTA, MEDLINE, and Scopus up to March 2022 to retrieve health economic studies. Relevant data were extracted on study type, model inputs, modeling methods and economic results.
Five studies were included. Two studies performed a full economic assessment to compare the cost-effectiveness of MRIgRT with other forms of image-guided radiation therapy. One study performed a cost minimization analysis and two studies performed an activity-based costing, all comparing MRIgRT with X-ray computed tomography image-guided radiation therapy (CTIgRT). Prostate cancer was the target condition in four studies and hepatocellular carcinoma in one. Considering the studies with a full economic assessment, MR-guided stereotactic body radiation therapy was found to be cost effective with respect to CTIgRT or conventional or moderate hypofractionated RT, even with a low reduction in toxicity. Conversely, a greater reduction in toxicity is required to compete with extreme hypofractionated RT without MR guidance.
This
review highlights the great potential of MRIgRT but also the need for further evidence, especially for late toxicity, whose reduction is expected to be the real added value of this technology.