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@ARTICLE{Sprave:180676,
      author       = {T. Sprave$^*$ and V. Verma and A. Fabian$^*$ and A.
                      Rühle$^*$ and D. Baltas$^*$ and A.-L. Grosu$^*$ and N.
                      Nicolay$^*$},
      title        = {{C}ost effectiveness and health-related quality of life of
                      chemoradiotherapy versus radiation therapy alone in elderly
                      head and neck cancer patients.},
      journal      = {Strahlentherapie und Onkologie},
      volume       = {198},
      number       = {11},
      issn         = {0179-7158},
      address      = {Heidelberg},
      publisher    = {Springer Medizin},
      reportid     = {DKFZ-2022-01476},
      pages        = {1008-1015},
      year         = {2022},
      note         = {2022 Nov;198(11):1008-1015 / #LA:E055#},
      abstract     = {Radiotherapy (RT) constitutes a mainstay in the treatment
                      of elderly patients with head and neck cancer (HNC), but use
                      of simultaneous chemoradiotherapy (CRT) remains
                      controversial. We have conducted a prospective analysis
                      based on real-world patient data to examine the
                      health-related quality of life (HRQoL) and cost
                      effectiveness (CE) of CRT vs. RT in elderly HNC
                      patients.Eligible participants ≥ 65 years treated in a
                      large tertiary cancer center between July 2019 and February
                      2020 who completed the validated EQ-5D-5L questionnaire
                      (health state index [HI] and visual analog scale [VAS])
                      before and after RT were included. CE referred to direct
                      medical costs, including diagnosis-related group (DRG)-based
                      billings for inpatients and uniform assessment standard
                      (EBM)-based costs for outpatients. The primary endpoint was
                      cost (euros [€]) per quality-adjusted life year (QALY).
                      The incremental cost-effectiveness ratios (ICERs) were
                      calculated. Costs and QALYs were not discounted for short
                      overall survival (OS).Baseline HRQoL was 0.878 (±0.11) in
                      the CRT group and 0.857 (±0.17) in the RT group. Upon
                      completion of therapy, HRQoL amounted to 0.849 (±0.14) in
                      the CRT and 0.850 (±0.13) in the RT group. The mean
                      treatment-related cost in the CRT cohort was €22,180.17
                      (±8325.26) vs. €18,027.87 (±26,022.48) in the RT group.
                      The corresponding QALYs amounted to 2.62 in the CRT and 1.91
                      in the RT groups. The ICER was €5848.31.This is the first
                      analysis from the German health care system demonstrating
                      that the addition of chemotherapy to RT for selected elderly
                      HNC patients is cost effective and not associated with a
                      significant HRQoL decline.},
      keywords     = {Chemoradiation (Other) / EQ‑5D (Other) / Geriatric
                      patients (Other) / Head and neck squamous cell carcinoma
                      (Other) / Quality-adjusted life year (Other)},
      cin          = {FR01 / E055},
      ddc          = {610},
      cid          = {I:(DE-He78)FR01-20160331 / I:(DE-He78)E055-20160331},
      pnm          = {315 - Bildgebung und Radioonkologie (POF4-315)},
      pid          = {G:(DE-HGF)POF4-315},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:35833963},
      doi          = {10.1007/s00066-022-01975-6},
      url          = {https://inrepo02.dkfz.de/record/180676},
}