Economical Evaluation of Cancer Types Using Intensity-Modulated Radiation Therapy Compared to 3D Conformal  Radiation Therapy: A Systematic Review

Vahid  Alipour; Aziz  Rezapour; Amin  Adel; Arefeh  Pourtaleb; Mitra  Bazrafshan; Mozhgan Sadat Ghaem  Mohammadi; Reza Jahangiri

doi:10.18502/ijph.v52i7.13237

Vahid Alipour Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
Aziz Rezapour Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
Amin Adel School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
Arefeh Pourtaleb School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
Mitra Bazrafshan School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
Mozhgan Sadat Ghaem Mohammadi School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
Reza Jahangiri School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran

DOI: https://doi.org/10.18502/ijph.v52i7.13237

Keywords: Cancer; Radiation therapy; Radiotherapy; Economic evaluation

Abstract

Background: Cancer is the second most common cause of death worldwide. Economic evaluation of cancer treatment to reduce costs can save the health care system millions of dollars while optimizing care. Therefore, this systematic review aimed to study the economic evaluation of cancer treatment using intermediate intensity radiation therapy (IMRT) compared to conventional 3D conformal radiation therapy (3D-CRT).

Methods: Literatures from PubMed, Embase, Cochran Library, Google scholar, Scopus and Iranian databases were retrieved since Jan 2000 to Apr 2020 for eligible English studies. The quality of the studies was evaluated using Cheers' checklist and then the textual data were analyzed manually by content analysis method.

Results: Overall, 1790 articles were retrieved, of which 12 studies were reviewed. The article quality score ranged from 14.5 to 23 out of a maximum of 24 points. Eleven studies referred to cost-effectiveness analysis and one study referred to cost-utility analysis. Studies have been conducted in the United States, Canada, Australia, Brazil, the Netherlands, the United Kingdom, and Hungary. IMRT appears to be a cost-effective treatment strategy for rectal cancer, soft tissue sarcoma, and localized carcinoma of the pharynx, and for prostate cancer in terms of prolonging survival, but it is a cost-effective treatment strategy for head cancer. In addition, the neck was not in India's cancer control program.

Conclusion: The results can help to decide whether to use radiation therapy and radiotherapy in the standard treatment path. Furthermore, they underline that IMRT treatment technique was cost effective for a long-time care service.