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Kim, Hayeon (2015) COST EFFECTIVENESS ANALYSES OF RADIATION THERAPY TREATMENTS. Doctoral Dissertation, University of Pittsburgh. (Unpublished)

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The impact of radiation therapy in cancer treatments has shown great improvement in clinical outcomes. Recent radiation therapy advances with innovative technologies have changed the standard of care in cancer treatments rapidly. Evolution in radiation therapy has demanded highly specialized trained resources and comes at substantial increase in cost. Even though evidence based treatments have demonstrated the important role of advanced radiation therapy technologies in various cancer treatments, the sustainability of quality healthcare in an increasingly resource constrained environment has been ongoing challenge. Therefore, economic evaluation for new treatment technologies has been requested to make the most effective use of resources.
In this dissertation, we evaluated cost effectiveness analysis (CEA) for various disease sites with innovative technologies. First, we conducted CEA of 3-dimensional (3D) image guided brachytherapy (IGBT) compared to conventional 2-dimensional (2D) high dose rate (HDR) brachytherapy for the treatment of locally advanced cervical cancer. We found that 3D IGBT is a cost effective strategy compared to 2D HDR brachytherapy with a willingness to pay (WTP) threshold of $50,000/quality adjusted life years (QALY) gained, strongly supporting the routine use of 3D image guided brachytherapy. Second, we performed a CEA of single fraction of stereotactic body radiation therapy (SBRT) compared with single fraction of external beam radiation therapy (EBRT) for palliation of vertebral bone metastases. We found that SBRT is not a cost effective treatment strategy compared to conventional EBRT with a WTP threshold of $100,000/QALY gained in patients with relatively short life expectancy. Finally, we performed a CEA of stereotactic body radiation therapy (SBRT) compared to radiofrequency ablation (RFA) for inoperable colorectal liver metastases. We found that SBRT is not cost effective compared to RFA with a WTP of $100,000/QALY gained unless large tumor size is treated.
In summary, given increasing attention placed on healthcare costs, a cost-effectiveness analysis can provide the appropriate platform to compare these treatment options. Therefore, the findings from the papers in this dissertation will identify the proper treatment choice to improve clinical outcomes at a reasonable cost, incorporating economic considerations into clinical decision making.


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Item Type: University of Pittsburgh ETD
Status: Unpublished
CreatorsEmailPitt UsernameORCID
Kim, Hayeonhak71@pitt.eduHAK710000-0002-1301-0190
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairHuq, M. Saifulhuqs@upmc.eduMSH34
Committee MemberBeriwal, Sushilberiwals@upmc.eduSUB45
Committee MemberRoberts, Mark Smroberts@pitt.eduMROBERTS
Committee MemberSmith, Kenneth
Committee MemberSwitzer, Galen Eswitzerge@upmc.eduGSWITZER
Date: 11 December 2015
Date Type: Publication
Defense Date: 14 October 2015
Approval Date: 11 December 2015
Submission Date: 10 December 2015
Access Restriction: No restriction; Release the ETD for access worldwide immediately.
Number of Pages: 82
Institution: University of Pittsburgh
Schools and Programs: School of Medicine > Clinical and Translational Science
Degree: PhD - Doctor of Philosophy
Thesis Type: Doctoral Dissertation
Refereed: Yes
Uncontrolled Keywords: Cost effectiveness, cancer, radiation therapy, brachytherapy, stereotactic body radiation therapy
Date Deposited: 11 Dec 2015 13:53
Last Modified: 19 Dec 2016 14:43


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