Cost Effectiveness of Modified Fractionation Radiotherapy versus Conventional Radiotherapy for Unresected Non–Small-Cell Lung Cancer Patients Bram L.T.

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Cost Effectiveness of Modified Fractionation Radiotherapy versus Conventional Radiotherapy for Unresected Non–Small-Cell Lung Cancer Patients Bram L.T. Ramaekers, MSc, Manuela A. Joore, PhD, Béranger Lueza, MSc, Julia Bonastre, PhD, Audrey Mauguen, MSc, Jean-Pierre Pignon, MD, PhD, Cecile Le Pechoux, MD, Dirk K.M. De Ruysscher, MD, PhD, Janneke P.C. Grutters, PhD Journal of Thoracic Oncology Volume 8, Issue 10, Pages 1295-1307 (October 2013) DOI: 10.1097/JTO.0b013e31829f6c55 Copyright © 2013 International Association for the Study of Lung Cancer Terms and Conditions

FIGURE 1 Diagrammatical representation of the Markov model structure. *The numbers (1 and 2) next to the arrows correspond to the Weibull models in Appendix 2 (Supplemental Digital Content 1, http://links.lww.com/JTO/A451). †Acute toxicity included grade 3 or higher pulmonary toxicity, esophageal toxicity, and hematological toxicity (see Appendix 3 [Supplemental Digital Content 1, http://links.lww.com/JTO/A451] for the corresponding logistic regression models). ‡Late toxicity included grade 3 or higher pulmonary toxicity and esophageal toxicity (Table 1). §Noncancer mortality was defined as deaths resulting from causes other than cancer and not occurring after disease progression. Journal of Thoracic Oncology 2013 8, 1295-1307DOI: (10.1097/JTO.0b013e31829f6c55) Copyright © 2013 International Association for the Study of Lung Cancer Terms and Conditions

FIGURE 2 Cost effectiveness acceptability curves. The vertical line represents the ceiling ratio that was adopted in our analyses (€80,000 per QALY gained). CRT, conventional fractionation radiotherapy; VART, very accelerated radiotherapy; MART, moderately accelerated radiotherapy; HRT, hyperfractionated radiotherapy. Journal of Thoracic Oncology 2013 8, 1295-1307DOI: (10.1097/JTO.0b013e31829f6c55) Copyright © 2013 International Association for the Study of Lung Cancer Terms and Conditions

FIGURE 3 Expected value of individualized care and expected value of perfect information. The vertical line represents the ceiling ratio that was adopted in our analyses (€80,000 per quality-adjusted life year gained). Journal of Thoracic Oncology 2013 8, 1295-1307DOI: (10.1097/JTO.0b013e31829f6c55) Copyright © 2013 International Association for the Study of Lung Cancer Terms and Conditions

10 trials (N = 2000) Journal of Thoracic Oncology 2013 8, 1295-1307DOI: (10.1097/JTO.0b013e31829f6c55) Copyright © 2013 International Association for the Study of Lung Cancer Terms and Conditions

HRTH versus CRT Journal of Thoracic Oncology 2013 8, 1295-1307DOI: (10.1097/JTO.0b013e31829f6c55) Copyright © 2013 International Association for the Study of Lung Cancer Terms and Conditions

HRTI versus CRT Journal of Thoracic Oncology 2013 8, 1295-1307DOI: (10.1097/JTO.0b013e31829f6c55) Copyright © 2013 International Association for the Study of Lung Cancer Terms and Conditions

VART versus CRT Journal of Thoracic Oncology 2013 8, 1295-1307DOI: (10.1097/JTO.0b013e31829f6c55) Copyright © 2013 International Association for the Study of Lung Cancer Terms and Conditions

MART Versus CRT Journal of Thoracic Oncology 2013 8, 1295-1307DOI: (10.1097/JTO.0b013e31829f6c55) Copyright © 2013 International Association for the Study of Lung Cancer Terms and Conditions

VART versus HRTI Journal of Thoracic Oncology 2013 8, 1295-1307DOI: (10.1097/JTO.0b013e31829f6c55) Copyright © 2013 International Association for the Study of Lung Cancer Terms and Conditions

MART versus VART Journal of Thoracic Oncology 2013 8, 1295-1307DOI: (10.1097/JTO.0b013e31829f6c55) Copyright © 2013 International Association for the Study of Lung Cancer Terms and Conditions