Economic implications of hepatic arterial infusion chemotherapy in treatment of nonresectable colorectal liver metastases.
Approximately 20% of patients with colorectal cancer die of metastases confined to the liver.
A meta-analysis recently performed by our group confirmed that in these patients hepatic arterial infusion of 5-fluoro-2'-deoxyuridine, compared with intravenous chemotherapy with fluoropyrimidines or supportive care (including symp-tom palliation when necessary), improved tumor response.
Because of the high cost of hepatic arterial infusion, we undertook a cost-effectiveness analysis that related the cost of such therapy to its medical efficacy.
The patient population was drawn from the seven randomized clinical trials included in the meta-analysis and included in-dividual data on 654 patients.
Of these seven trials, five compared hepatic arterial infusion and intravenous chemotherapy and two compared hepatic arterial infusion and a control group in which some patients could be left untreated.
Patients assigned to receive hepatic arterial infusion made up the hepatic arterial infusion group ; the other patients constituted the control group.
The measures of efficacy were survival and tumor response.
Health-care costs (in 1995 U.S. dollars) were computed over the duration of patient follow-up and were derived from actual costs in two centers, one at Henri Mondor Hospital (Paris, France) and the other at Stanford University Medical Center (Palo Alto, CA). (...)
Mots-clés Pascal : Tumeur maligne, Côlon, Rectum, Foie, Métastase, Chimiothérapie, Anticancéreux, Voie intraartérielle, Artère hépatique, Analyse coût efficacité, Economie santé, Etats Unis, Amérique du Nord, Amérique, France, Europe, Homme, Inopérable, Appareil digestif pathologie, Intestin pathologie, Côlon pathologie, Rectum pathologie, Foie pathologie
Mots-clés Pascal anglais : Malignant tumor, Colon, Rectum, Liver, Metastasis, Chemotherapy, Antineoplastic agent, Intraarterial administration, Hepatic artery, Cost efficiency analysis, Health economy, United States, North America, America, France, Europe, Human, Unresectable, Digestive diseases, Intestinal disease, Colonic disease, Rectal disease, Hepatic disease
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 97-0512599
Code Inist : 002B02R02. Création : 13/02/1998.