Best Rx Most Cost-Effective: RTOG

PHILADELPHIA—In RTOG 9111, a randomized phase III trial in locally advanced laryngeal cancer, there was no difference in overall survival between the three arms, but disease-free survival, locoregional control, and preservation of the larynx were better in patients receiving induction chemotherapy plus radiation or concurrent chemoradiation, compared with radiation therapy alone.

In a subsequent economic analysis, based on 66 Medicare patients, "these better outcomes translated into significant savings of dollars spent on treating patients for complications and recurrences seen with the less effective therapy of radiation alone," Andre Konski, MD, MBA, of Fox Chase Cancer Center, said at the American Society for Therapeutic Radiology and Oncology 48th Annual Meeting (abstract 115). The expected mean 47-month cost of radiation alone was $57,357. Concurrent chemoradiation cost $57,870. Induction chemotherapy plus radiation was the most cost-effective. "At a 47-month cost of $49,018, this treatment saved $7,031 per disease-free life-year and $9,336 per life-year of overall survival, compared with radiation alone," Dr. Konski said.