Clinical and economic evaluation of modulated electrohyperthermia concurrent to dose-dense temozolomide 21/28 days regimen in the treatment of recurrent glioblastoma: a retrospective analysis of a two-centre German cohort trial with systematic comparison and effect-to-treatment analysis

BMJ Open
Sergey V Roussakow

Abstract

To assess the efficacy and cost-effectiveness of modulated electrohyperthermia (mEHT) concurrent to dose-dense temozolomide (ddTMZ) 21/28 days regimen versus ddTMZ 21/28 days alone in patients with recurrent glioblastoma (GBM). A cohort of 54 patients with recurrent GBM treated with ddTMZ+mEHT in 2000-2005 was systematically retrospectively compared with five pooled ddTMZ 21/28 days cohorts (114 patients) enrolled in 2008-2013. The ddTMZ+mEHT cohort had a not significantly improved mean survival time (mST) versus the comparator (p=0.531) after a significantly less mean number of cycles (1.56 vs 3.98, p<0.001). Effect-to-treatment analysis (ETA) suggests that mEHT significantly enhances the efficacy of the ddTMZ 21/28 days regimen (p=0.011), with significantly less toxicity (no grade III-IV toxicity vs 45%-92%, p<0.0001). An estimated maximal attainable median survival time is 10.10 months (9.10-11.10). Cost-effectiveness analysis suggests that, unlike ddTMZ 21/28 days alone, ddTMZ+mEHT is cost-effective versus the applicable cost-effectiveness thresholds €US$25 000-50 000/quality-adjusted life year (QALY). Budget impact analysis suggests a significant saving of €8 577 947/$11 201 761 with 29.1-38.5 QALY gained per 1000 patients...Continue Reading

Citations

Oct 6, 2018·The European Respiratory Journal·Neel R GandhiN Sarita Shah
Mar 24, 2020·The Cochrane Database of Systematic Reviews·Catherine HannaRobin Grant
Jul 17, 2020·International Journal of Hyperthermia : the Official Journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group·Georgios P SkandalakisConstantinos G Hadjipanayis
Oct 6, 2020·Frontiers in Oncology·Sun-Young LeeCarrie Anne Minnaar
Sep 3, 2020·International Journal of Molecular Sciences·Tibor KrenacsTamas Vancsik
Oct 16, 2020·Integrative Cancer Therapies·Giammaria FiorentiniStefano Guadagni
Dec 5, 2020·BioMed Research International·Huda F AlshaibiTaghreed Assiss
Dec 31, 2020·Cancers·Stefaan W Van GoolWilfried Stuecker

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