质子疗法的成本效益与乳腺癌中的光子疗法相比
Sara-Lise Busschaert1,2, Eva Kimpe1, Thierry Gevaert2
1Research Centre on Digital Medicine, Department of Public Health, Vrije Universiteit Brussel, Brussels, Belgium.
JAMA network open
|January 22, 2026
概括
在比利时,用于乳腺癌的质子疗法通常不具有成本效益. 它可能为一小部分高风险患者提供好处,特别是当使用深呼吸呼吸 (DIBH) 时.
科学领域:
- 在瘤学瘤学.
- 辐射疗法 辐射疗法
- 卫生经济学 卫生经济学
背景情况:
- 与光子疗法相比,质子疗法可以减少对有风险的器官的辐射暴露.
- 质子疗法与光子疗法的临床益处和成本效益,特别是深呼吸呼吸 (DIBH),对于乳腺癌患者来说仍然不确定.
研究的目的:
- 评估质子疗法与光子辐射疗法 (包括DIBH和自由呼吸) 的成本效益,用于比利时的乳腺癌患者.
主要方法:
- 从比利时医疗保健支付人的角度进行了状态过渡微模拟成本效益分析.
- 该模型结合了患者特定的并发症概率和国家乳腺癌数据.
- 模拟了100万名患有乳腺癌的比利时女性队列,按风险因素分层.
主要成果:
- 根据基本情况假设,在大多数场景中,质子疗法没有成本效益.
- 在接受左侧照射与区域节点照射的高心血管风险患者中,发现了最大的潜在益处,ICER为292,438欧元/QALY,相对于无光子呼吸.
- 即使在乐观的成本情景下,质子疗法在任何子组中与光子DIBH相比也没有成本效益.
结论:
- 在目前的成本条件下,对大多数比利时乳腺癌患者来说,质子疗法不太可能具有成本效益.
- 一小部分高风险患者可能会受益,特别是当DIBH可用时.
- 随着质子疗法成本的演变,需要进一步进行经济评估.
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