Cost-effectiveness of low-level laser therapy (LLLT) in head and neck cancer patients receiving concurrent chemoradiation.

Abstract

BACKGROUND:

Oral mucositis is a major event increasing treatment costs of head and neck squamous cell carcinoma (HNSCC) patients treated with chemoradiation (CRT). This study was designed to estimate the cost-effectiveness of low-level laser therapy (LLLT) to prevent oral mucositis in HNSCC patients receiving CRT.

METHODS:

From June 2007 to December 2010, 94 patients with HNSCC of nasopharynx, oropharynx, and hypopharynx entered a prospective, randomized, double blind, placebo-controlled, phase III trial. CRT consisted of conventional radiotherapy (RT: 70.2 Gy, 1.8 Gy/d, 5 times/wk)+concurrent cisplatin (100mg/m2) every 3 weeks. An InGaAlP (660 nm-100 mW-4J/cm2) laser diode was used for LLLT.

RESULTS:

From the perspective of Brazil's public health care system (SUS), total costs were higher in Placebo Group (PG) than Laser Group (LG) for opioid use (LG=US$ 9.08, PG=US$ 44.28), gastrostomy feeding (LG=US$ 50.50, PG=US$ 129.86), and hospitalization (PG=US$ 77.03). In LG, the cost was higher for laser therapy only (US$ 1880.57). The total incremental cost associated with the use of LLLT was US$ 1689.00 per patient. The incremental cost-effectiveness ratio (ICER) was US$ 4961.37 per grade 3-4 OM case prevented compared to no treatment.

CONCLUSIONS:

Our results indicate that morbidity was lower in the Laser Group and that LLLT was more cost-effective than placebo up to a threshold of at least US$ 5000 per mucositis case prevented.

CLINICAL TRIAL INFORMATION:

NCT01439724.

• Authors: Héliton S Antunes, Luciene Fontes Schluckebier, Daniel Herchenhorn, Isabele A Small, Carlos M M Araújo, Celia Maria Pais Viégas, Mariana P Rampini, Elza M S Ferreira, Fernando L Dias, Vanessa Teich, Nelson Teich, Carlos G Ferreira
• Journal: Oral oncology (Oral Oncol) Vol. 52 Pg. 85-90 (Jan 2016) ISSN: 1879-0593 [Electronic] England
• PMID: 26559740 (Publication Type: Clinical Trial, Phase III, Journal Article, Randomized Controlled Trial)
• Copyright: Copyright © 2015 Elsevier Ltd. All rights reserved.

Topics

• Aged
• Brazil
• Carcinoma, Squamous Cell (economics, therapy)
• Chemoradiotherapy (adverse effects, economics)
• Cost-Benefit Analysis
• Double-Blind Method
• Female
• Head and Neck Neoplasms (economics, therapy)
• Humans
• Low-Level Light Therapy (economics)
• Male
• Middle Aged
• Mucositis (economics, prevention & control)
• Prospective Studies
• Treatment Outcome