Navigation Links
PRT versus IMRT toxicity in Medicare beneficiaries with prostate cancer
Date:12/17/2012

There is no difference between proton radiotherapy (PRT) and intensity-modulated radiotherapy (IMRT) when comparing the toxicity among Medicare beneficiary patients with prostate cancer at 12 months post-treatment according to a study published December 14 in the Journal of the National Cancer Institute.

IMRT is the standard form of radiotherapy for the treatment of prostate cancer, accounting for more than 80% of all treatments. Alternative treatments for radiotherapy have emerged, with the most notable being PRT. PRT treatment has surfaced partly due Medicare reimbursement, which reimburses PRT at a rate of 1.4-2.5 times that of IMRT. Despite its widespread use, the benefits and harms of PRT compared with other types of radiotherapy remain unknown.

To determine the long-term effects of PRT treatment compared with IMRT treatment, James B. Yu, M.D., Yale University School of Medicine, Department of Therapeutic Radiology, and colleagues performed a retrospective study of all Medicare beneficiaries aged 66 years or older who had received PRT or IMRT for prostate cancer during 2008 and/or 2009. Each PRT patient was then matched with two IMRT patients with both similar clinical and sociodemographic characteristics to assess the toxicity of each treatment, while the cost of IMRT or PRT treatment was calculated for each patient using the sum of Medicare reimbursements for outpatient and physician claims.

The researchers found that patients who received PRT were younger, healthier and from more thriving areas than those who received IMRT. While PRT was linked to a statistically significant reduction in genitourinary toxicity at 6 months compared with IMRT, there was no statistically significant difference in gastrointestinal or other toxicities at 6 or 12 months post-treatment. "The relative reimbursement of new medical technologies needs to be considered carefully so that physicians and hospitals do not have a financial incentive to adopt a technology before supporting evidence is available," the researchers write. "Continued longitudinal study of the comparative effectiveness of PRT compared with IMRT is needed before widespread application of PRT for prostate cancer can be justified."

In an accompanying editorial, Justin E. Bekelman, M.D., Abramson Cancer Center, Perelman Center for Advanced Medicine and Stephen M. Hahn, M.D., Chair and Henry K. Pancoast Professor of Radiation Oncology at the University of Pennsylvania School of Medicine, write that the study has limitations and could lead to misclassifications of the results. "Without studies to validate the surrogacy of claims-based endpoints, outcome misclassification could lead to false-negative or false-positive results," they write.

In another accompanying editorial, Theodore S. Lawrence, M.D., Ph.D., Chair, Radiation Oncology, University of Michigan, and Mary Feng, M.D., Department of Radiation Oncology, University of Michigan, write that, "It is assumed that one can assess toxicity by evaluating billing codes, but toxicities are not well graded, and many could be missed," arguing that a thorough comparison of the two treatments cannot yet be made. "Although it seems unlikely that proton therapy will be superior to IMRT photons for prostate cancer, protons may be superior for tumors in which the elimination of the low-dose regions might decrease normal tissue injury (eg, lung cancers, when combined with chemotherapy)."


'/>"/>
Contact: Zachary Rathner
Zachary.Rathner@oup.com
301-841-1286
Journal of the National Cancer Institute
Source:Eurekalert

Related medicine news :

1. New genetic clues to why most bone marrow transplant patients develop graft-versus-host disease
2. New Polar RCX3 Heart Rate Monitor Versus Suunto Quest
3. Studies assess genetics, modified treatment to improve outcomes, reduce toxicity
4. First-of-its-kind approach nanomedicine design effectively targets cancer with decreased toxicity
5. Study suggests eliminating Medicare consultation payments associated with a net increase in spending
6. Costly, Repeat Medical Testing Common for Medicare Patients: Study
7. Study suggests repeat testing common among medicare beneficiaries
8. Medicare: Barrier to hospice increases hospitalization
9. Canadas health costs for seniors rising slowly: Points way to Medicare solvency
10. Medicare Gaps Leave Many With Big Bill at End of Life, Study Finds
11. Health-care costs at end of life exceed total assets for 25 percent of Medicare population
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:2/13/2016)... ... February 13, 2016 , ... The producers of ... American businesses. , The increasingly modern world of instantaneous consumption proves very convenient ... energy sources such as oil and coal, which pollutes our air, water, and soil. ...
(Date:2/13/2016)... ... ... In the early or “honeymoon” stage of a relationship, couples strive to ... way to be romantic, and may exaggerate a strength or two in an effort ... , A recent study from Queendom.com , however, suggests that new couples ...
(Date:2/12/2016)... Opelousas, LA (PRWEB) , ... February 12, 2016 , ... ... of St. Landry and Evangeline Parishes. The purpose of these scholarships is to ... to encourage those individuals to seek employment within these two parishes. , “We ...
(Date:2/12/2016)... , ... February 12, 2016 , ... ... 2016 — 1:30 p.m. – 3:00 p.m. EST, http://www.fdanews.com/fixeddosecombination ... life cycle of pharmaceutical products, garnering increased attention from all stakeholders in the ...
(Date:2/12/2016)... ... February 12, 2016 , ... ... nominations have closed for the ISE Southeast Awards 2016. Finalists and winners of ... the ISE® Southeast Executive Forum and Awards Gala on March 15, 2016 at ...
Breaking Medicine News(10 mins):
(Date:2/12/2016)... -- SI-BONE, Inc., a medical device company that pioneered the use of ... (MIS) device indicated for fusion for certain disorders of the sacroiliac ... Administrative Contractor (MAC) covering the states of Connecticut ... Massachusetts , Minnesota , ... Rhode Island , Vermont ...
(Date:2/12/2016)... , Feb. 12, 2016 On Thursday, ... Robotic Surgery at St. David,s North Austin Medical Center ... Vinci ® Xi ® Surgical System with ... 7000dV. Thiru Lakshman , M.D., colorectal surgeon ... total proctocolectomy utilizing Integrated Table Motion technology, which seamlessly ...
(Date:2/12/2016)... , Feb. 12 2016  OMS Supply, a ... and medical practitioners, announced today the recent launching of ... visitors a variety of features that enhance the user ... surgery supplies. --> ... a fairly new company that started in early 2016, ...
Breaking Medicine Technology: