Skip to main content
Prophylactic Cranial Irradiation Revisited: Cost-effectiveness and Quality of Life in Small-cell Lung Cancer
International Journal of Radiation Oncology, Biology, Physics (2002)
  • T. H. Patricia Tai
  • Edward Yu, University of Western Ontario
  • Peter Dickof
  • Glen Beck, University of Saskatchewan
  • Jon Tonita
  • Tete Ago
  • David Skarsgard
  • Marlene Schmidt
  • Matthew Schmid
  • John S. K. Liem
PURPOSE: To investigate the therapeutic usefulness and cost-effectiveness of prophylactic cranial irradiation (PCI) in patients with limited-stage small-cell lung cancer (SCLC) who had achieved a complete remission. METHODS: A retrospective chart review was undertaken of all patients diagnosed in Saskatchewan with SCLC between 1987 and 1998 inclusive. Patients who achieved a complete remission were divided into two groups, depending on whether they underwent PCI (PCI+ and PCI-, respectively). The quality-of-life-adjusted survival was estimated by the Q-TWiST method (quality time without symptoms and toxicity). The mean incremental costs per month of incremental OS were calculated in a cost-effectiveness analysis. RESULTS: Among the 98 complete remission patients, the median OS for PCI+ and PCI- patients was 20.0 and 19.0 months, respectively (p > 0.05, nonsignificant). The median disease-free survival was 14.7 and 10.0 months, respectively (p < 0.05). The difference in the mean Q-TWiST survival was significant (p < 0.01). The mean marginal cost was $18,834/PCI+ patient and $17,885/PCI- patient (p > 0.05, nonsignificant). The cost-effectiveness ratio was $70/mo of incremental OS if u(tox) and u(rel) (the utility coefficients to reflect the value of time in health states of toxicity and relapse) were assumed to be 1.0. CONCLUSION: PCI is a cost-effective treatment that improves the quality-of-life-adjusted survival for patients with a complete remission of SCLC.
  • Aged,
  • Antineoplastic Combined Chemotherapy Protocols,
  • Brain Neoplasms,
  • Carcinoma,
  • Small Cell,
  • Confidence Intervals,
  • Cost-Benefit Analysis,
  • Cranial Irradiation,
  • Female,
  • Humans,
  • Lung Neoplasms,
  • Male,
  • Middle Aged,
  • Prognosis,
  • Quality of Life,
  • Remission Induction,
  • Retrospective Studies,
  • Survival Rate
Publication Date
January 1, 2002
Citation Information
T. H. Patricia Tai, Edward Yu, Peter Dickof, Glen Beck, et al.. "Prophylactic Cranial Irradiation Revisited: Cost-effectiveness and Quality of Life in Small-cell Lung Cancer" International Journal of Radiation Oncology, Biology, Physics Vol. 52 Iss. 1 (2002)
Available at: