Cost-Effectiveness Analysis of Chemoradiation and Radiotherapy Treatment for Stage IIB and IIIB Cervical Cancer Patients

Figures & data

Figure 1 Patients’ data collection process.

Table 1 Data of Patients’ Characteristics

Characteristics	Chemoradiation (n = 110)		Radiotherapy (n = 114)		Total (n = 224)
	n	(%)	n	(%)	n	(%)
Age (years)
<40	14	12.7	8	7.0	22	9.8
40–55	72	65.5	67	58.8	139	62.1
>55	24	21.8	39	34.2	63	28.1
Education
No education	2	1.8	2	1.8	4	1.8
Elementary school	67	60.9	62	54.4	129	57.6
Secondary school	14	12.7	22	19.3	36	16.1
High school	20	18.2	20	17.5	40	17.9
University	7	6.4	8	7.0	15	6.7
Occupation
Housewife	92	83.6	88	77.2	180	80.4
Public employee	5	4.5	3	2.6	8	3.6
Employee	3	2.7	13	11.4	16	7.1
Entrepreneur	8	7.3	2	1.8	10	4.5
Other	2	1.8	8	7.0	10	4.5
Residence
West Java	105	95.5	107	93.9	212	94.6
Outside West Java	5	4.5	7	6.1	12	5.4
Stage
IIB	61	55.5	55	48.2	116	51.8
IIIA	2	1.8	1	0.9	3	1.3
IIIB	47	42.7	58	50.9	105	46.9
Histology type
SCC	77	70.0	82	71.9	159	71.0
Adenocarcinoma	13	11.8	11	9.6	24	11.7
Epidermoid carcinoma	13	11.8	10	8.8	23	10.3
Others	7	6.4	11	9.6	18	8.0
Chemotherapy regimen
Cisplatin	87	79.1	–	–	87	79.1
Carboplatin	13	11.8	–	–	13	11.8
Cisplatin and Carboplatin	4	3.6	–	–	4	3.6
Paclitaxel and Carboplatin	4	3.6	–	–	4	3.6
Cisplatin, Vinblastine, and Bleomicyn	2	1.8	–	–	2	1.8

Abbreviation: SCC, squamous cell carcinoma.

Table 2 Side Effects of Stage IIB-IIIB Cervical Cancer Patients’ Treatment

Side Effects (SE)	Chemoradiation (n = 110)		Radiotherapy (n = 114)		Total (n = 224)		p-value
	n	%	n	%	n	%
Number of SE							<0.01*
Without SE	14	12.7	27	23.7	41	18.3
With SE
− 1 SE	46	41.8	25	21.9	71	31.7
− 2 SE	34	30.9	36	31.6	70	31.3
− ≥3 SE	16	14.6	26	22.8	42	18.7
	96	87.3	87	76.3	183	81.7
Types of SE
Diarrhea	23	20.9	39	34.2	62	27.7	-
Nausea/Vomiting	54	49.1	47	41.2	101	45.0
Heartburn	12	10.9	21	18.4	33	14.7
Painful urination	18	16.4	15	13.2	33	14.7
Blister	17	15.5	15	13.2	32	13.4
Itchy	12	10.9	16	14.0	28	12.5
Others	26	24.6	29	25.4	55	24.5

Note: *Significant.

Table 3 Healthcare Costs for Stage IIB-IIIB Cervical Cancer Patients’ Treatment

Average Cost	Chemoradiation	Radiotherapy	p-value
Outpatient services	$7.33	$10.82
Inpatient services	$69.01	$4.70
Emergency	$1.17	$1.13
Medical doctor visit	$20.77	$4.11
Laboratory	$142.46	$86.19
Radiology	$48.54	$42.80
Radiation oncologist consultation	$55.6	$53.76
Radiotherapy	$2792.24	$2717.53
Medical consumables	$25.38	$11.21
Chemotherapy drug	$40.18	0
Non chemotherapy drug	$28.44	$12.12
Average cost per patient	$3231	$2944	<0.01*

Note: *Significant.

Table 4 Effectiveness of Stage IIB-IIIB Cervical Cancer Patients’ Treatment

Tumor Remission Status	Chemoradiation (n = 110)		Radiotherapy (n = 114)		Total (n = 224)		p-value
	n	%	n	%	n	%
Complete response (CR)	76	69.1	72	63.2	146	65.2	0.61
Partial response (PR)	31	28.2	36	31.6	67	29.9
Stable disease (SD)	3	2.7	5	4.4	8	3.6
No response (NR)	0	0	1	0.9	1	0.4

Figure 2 Factors influencing the ICER.

Abbreviations: ICER, incremental cost-effectiveness ratio, the cost for a 1% gain in complete response.