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

Antunes, Heilton S
Schluckebier, Luciene Fontes
Herchenhorn, Daniel
Small, Isabele A.
Araújo, Carlos M.M.
Viégas, Celia Maria Pais
Rampini, Mariana P.
Ferreira, Elza M.S.
Dias, Fernando L.
Teich, Vanessa
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Oral Oncology
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 (100 mg/m2 ) every 3 weeks. An InGaAlP (660 nm–100 mW–4 J/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.
Cost-effectiveness, Low-level laser therapy, Oral mucositis, Head and neck cancer, Radiotherapy, Chemotherapy, Quality of life
Antunes,HS, Schluckebier LF, Herchenhorn D, Small IA, Araújo CMM, Viégas CMP et al. Cost-effectiveness of low-level laser therapy (LLLT) in head and neck cancer patients receiving concurrent chemoradiation. Oral Oncol. 2016;52:85-90. Doi: 10.1016/j.oraloncology.2015.10.022.