Imperial College London
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Professor Thanos Athanasiou MD PhD MBA FECTS FRCS

Faculty of Medicine, Department of Surgery & Cancer

Professor of Cardiovascular Sciences
 
 
 
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Contact

 

t.athanasiou

 
 
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Location

 

1022Queen Elizabeth the Queen Mother Wing (QEQM)St Mary's Campus

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Summary

 

Publications

Citation

BibTex format

@article{Rao:2017:10.1016/j.clon.2017.11.0150936-6555,
author = {Rao, C and Smith, FM and Martin, AP and Dhadda, AS and Stewart, A and Gollins, S and Collins, B and Athanasiou, T and Sun, Myint A},
doi = {10.1016/j.clon.2017.11.0150936-6555},
journal = {Clinical Oncology},
title = {A Cost-Effectiveness Analysis of Contact X-ray Brachytherapy for theTreatment of Patients with Rectal Cancer Following a Partial Responseto Chemoradiotherapy},
url = {http://dx.doi.org/10.1016/j.clon.2017.11.0150936-6555},
year = {2017}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - AimsFollowing chemoradiotherapy in patients with rectal cancer, the addition of contact X-ray brachytherapy (CXB) in partial responders might increase the proportion of patients with a clinical complete response (cCR) and who are thus suitable for watch and wait management. However, the long-term cost-effectiveness of this approach has not been evaluated.Materials and methodsDecision analytical modelling and a Markov simulation were used to compare long-term costs, quality-adjusted life years (QALYs) and cost-effectiveness from a third-party payer (National Health Service) perspective for treatment strategies after chemoradiotherapy; watch and wait with CXB when a cCR was not initially achieved after external beam radiotherapy (EBRT) (WWCXB), watch and wait with EBRT alone (WWEBRT) and radical surgery for all patients. The effect of uncertainty in model parameters and patient demographics was investigated.ResultsWWCXB had a higher QALY payoff than both radical surgery and WWEBRT and was less costly in most scenarios and demographic cohorts. In all plausible scenarios, WWCXB was the most cost-effective, at a threshold of £20 000/QALY. This finding was insensitive to uncertainty associated with model parameters.ConclusionsWWCXB is likely to be cost-effective compared with both WWEBRT alone and radical surgery. These findings support the use of CXB boost as an adjunct to a watch and wait strategy.
AU  - Rao,C
AU  - Smith,FM
AU  - Martin,AP
AU  - Dhadda,AS
AU  - Stewart,A
AU  - Gollins,S
AU  - Collins,B
AU  - Athanasiou,T
AU  - Sun,Myint A
DO  - 10.1016/j.clon.2017.11.0150936-6555
PY  - 2017///
SN  - 0936-6555
TI  - A Cost-Effectiveness Analysis of Contact X-ray Brachytherapy for theTreatment of Patients with Rectal Cancer Following a Partial Responseto Chemoradiotherapy
T2  - Clinical Oncology
UR  - http://dx.doi.org/10.1016/j.clon.2017.11.0150936-6555
ER  -
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