Role of 18F-FDG PET/CT in improving cost-effectiveness of nimotuzumab in nasopharyngeal carcinoma| ACTA Otorhinolaryngologica Italica

Abstract

Objective: This study was aimed towards improving the cost-effectiveness of nimotuzumab (NTZ) in locoregionally advanced nasopharyngeal carcinoma (LA-NPC) using the maximum standardized uptake value (SUVmax) of 18F-fluorodeoxyglucose positron emission tomography (18-FDG PET).

Methods: 248 patients with LA-NPC who met the inclusion criteria from January 2012 to June 2019 were recruited. Survival differences and independent factors were assessed by the Kaplan–Meier method and Cox proportional hazards regression analysis. Outcome measures included analysis of the cost-effectiveness ratio (ICER).

Results: The optimal cutoff value for the SUVmax was 12.92. The prognostic significance for overall survival (OS) with NTZ treatment (P=0.023) and SUVmax (P=0.014) was indicated by multivariate analysis. Exploratory subgroup survival analysis revealed that NPC patients with SUVmax >12.92 treated with concurrent chemoradiotherapy (CCRT) plus NTZ had a significantly improved 3-year OS than those treated with CCRT alone (96.2% vs. 73.2%, P=0.047). The treatment cost with nimotuzumab was $6317.61, this additional cost being only $274.68 extra for every 1% increase in the OS rate.    

Conclusion: In LA-NPC patients with SUVmax >12.92, adding NTZ to CCRT improves OS and is cost-effective.