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Cost-Effectiveness of the Biozorb Device for Radiation Planning in Oncoplastic Surgery

机译：Biozorb装置在肿瘤整形手术中的辐射计划的成本效益。

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Purpose: With the extent of breast tissue manipulation using oncoplastic surgical techniques, there lies a challenge in marking the tumor bed for adjuvant radiation therapy planning. Two competing techniques in doing so exist and involve the traditional placement of surgical clips in the surgical tumor bed or the newer technique of placing a Biozorb marker in the tumor bed. Our goal was to perform a cost-utility assessment to see which tumor bed marking approach is more cost-effective. Based on device list prices and clinical outcomes from a comprehensive literature review, we assessed if an approach either dominated or had an incremental cost-utility ratio of less than $50,000/QALY since either would signify cost-effectiveness. Results: From a cost comparison, the Biozorb marker ($1250) was far costlier than the clip applier device ($50). Our PRISMA search (Figure 1) reviewed 133 articles for clip placement and 42 articles for Biozorb placement in oncoplastic surgery with 2 clip placement articles and 3 Biozorb articles meeting criteria. The available data for either marking technique suggests reasonable tumor bed identification for adjuvant radiation treatment without clear clinical advantages supporting one technique over the other. Overall clinical equivalence in the setting of a clear cost advantage suggests dominant cost-effectiveness in favor of clips. Conclusion: Using surgical clips to identify the tumor bed in oncoplastic surgery is dominant and more cost-effective over the Biozorb technique as clips are relatively inexpensive while both techniques reasonably identify the tumor bed.
机译：目的：随着使用肿瘤整形外科技术操纵乳房组织的程度，在标记肿瘤床以辅助放射治疗计划方面存在挑战。存在两种竞争技术，其中涉及将手术夹子传统地放置在手术肿瘤床中或将Biozorb标记物放置在肿瘤床中的新技术。我们的目标是进行成本效用评估，以了解哪种肿瘤床标记方法更具成本效益。根据设备清单价格和全面文献综述的临床结果，我们评估了一种方法是否占主导地位或成本效用比低于50,000美元/ QALY，因为这两种方法均表示成本效益。结果：从成本比较来看，Biozorb标记器（1250美元）比夹子施放器（50美元）要贵得多。我们的PRISMA搜索（图1）审查了133篇关于夹子放置的文章和42篇关于Biozorb放置在整形外科手术中的文章，其中有2篇夹子放置文章和3篇符合标准的Biozorb文章。两种标记技术的可用数据表明，对于辅助放射治疗而言，合理的肿瘤床鉴定没有明显的临床优势可支持一种技术优于另一种技术。在确定明显的成本优势的情况下，总体临床等效性表明，支夹的优势在于成本效益。结论：与Biozorb技术相比，在肿瘤整形手术中使用外科手术夹来识别肿瘤床是主要的，并且更具成本效益，因为夹子相对便宜，而两种技术都可以合理地识别肿瘤床。

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