Impact of Monitoring Heart Function During Cancer Treatment
Author Information
Author(s): Shureiqi I, Cantor S B, Lippman S M, Brenner D E, Chernew M E, Fendrick A M
Primary Institution: The University of Texas M. D. Anderson Cancer Center
Hypothesis
The clinical and economic impacts of monitoring cardiac function in patients given doxorubicin have yet to be determined.
Conclusion
Monitoring heart function with multiple gated acquisition scans during doxorubicin therapy provides minimal improvement in survival rates, especially for younger patients.
Supporting Evidence
- Monitoring heart function minimally improved the probability of 5-year survival by less than 1.5%.
- The cost-effectiveness ratio for patients younger than 40 years was $425,402 per life saved.
- Patients older than 60 years had a significantly lower cost-effectiveness ratio of $86,829 per life saved.
- The small gain in survival probability doubled when the cumulative doxorubicin dose reached 500 mg/m².
Takeaway
Doctors checked heart health in cancer patients taking a specific drug, but it didn't help them live much longer, especially if they were younger.
Methodology
A decision analysis model was developed to estimate the survival benefit and cost-effectiveness of using multiple gated acquisition scans during doxorubicin chemotherapy.
Potential Biases
The model may be biased towards maximizing the benefits of MUGA-scan monitoring based on high-risk patient data.
Limitations
The study's findings may not apply to patients with pre-existing cardiac problems, and the data used were derived from retrospective studies.
Participant Demographics
Participants included 21% aged 15–39, 43% aged 40–59, and 36% aged 60 or older.
Digital Object Identifier (DOI)
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