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The total survival of the middle of untreated glioblastoma (GBM) patients is less than one year.
EVEN patients who have surgery to remove the tumor completely, GBM will relapse.
to extend the progression-free lifetime (PFS) and total survival (OS) of GBM patients, there are a number of postoperative assisted treatment options.
currently, the GBM standard strategy is to have a combination of radiotherapy combined with TMZ chemotherapy after surgical excision, followed by 6 cycles of TMZ chemotherapy, which has extended the mid-OS from 12.1 months to 14.6 months.
other chemotherapy drugs, such as beva bead monoantin, failed to improve OS, increasing the TMZ cycle by only slightly improving survival.
EF-14 trial to add tumor treatment electric field (tumor treatment fields, TTF) therapy while maintaining TMZ chemotherapy.
low-intensity medium frequency electric field from TTF devices.
preliminary results of EF-14 Trial PHASE III RCT show that by adding TTF therapy to TMZ simultaneous chemotherapy, the patient's median overall survival can be extended by 4.9 months and the non-progressing median survival by 3.1 months.
fda could rewrite new guidelines for GBM first-line treatment based on the results, focusing clinical attention on TTF.
but concerns have been raised about the cost of the TTF device, which currently costs 21,000 euros a month to treat.
"standard" Markov model for cost-benefit analysis of previous EF-14 trials.
Connock, of the Warwick School of Medicine at the University of Warwick in the UK, tried to design a flexible and cost-benefit assessment using the latest valid data through a "partition survival" model, the results of which were published in the July 2019 issue of J Neurooncol.
Research Methods Researchers designed three mutually exclusive health models with "disease stability, disease progression and death" and good fit parameter models for OS and PFS, which can generate reasonable clinical inferences based on observational data.
using a 20-year-old View of the French National Health Service and calculated by cost/life-years gained, LYG.
study found that the base case model generated an incremental gain of 0.604 LY at a cost of Euro453,848, and an incremental cost-benefit ratio (ICER) of Euro510,273/LYG after a 4% annual discount on benefits and costs.
using sensitivity analysis and self-help methods, the results are found to be relatively reliable and sensitive only to the TTF equipment cost and total survival model.
to achieve an IKER below EUR 100,000/LYG, the cost of TTF equipment would need to be reduced by about 85%.
conclusion, the authors conclude that TTF is still an unealable intervention after using different types of models and updating survival results, and that TTF greatly limits the prevalence of patients with adaptive certificates.
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