Value of intensity-modulated radiation therapy
Haute Autorite de sante/French National Authority for Health
Record ID 32007000399
To assess the clinical value of IMRT in order to advise French National Health Insurance (NHI) on reimbursement.
Authors' results and conclusions: We selected 20 studies (1406 patients): 1 phase I study, 1 randomized dosimetric study (phase III), 2 non randomized controlled studies, 16 case series and 18 dosimetric studies. They concerned mainly tumours of the head and neck (13 studies - 973 patients), skull base (2 studies - 60 patients), and prostate (3 studies - 315 patients). There were no cases of grade 3-4 xerostomy in 6 of the 7 studies reporting complications. There was no difference in efficacy or survival between IMRT and 3D-conformal therapy. Further indications not backed up by published evidence were proposed by the working group.
Authors' recommendations: HAS advises: -reimbursement of IMRT for total body irradiation and the treatment of the following tumours: head and neck, skull base and vault, spinal cord, and prostate; -conditional coverage for the following tumours: craniospinal tumours and total medullar irradiation, multiple bone metastases, retroperitoneal tumours, tumours of the limbs and lungs, and paediatric tumours. Further research/reviews required: -long-term follow-up (in particular in paediatrics) because of the potential risk of radio-induced cancer; -confirmation of safety and efficacy in indications with a conditional coverage; -assessment of the impact on quality of life and the public health system (both in terms of health economics and care organization) for all indications.
Authors' methods: Review
Project Status: Completed
URL for project: http://www.has-sante.fr
Year Published: 2007
English language abstract: An English language summary is available
Publication Type: Not Assigned
Organisation Name: Haute Autorité de Santé
Contact Address: 2 avenue du Stade de France, 93218 Saint-Denis La Plaine Cedex, France. Tel: +33 01 55 93 71 88; Fax: +33 01 55 93 74 35;
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Copyright: Haute Autorite de sante/French National Authority for Health (HAS)
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