http://repub.eur.nl/res/aut/21313/ List of Publications en http://repub.eur.nl/static-eur/img/logo.png http://repub.eur.nl http://repub.eur.nl/res/pub/31769/ 2011-01-01T00:00:00Z The aim of the present study is to determine and compare initial treatment costs of microsurgery, linear accelerator (LINAC) radiosurgery, and gamma knife radiosurgery in meningioma patients. Additionally, the follow-up costs in the first year after initial treatment were assessed. Cost analyses were performed at two neurosurgical departments in The Netherlands from the healthcare providers' perspective. A total of 59 patients were included, of whom 18 underwent microsurgery, 15 underwent LINAC radiosurgery, and 26 underwent gamma knife radiosurgery. A standardized microcosting methodology was employed to ensure that the identified cost differences would reflect only actual cost differences. Initial treatment costs, using equipment costs per fraction, were €12,288 for microsurgery, €1,547 for LINAC radiosurgery, and €2,412 for gamma knife radiosurgery. Higher initial treatment costs for microsurgery were predominantly due to inpatient stay (€5,321) and indirect costs (€4,350). LINAC and gamma knife radiosurgery were equally expensive when equipment was valued per treatment (€2,198 and €2,412, respectively). Follow-up costs were slightly, but not significantly, higher for microsurgery compared with LINAC and gamma knife radiosurgery. Even though initial treatment costs were over five times higher for microsurgery compared with both radiosurgical treatments, our study gives indications that the relative cost difference may decrease when follow-up costs occurring during the first year after initial treatment are incorporated. This reinforces the need to consider follow-up costs after initial treatment when examining the relative costs of alternative treatments. http://repub.eur.nl/res/pub/17717/ 2009-12-16T00:00:00Z In their 2009 press report the Central Bureau for Statistics (CBS) of the Netherlands states that in 2008 cancer exceeded cardiovascular mortality for the first time in history. This ranks cancer with about 29% of all deaths as the number one cause of death in the Netherlands (webmagazine 03 February 2009). It is anticipated that in the next two decades the incidence of malignant tumors will even further increase, annually by 1 to 1,5%. With regard to the incidence of malignant tumors typically seen in the department of radiotherapy, an increase in incidence was seen for the southwestern part of the Netherlands of about 5%, mainly due to the increase in treatment options with radiotherapy (more indications and better treatment per indication). Of the newly diagnosed malignancies in the Netherlands, cancer in the head and neck region has an incidence of around 4%, with a male to female ratio of 6 to 1. Annually, approximately 2000 people develop a tumor in the head and neck, with 600 patients dying of this disease. http://repub.eur.nl/res/pub/23529/ 2008-10-01T00:00:00Z PURPOSE: Based on earlier studies we were interested in finding out if longitudinal assessment of quality of life (QoL) and costs in long-term survivors of oropharyngeal cancers treated with external beam radiation therapy and brachytherapy (BT) or surgery and postoperative radiotherapy showed a change in QoL over the years. Besides, we were curious to know how much the costs per life year and the QALY would be for this patient group. METHODS AND MATERIALS: Performance status scales: eating in public, understandability of speech, normalcy of diet, xerostomia and ability to swallow were determined in 2003 and 2005. In 2005, the responses to EORTC QLQ-C30, EORTC H&N35, and the Euroqol questionnaire were also measured. Costs and quality-adjusted life years (QALYs) were calculated. RESULTS: Eating in public, understandability of speech, and normalcy of diet significantly differed in favor of BT. Surgical patients experienced more speech, teeth, and mouth-opening problems. Mean costs and QALYs for BT were V16,112 and V56,060 and for surgery V26,590 and V93,275, respectively. CONCLUSIONS: QoL scores don’t change over time. Due to the number of admission days, surgery is more costly. Difference in costs for QALYs in favor of BT was observed. http://repub.eur.nl/res/pub/23526/ 2005-10-01T00:00:00Z