Appropriate Use of Advanced Technologies for Radiation Therapy and Surgery in Oncology: Workshop Summary

In Recent Years, The Field Of Oncology Has Witnessed A Number Of Technological Advances, Including More Precise Radiation Therapy And Minimally Invasive Surgical Techniques. Three-dimensional (3d), Stereotactic, And Proton-beam Radiation Therapy, As Well As Laparoscopy And Robotic Surgery, Can Enhance Clinician's Ability To Treat Conditions That Were Clinically Challenging With Conventional Technologies, And May Improve Clinical Outcomes Or Reduce Treatment-related Problems For Some Patients. Both Patients And Physicians Seek Access To These New Technologies, Which Are Rapidly Being Adopted Into Standard Clinical Practice. Such Demand Is Often Propelled By Marketing That Portrays The New Technologies As The Latest And Greatest Treatments Available. However, Evidence Is Often Lacking To Support These Claims, And These Novel Technologies Usually Come With Higher Price Tags And Are Often Used To Treat Patients Who Might Have Achieved Similar Benefits From Less Expensive, Conventional Treatment. The Increased Cost Of Novel Treatments Without Adequate Assessment Of How They Affect Patient Outcomes Is A Pressing Concern Given That Inappropriate Use Of Expensive Technologies Is One Of The Key Factors That Threaten The Affordability Of Cancer Care In The United States. To Explore These Issues Further, The National Cancer Policy Forum (ncpf) Of The Institute Of Medicine Organized A Workshop In July 2015. This Ncpf Workshop Entitled Appropriate Use Of Advanced Technologies For Radiation Therapy And Surgery In Oncology, Held On July 20 And 21, 2015, In Washington, Dc, Is The Third In A Series Examining The Affordability Of Cancer Care. Participants Explored Clinical Benefits And Comparative Effectiveness Of Emerging Advanced Technologies For Cancer Treatment In Radiation Therapy And Surgery And Potential Strategies To Assess The Value And Promote Optimal Use Of New Technologies In Cancer Treatment. This Report Summarizes The Presentations And Discussions From The Workshop. Introduction -- Overview Of New Technologies -- Evaluation Of Comparative Effectiveness -- Regulatory Oversight -- Rapid Widespread Adoption Of New Technologies -- Costs Of New Technologies -- Value Of New Technologies -- Potential Research Challenges -- Study Designs -- Training And Monitoring Clinical Performance -- Payment Models -- Wrap-up -- References -- Appendix A: Statement Of Task -- Appendix B: Workshop Agenda. Sharyl J. Nass And Margie Patlak, Rapporteurs ; National Cancer Policy Forum, Board On Health Care Services, Institute Of Medicine, National Academies Of Sciences, Engineering, And Medicine. Includes Bibliographical References. This Project Was Supported By Contract No. Hhsn261200900003c And Contract No. Hhsn263201200074i (task Order No. Hhsn26300052) Between The National Academy Of Sciences And The Centers For Disease Control And Prevention And The National Cancer Institute/national Institutes Of Health, Respectively, And By The American Association For Cancer Research, American Cancer Society, American Society For Radiation Oncology, American Society Of Clinical Oncology, American Society Of Hematology, Association Of American Cancer Institutes, Astrazeneca, Bristol-myers Squibb, Cancer Support Community, Ceo Roundtable On Cancer, Emd Serono, Helsinn Healthcare Sa, Livestrong Foundation, National Comprehensive Cancer Network, Novartis Oncology, The Oncology Nursing Society, And Pfizer Inc.