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

When: July 20, 2015 - July 21, 2015 (8:00 AM Eastern)
Where: Keck Center of the National Academies (100) • 500 5th Street NW , Washington, DC 20001

Topics Biomedical and Health Research, Diseases, Health Care Workforce, Health Services, Coverage, and Access, Quality and Patient Safety
Activity: National Cancer Policy Forum
Board: Board on Health Care Services

In recent years, the field of oncology has witnessed a number of technological advances, ranging from the development of sophisticated radiotherapy software and hardware to minimally invasive surgical techniques.  Once available in the clinic, both patients and physicians seek access to these new technologies, which are often marketed as the “latest and greatest” treatment available.  The increased cost of novel treatments without adequate assessment on patient outcomes, however, warrants further discussion. Inappropriate use of expensive technologies has been identified as one of the key factors that threaten the affordability of cancer care in the United States. Thus, a critical assessment of the comparative effectiveness and cost-effectiveness of emerging technologies in radiation therapy and surgery is needed.

Emerging radiation technologies, such as intensity-modulated radiation therapy (IMRT), various forms of stereotactic radiotherapy and radiosurgery, and particle beam therapy can enhance clinicians’ ability to treat conditions that were clinically challenging with conventional technologies and offer the potential for better clinical outcomes or reduced treatment-related morbidity for some patients. However, these novel technologies come with higher price tags and are often used to treat patients who might have achieved similar benefits from less expensive external beam radiation treatment. The challenge of evaluating new surgical procedures for effectiveness also has implications for system costs insofar as new surgical technologies are often more expensive, and tend to be rapidly adopted by both patients and clinicians.

This IOM workshop will examine the clinical benefits and comparative effectiveness of emerging advanced technologies for cancer treatment in radiation therapy and surgery. Workshop participants will discuss current utilization patterns, with a focus on diffusion of new technologies into oncology practice, as well as evidence on the overuse, underuse, and misuse of these technologies, and potential strategies to assess the value and define optimal use of new technologies in cancer treatment.

Confirmed Speakers

Stanley Ashley, Brigham and Women's Hospital
Justin Bekelman, University of Pennsylvania
Dave Beyer, American Society for Radiation Oncology (ASTRO)
Steve Chmura, University of Chicago
James Dignam, University of Chicago
Jason Efstathiou, Massachusetts General Hospital
Thomas Farrington, Prostate Health Education Network
Reshma Jagsi, University of Michigan
Peter Johnstone, H. Lee Moffitt Cancer Center
Marc Hartstein, Hospital and Ambulatory Policy Group
Jim Hu, Weill Cornell Medical Center
Larry Kessler, University of Washington
David Miller, University of Michigan
James Mohler, Roswell Park
Michael O'Hara, Center for Devices and Radiological Health, FDA
Grace Smith, MD Anderson Cancer Center
Michael Steinberg, University of California--Los Angeles
Tamara Syrek Jensen, Coverage and Analysis Group
Sean Tunis, Center for Medical Technology Policy
Stephen Williams, MD Anderson Cancer Center
Richard Whelan, Mt. Sinai Health System
Jason Wright, Columbia University
James Yu, Yale University
Anthony Zietman, Massachusetts General Hospital

Workshop Planning Committee

Ya-Chen Tina Shih, Co-Chair, University of Texas MD Anderson Cancer Center
Ralph R. Weichselbaum, Co-Chair, University of Chicago
Monica M. Bertagnolli, Harvard University
Otis W. Brawley, American Cancer Society
Robert W. Carlson, National Comprehensive Cancer Network
Patricia A. Ganz, Jonsson Comprehensive Cancer Center, University of California, Los Angeles
Carol A. Hahn, Duke University Medical Center
Lori Hoffman Hogg, Albany Stratton VA Medical Center
Theodore Lawrence, University of Michigan Medical School
Steven Piantadosi, Cedars-Sinai Medical Center

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