几项研究已经证明，根据所使用的放射性核素，游离淋巴结活检（SLNB）在早期口腔腔鳞状细胞癌（OCSCC）隐匿淋巴结病变的检测中的有效性、可靠性和敏感性存在差异。至今尚未进行根据费用或临床结果对使用[99mTc]tilmanocept与[99mTc]硫胶体进行头对头比较的研究。本研究旨在建立一个决策模型，比较早期OCSCC中使用[99mTc]tilmanocept与[99mTc]硫胶体的成本效益。我们创建了一个以SLNB为函数的疾病和治疗决策模型。SLNB阴性的患者进入一个马尔可夫模型，该模型根据已发表的数据，模拟OCSCC的自然史，迭代地展示五种健康状态，并在30年的时间范围内进行计算。我们计入了每种健康状态的治疗费用和质量调整生命年（QALY）。以每增加一个QALY为100,000美元的阈值进行成本效益比分析。基本情景下的成本效益分析表明，[99mTc]tilmanocept比[99mTc]硫胶体更为有效，差值为0.12 QALYs（7.06与6.94 QALYs）。[99mTc]tilmanocept的生命周期成本为84,961美元，而硫胶体的生命周期成本为84,264美元，然而，整体基本情景下的ICER为每增加一个QALY 5,859美元，远低于成本效益的阈值。进行了多次单向敏感性分析，并证明该模型对替代参数值具有稳健性。我们的分析结果显示，虽然[99mTc]tilmanocept的前期成本更高，但通过使用[99mTc]tilmanocept所获得的额外QALYs是值得的。© 2023. 作者。

Several studies have demonstrated varying rates of efficacy, reliability, and sensitivity of sentinel lymph node biopsy (SLNB) in identifying occult nodal disease for early stage oral cavity squamous cell carcinoma (OCSCC) depending on the radionuclide agent utilized. No head-to-head comparison of cost or clinical outcomes of SLNB when utilizing [99mTc]tilmanocept versus [99mTc]sulfur colloid has been performed. The goal of this study was to develop a decision model to compare the cost-effectiveness of [99mTc]tilmanocept versus [99mTc]sulfur colloid in early stage OCSCC.A decision model of disease and treatment as a function of SLNB was created. Patients with a negative SLNB entered a Markov model of the natural history of OCSCC parameterized with published data to simulate five states of health and iterated over a 30-year time horizon. Treatment costs and quality-adjusted life-years (QALYs) for each health state were included. The incremental cost-effectiveness ratio (ICER) was then estimated using $100,000 per additional QALY as the threshold for determining cost-effectiveness.The base case cost-effectiveness analysis suggested [99mTc]tilmanocept was more effective than [99mTc]sulfur colloid by 0.12 QALYs (7.06 versus 6.94 QALYs). [99mTc]Tilmanocept was more costly, with a lifetime cost of $84,961 in comparison with $84,264 for sulfur colloid, however, the overall base case ICER was $5859 per additional QALY, well under the threshold for cost-effectiveness. Multiple one-way sensitivity analyses were performed, and demonstrated the model was robust to alternative parameter values.Our analysis showed that while [99mTc]tilmanocept is more costly upfront, these costs are worth the additional QALYs gained by the use of [99mTc]tilmanocept.© 2023. The Author(s).