Choose wisely.

It’s time to revisit the use of radiation in early-stage favorable Hodgkin lymphoma, this time from a cost effectiveness take. As we all know, radiation decreases local recurrences, but whether or not that endpoint is “worth” the dreaded consolidative 20 Gy to an involved site is where the debate continues to rage. Using data from HD16, these Markov models demonstrate that the addition of 20 Gy following a negative PET achieved after 2 cycles of ABVD buys an additional quality-adjusted life year (QALY) at the low, low price of $8,028 (an oft-used a priori threshold for “cost effectiveness” is $100K per QALY). Sensitivity analyses indicate consolidative radiation remains cost-effective if it lowers risk of recurrence by 6% or more. | Kim, Pract Radiat Oncol 2021

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