ESTRO 2023 - Abstract Book

S620

Monday 15 May 2023

ESTRO 2023

Results A 100% application of UHF leads to reductions in mean work time and cost compared to a 100% application of HF (25% and 43%, resp.) and a 100% application of NF (43% and 61%, resp.). The mixed schedule also results in reductions in mean work time and cost in comparison to a 100% application of HF (18% and 30%, resp.) and NF (37% and 51%, resp.). These results can be attributed to a shorter treatment phase and an associated lower utilisation of the linac and radiation therapy technicians (RTTs). Both adopting UHF as the standard of care as the mixed schedule allows a treatment centre to reach a throughput of 750 patients per year with one linac and three RTTs. Treating 750 patients requires two linacs and four RTTs in the HF schedule and three linacs and six RTTs in the NT schedule.

Fig. 1: Average cost per patient for different fractionation schedules divided up by resource. Total average cost is displayed above bars, with 95% confidence interval between brackets. Conclusion Adopting UHF as the standard procedure for breast cancer leads to substantial work time and cost savings. Treating node- negative breast cancer patients with UHF and the remainder with HF provides similar, yet slightly lower savings. Both strategies entail a lower utilisation of linacs and RTTs and therefore permit radiotherapy departments to maximise throughput with a minimum of resources, assuming an equivalent clinical effectiveness in treatment schedules. This study illustrates the potential of combining DES with TD-ABC to minimise costs and optimise resource planning in radiotherapy. OC-0754 Cost-effectiveness analysis of radiotherapy for patients with Ledderhose disease A. de Haan 1 , H. Groen 2 , J.G. van Nes 3 , P. van der Toorn 4 , A.H. Westenberg 5 , M.W. Kolff 6 , P.M. Werker 7 , J.A. Langendijk 1 , R.J. Steenbakkers 1 1 University Medical Center Groningen, Radiation Oncology, Groningen, The Netherlands; 2 University Medical Center Groningen, Epidemiology, Groningen, The Netherlands; 3 Radiotherapeutisch Instituut Friesland, Radiation Oncology, Leeuwarden, The Netherlands; 4 Catharina Hospital , Radiation Oncology, Eindhoven, The Netherlands; 5 Radiotherapiegroep, Radiation Oncology, Arnhem/Ede, The Netherlands; 6 Amsterdam University Medical Center, Radiation Oncology, Amsterdam, The Netherlands; 7 University Medical Center Groningen, Plastic Surgery, Groningen, The Netherlands Purpose or Objective Radiotherapy is considered a treatment option for Ledderhose disease. Evidence for its effectiveness was found in the LedRad-study, a prospective multicentre randomized double-blind phase III clinical trial, comparing radiotherapy with sham-radiotherapy in patients with symptomatic Ledderhose disease (NCT03507010). However, the health economic impact of Ledderhose disease is unclear. To fill this knowledge gap, an economic evaluation alongside the LedRad-study was planned. Materials and Methods The economic evaluation was performed as a cost-effectiveness and cost-utility analysis from the societal perspective. The outcome parameters for the economic evaluation were the pain score and quality of life (QoL) at 12 months after the end of treatment. Secondary analyses were performed with outcomes at 18 months. Pain scores from Ledderhose disease in the affected foot were measured with the Numeric Rating Scale (NRS). The validated EURO-QoL-5D-5L questionnaire was used to collect QoL data. For cost calculations, questionnaires were used to collect data regarding health care consumption inside and outside the hospital, travel and time costs, household support and informal care, out of pocket costs, and productivity loss. These questionnaires were completed simultaneously with pain and QoL measurements. Using the outcomes and cost data, incremental cost-effectiveness and cost-utility ratios were calculated to express costs per unit improvement in pain burden and costs per Quality Adjusted Life Years (QALY) gained for radiotherapy compared to sham- radiotherapy. Results In total 84 patients were enrolled in the LedRad-study. Previous analysis showed a significant improvement in pain- and QoL scores, at 12 and 18 months, in favor of the radiotherapy group. At these timepoints, cumulative total costs were considerably lower in the radiotherapy group, not including treatment costs. After the bootstrap replications, the incremental cost-effectiveness ratio (ICER) at 12 months after treatment based on pain burden was 1699.5 Euro per unit of pain burden reduction. With quality adjusted life-years as the outcome the incremental cost-utility ratio (ICUR) was 8286.7 Euro per QALY gained. The results of the bootstrap replications for pain burden and QALY are presented in Figures 1a and 1b. For both outcomes, most of the replications were in the upper left quadrant, indicating that health gain can be achieved at higher costs. The probability of cost-effectiveness gradually increased to approximately 85% (Figure 2).