ESTRO 2023 - Abstract Book

S875

Digital Posters

ESTRO 2023

Purpose or Objective Report expenditure on cancer treatment incurred by breast cancer patients

Materials and Methods The study used longitudinal data of 492 breast cancer patients registered at our centre, during June 2019 and March 2022. The direct and indirect cost of treatment was captured from the time of registration till the end of treatment. All the visits of the patients were captured and relevant information on expenditure was collected. At the end of treatment, details regarding reimbursement was collected. Results Majority of the cohort comprised of pre/perimenopausal (56.3%), overweight/obese (55.9%) and multiparous (78%) women. The disease was left sided (54.2%) and of advanced stage (66.4%) with one-quarter of patients having prior history of medical ailment other than cancer. Cooking facility was available for 68.8% of the patients and 92.4% of patients stayed in paid or rented accommodation. Mean number of hospital visits were 50 (SD 15.8). The direct and indirect cost of treatment has been tabulated below. Patients in the service category had one third of the direct cost (both non-treatment as well as treatment) while almost half of the indirect cost compared to patients in the paying category. Mean number of days of wage loss was 68 days (SD 245. Mean amount of reimbursement was 64650 (SD 79788) and 160215 (SD 251090) for the service and paying category respectively.

Conclusion Investigations constitute the major driver of non-treatment direct cost. The least expensive to most expensive treatment modalities were surgery, radiotherapy and systemic therapy. Similarly for the indirect cost, accommodation and food form the most expensive components. The study highlights the need of taking measures to reduce the financial burden of cancer treatment.

PO-1093 Development of a patient decision aid prototype for treatment of muscle invasive bladder cancer

S. Sigurdson 1 , H. Lukka 1

1 McMaster University, Oncology, Hamilton, Canada

Purpose or Objective Patients with muscle invasive bladder cancer may be candidates for bladder preservation with trimodality therapy (TMT) consisting of maximal tumor resection and concurrent chemoradiotherapy, or radical cystectomy (RC) with ileal conduit. This choice is life altering due to the significant differences in modality and quality of life associated with each treatment option. It is difficult for patients to understand the major decision they are facing and the associated harms, benefits, and functional outcomes during the few clinical encounters they will have with their oncologists. A patient decision aid (PtDA) is a clinical tool that promotes shared decision making by providing information about management options and helping patients understand which values are most important to them. We developed a prototype PtDA for individuals who are offered TMT or RC with ileal conduit to improve their knowledge of options and outcomes. Materials and Methods We used the International Patient Decision Aids Standards (IPDAS) to guide the systematic development process and ensure minimal risk of bias. A literature review was performed to determine the options and incidence of outcomes. Results Ileal conduit was included as the primary urinary diversion option since this is the diversion most commonly performed at our centre, especially for patients who are also candidates for TMT as these patients are generally older or have higher burden of comorbidities than patients who are candidates for a continent neobladder. The PtDA highlights the difference in process between TMT and RC with ileal conduit, specifically evidence for each option, time in the hospital or cancer centre, and urination method after treatment. Outcomes specific to ileal conduit were post-operative morbidity and mortality, stomal stenosis, and parastomal hernia. Outcomes specific to TMT were acute and late toxicity, and salvage cystectomy. The PtDA emphas the similar disease-free survival expected with either treatment option.

Conclusion