ESTRO 2024 - Abstract Book

S2839

Interdisciplinary - Health economics & health services research

ESTRO 2024

2227

Digital Poster

Implementation of ultra-hypofractionated radiotherapy in early breast cancer: economic impact

Luis Mateu Castell, Jon Gadea Quinteiro, Carlos Garcia Zanoguera, Alba G Curbelo Artiles, Andrea Grau Morenilla, Gemma V Llabres Busch, Irene Ortiz Gonzalez, Francisco J Mestre Meste

Hospital Universitari Son Espases, Radiation Oncology, Palma de Mallorca, Spain

Purpose/Objective:

The phase 3 FAST-FORWARD trial reported that 26Gy in 5 fractions (fx) over 1 week for early-breast cancer after conservative surgery or mastectomy were non inferior to 40Gy in 15fx over 3 weeks for local control and toxicity. The aim of this study is to compare the direct and indirect costs between both treatment schedules.

Material/Methods:

143 patients suitable for 5fx RT schedule were referred to our department in 2022. Direct costs were calculated based on time per treatment fx. Each treatment slot is 15 minutes plus additional 5 minutes if CBCT (Cone Beam Computed Tomography) is required. The treatment was applied by 2 radiation therapy technicians and supervised by a radiation oncologist. Indirect costs were extracted from 1,736 patient interviews through a questionnaire from 55 hospitals in Spain and include expenses related to transportation, loss of income due to inactivity and meals.

Results:

Considering an 8- hour workday for 5 days a week, the direct cost for each RT fx was 14.28€ for a radiation oncologist and 7.39€ for each radiation therapy technician. Regarding our 143 patients, ultra -hypofractionation resulted in 1430 less RT fx delivered, achieving savings of 41,555.80€. Complete details can be seen in Table 1. With reference to transportation, 50% of the patients used private vehicles, 30% relied on public transportation and 20% required an ambulance. Complete details for transportation costs can be seen in Figure 1. 27% of the patients had meals at the hospital or snacks during waiting times, with an average cost of 76.7€ per patient. Total expenses for meals were 2,991.30€ for 5fx and 8,970€ for 15fx. For 31% of patients, RT treatment meant a loss of income due to not being able to work as a self-employed person or as an employee, these losses being higher in those self employed. Costs related to inactivity amounted to 432.80€ for 5fx and 1,298.40€ for 15fx. Total indirect costs were 18,541.30€ for 5fx compared to 55,620.00€ for 15fx, resulting in a total savings of 37,078.70€.