ESTRO 2025 - Abstract Book

S867

Clinical - Gynaecology

ESTRO 2025

Purpose/Objective: The randomized phase III HypoG-01 trial (NCT03127995) showed the non-inferiority of hypofractionated (HF) radiation therapy (RT) with 40 Gy/15 fractions versus normofractionated (NF) RT with 50 Gy/25 fractions in locoregional early breast cancer (EBC). A secondary objective of the trial was to assess the cost-effectiveness of HF in comparison to NF in the French setting. Material/Methods: We conducted a cost-utility analysis using the per-protocol patient population of HypoG-01 (HF: 614 pts, NF: 607 pts). Direct costs included RT and transportation which were estimated from the French National Health Insurance perspective. The irradiation technique (IMRT or 3D), the number of fractions (including boost), and health-related quality of life (EQ-5D-3L) were prospectively collected for each patient over the trial follow-up. Transportation costs were considered, assuming a unit cost of € 58 1 per fraction for each patient. QALYs were estimated combining utility values (mixed model for repeated measures adjusted for baseline values) and survival probabilities. The time horizon was 3 years, and a yearly discount rate of 2.5% was applied. We estimated mean cost and QALY differences between arms and their bootstrap 95% confidence intervals. Sensitivity analysis was performed by varying the proportion of IMRT (0-100%) and considering alternative hypotheses for transportation costs. Results: The average number of fractions (including boost) per patient was 18 in HF and 28 in NF. The proportion of IMRT was similar in both arms (52% and 53% in HF and NF arms respectively). Per-patient cost of RT was estimated at € 6 914 [6703; 7125] for HF and at € 10 019 [9700; 10338] for NF. Total cost (including transportation) was € 7 957 [7741; 8173] and € 11 649 [11327; 11971] in HF and NF respectively. Cost difference was in favor of HF amounting to € 3 692 [-4074; -3297] net cost-savings. QALYs were 2.242 [2.196; 2.287] in HF and 2.284 [2.243; 2.328] in NF, with a mean non statistically significant QALY difference of -0.042 [-0.099; 0.014]. In the sensitivity analysis, mean cost difference was always in favor of HF varying from - € 2 861 to - € 5 726.

Conclusion: In the French setting, moderately HF RT is a cost-saving option for loco-regional radiation therapy in EBC patients.

Keywords: evaluation, hypofractionation, early breast cancer

References: 1 Castelli, C., Mounié, M. et Costa, N. (2024) . Le défi de la standardisation des coûts : construction d’un référentiel statistique de coûts unitaires des prestations en santé. Journal de gestion et d'économie de la santé, Vol. 41(1), 58 72. https://shs.cairn.info/revue-journal-de-gestion-et-d-economie-de-la-sante-2024-1-page-58?lang=fr.

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Digital Poster Outcomes of locally advanced cervical cancer in South America: analysis of a bicentric cohort Francisco Pérez Peña 1 , Tomás Walter Martin 1 , Darlett Folch Mora 1 , José Solís Campos 1,2 , Gustavo Ferraris 3 , Ariel Gómez Palacios 3 , Agustín Gilardi 3 , Ana Raies 3 , Luciana Brun 3 , María Díaz Vázquez 3 , Belen Raiden 3 , Ofelia Pérez Conci 3 , Anaís Molina Cárcamo 4 , Florencia Olivares Duval 4 , Josefa Giusti-Bilz Schäfer 4 , Ilan Perrot Rosenberg 1,2 , Benjamín Tudela Staub 1,2 , Gabriel Veillon Contreras 1,2 , Ximena Quintela Dávila 1,2 , Gabriel Lazcano Álvarez 1,2 1 Radiation Oncology, Universidad de Valparaíso, Valparaíso, Chile. 2 Oncology, Hospital Carlos Van Buren, Valparaíso, Chile. 3 Radiation Oncology, Centro de Radioterapia Deán Funes, Córdoba, Argentina. 4 School of Medicine, Universidad de Valparaíso, Valparaíso, Chile