ESTRO 37 Abstract book

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ESTRO 37

biochemical control was 100%. Ten patients (15%) presented distant disease progression, 4 of them were castration-resistant (CRPC). Specifically, in patients with CRPC, after a median follow- up of 9.8 months, 8 of the 12 CRPC patients (66%) are free from disease progression at last follow-up, without the need to start second generation hormonal treatment. Tolerance and toxicity profiles were excellent, none of the patients developed toxicity ≥G3 or symptoms related to local progression of

the disease. Conclusion

Preliminary results of this trial demonstrate that combination of SBRT and ADT is safe treatment with encouraging local and biochemical control.

Proffered Papers: CL 2: Health services research to improve value and access

The PSA showed that SBRT had the highest probability of cost-effectiveness compared to lobectomy.

OC-0063 Medico-economics analysis of SBRT and surgery for early stage non small cell lung cancer. A. Paix 1 , G. Noel 1 , P.E. Falcoz 2 , A. Filipovic Pierucci 3 , P. Lévy 4 1 Centre Paul Strauss, Radiothérapie, Strasbourg, France 2 Hôpitaux Universitaires de Strasbourg, Department of thoracic surgery, strasbourg, France 3 Assistance Publique des Hôpitaux de Paris, URCéco, Paris, France 4 Université Paris Dauphine, LEDa LEGOS, Paris, France Purpose or Objective Projections estimate an increase of 50% of the incidence of lung cancers by 2030. Early stage NSCLC represented 19% of NSCLC diagnosed in France in 2004.There are rising evidences in favor of a lung cancer screening which will reduced the occurrence of later-stage lung cancers while rising the incidence of early stage NSCLC. Current guidelines states that for early stage NSCLC surgical resection should be performed and stereotactic body radiotherapy (SBRT) is an option in patient non-medically operable. In this study, we compared the cost- effectiveness of SBRT with lobectomy in medically operable patients. Material and Methods We developed a Markov model, based on the survival results of STARS and ROSEL, two randomized studies comparing SBRT and lobectomy in early stage NSCLC, to describe survival and treatment related complications of a patient treated for early stage NSCLC. This analysis was conducted from the French payer perspective on a lifetime perspective. Utility values, recurrence risks, and costs were adapted from the literature. Deterministic (DSA) and probabilistic (PSA) sensitivity analyses were performed to assess the influence of the assumptions made. Results The Markov model developed was found consistent with survival data reported in the pool analysis of the randomized studies. SBRT and lobectomy total cost was 8,681€ and 10,616€ respectively, and the quality- adjusted life expectancy was 16.3 and 15.8 QALY respectively. The DSA, ran on every assumptions made, revealed that the incremental cost-effectiveness ratio was mainly sensitive to the decrement of utility cause by treatment related complications and initial cost of both surgery and SBRT.

For a willingness to pay of 30,000 and 100,000€/QALY, probability of cost effectiveness of SBRT compared to surgery is 64% and 61% respectively. Conclusion This is the first medico-economic study evaluating SBRT and lobectomy in stage I NSCLC based on randomized studies and our analyses suggest that SBRT is dominant over lobectomy in operable early stage NSCLC treatment. Deterministic and probabilistic sensitivity analyses confirmed that this result was robust and that it was not significantly modified by the assumptions made in the Markov model building. OC-0064 Estimating the cost benefit of radiotherapy for overall survival and local control V. Batumalai 1,2,3 , K. Wong 1,2,3 , J. Shafiq 2,3 , T. Hanna 2,4 , G. Gabriel 2,3 , J. Heberle 5 , I. Koprivic 5 , L. Cassapi 6 , N. Kaadan 1 , D. Forstner 1 , O. King 1 , G.P. Delaney 1,2,3 , M. Barton 1,2,3 1 Department of Radiation Oncology, South Western Sydney Local Health District, New South Wales, Australia 2 Collaboration for Cancer Outcomes Research and Evaluation, Ingham Institute for Applied Medical Research, New South Wales, Australia 3 South Western Clinical School, University of New South Wales, New South Wales, Australia 4 Division of Cancer Care and Epidemiology, Cancer Research Institute- Queen’s University, Ontario, Canada 5 Activity Based Management, Department of Health, New South Wales, Australia 6 Department of Radiation Oncology, Calvary Mater Newcastle, New South Wales, Australia Purpose or Objective Escalating health care costs have led to greater efforts directed at measuring the cost and benefits of medical treatments. The aim of this study was to estimate the cost of radiotherapy (RT) for 5-year overall survival and