(P058) The Long-Term Economic Value of Hypofractionated Prostate Radiation: A Cost Minimization Analysis of a Randomized Trial

OncologyOncology Vol 29 No 4_Suppl_1
Volume 29
Issue 4_Suppl_1

HIMRT is more cost-efficient than CIMRT for treating prostate cancer, taking into account additional costs owing to late radiation toxicities.

Khinh Ranh Voong, MD, MPH, Lincy S. Lal, PhD, Deborah A. Kuban, MD, Thomas J. Pugh, MD, J. Michael Swint, PhD, Robert R. Trujillo, Joy Godby, Seungtaek Choi, MD, Andrew K. Lee, MD, MPH, Pamela J. Schlembach, MD, Usama Mahmood, MD, Steven J. Frank, MD, Sean E. McGuire, MD, PhD, Karen E. Hoffman, MD, MPH; UT MD Anderson Cancer Center; UT School of Public Health

PURPOSE: Hypofractionated prostate radiation (HIMRT) shortens the treatment course while providing outcomes comparable with conventionally fractionated radiation (CIMRT). To determine the long-term economic value of HIMRT, including the costs of managing radiation toxicities that develop after treatment, a cost minimization analysis compared CIMRT with dose-escalated HIMRT using data from a randomized trial.

PATIENTS AND METHODS: Men with localized prostate cancer were randomized to CIMRT (75.6 Gy in 42 fractions over 8.4 weeks) or HIMRT (72 Gy in 30 fractions over 6 wk). A decision tree modeled trial probabilities of maximum late bowel and urinary toxicities using patient-level data with a median follow-up of 6 years. Costs were estimated from the healthcare perspective, using 2014 national reimbursement rates for services received. Patient-level institutional costs, adjusted to 2014 dollars, verified reimbursements. Sensitivity analysis assessed model uncertainty.

RESULTS: The cost for HIMRT and toxicity management was $22,957, saving $7,000 compared with CIMRT ($30,241). CIMRT was the common factor among the five most influential scenarios that contributed to total costs. Toxicity represented a small part (< 10%) of the average total cost for patients with either grade 2/3 bowel or urinary toxicity. However, toxicity management reached up to 26% of total costs for patients with both high-grade bowel and urinary toxicities. There was no threshold at which CIMRT became the less costly regimen. Institutional costs confirmed the economic value of HIMRT ($6,000 savings).

CONCLUSION: HIMRT is more cost-efficient than CIMRT for treating prostate cancer, taking into account additional costs owing to late radiation toxicities.

Proceedings of the 97th Annual Meeting of the American Radium Society- americanradiumsociety.org

Articles in this issue

(P005) Ultrasensitive PSA Identifies Patients With Organ-Confined Prostate Cancer Requiring Postop Radiotherapy
(P001) Disparities in the Local Management of Breast Cancer in the United States According to Health Insurance Status
(P002) Predictors of CNS Disease in Metastatic Melanoma: Desmoplastic Subtype Associated With Higher Risk
(P003) Identification of Somatic Mutations Using Fine Needle Aspiration: Correlation With Clinical Outcomes in Patients With Locally Advanced Pancreatic Cancer
(P004) A Retrospective Study to Assess Disparities in the Utilization of Intensity-Modulated Radiotherapy (IMRT) and Proton Therapy (PT) in the Treatment of Prostate Cancer (PCa)
(S001) Tumor Control and Toxicity Outcomes for Head and Neck Cancer Patients Re-Treated With Intensity-Modulated Radiation Therapy (IMRT)-A Fifteen-Year Experience
(S003) Weekly IGRT Volumetric Response Analysis as a Predictive Tool for Locoregional Control in Head and Neck Cancer Radiotherapy 
(S004) Combination of Radiotherapy and Cetuximab for Aggressive, High-Risk Cutaneous Squamous Cell Cancer of the Head and Neck: A Propensity Score Analysis
(S005) Radiotherapy for Carcinoma of the Hypopharynx Over Five Decades: Experience at a Single Institution
(S002) Prognostic Value of Intraradiation Treatment FDG-PET Parameters in Locally Advanced Oropharyngeal Cancer
(P006) The Role of Sequential Imaging in Cervical Cancer Management
(P008) Pretreatment FDG Uptake of Nontarget Lung Tissue Correlates With Symptomatic Pneumonitis Following Stereotactic Ablative Radiotherapy (SABR)
(P009) Monte Carlo Dosimetry Evaluation of Lung Stereotactic Body Radiosurgery
(P010) Stereotactic Body Radiotherapy for Treatment of Adrenal Gland Metastasis: Toxicity, Outcomes, and Patterns of Failure
(P011) Stereotactic Radiosurgery and BRAF Inhibitor Therapy for Melanoma Brain Metastases Is Associated With Increased Risk for Radiation Necrosis
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