Health Services Research

PV QA 3 - Poster Viewing Q&A 3

TU_35_2937 - Economic Impact of Decreasing the Number of Fractions in Posoperative Brachytherapy of Endometrial Carcinoma by One Third.

Tuesday, October 23
1:00 PM - 2:30 PM
Location: Innovation Hub, Exhibit Hall 3

Economic Impact of Decreasing the Number of Fractions in Posoperative Brachytherapy of Endometrial Carcinoma by One Third.
A. Rovirosa Sr1,2, A. Herreros3, C. Ascaso4, J. Sola3, A. Huguet3, S. Garrido3, Y. Zhang5, K. Cortes3, Y. Li5, A. Torne3, A. Biete6, and J. Sanchez7; 1Gynecological Cancer Unit. Hospital Clinic Universitari, Barcelona, Spain, 2Radiation Oncology Dpt. Hospital Cli­nic Universitari, Barcelona, Spain, 3Radiation Oncology Dpt. Hospital Clinic Universitari, Barcelona, Spain, 4Public Health Dpt. Faculty of Medicine, University of Barcelona, Barcelona, Spain, 5Radiation Oncology Dpt. Hospital Clinic i Universitari, Barcelona, Spain, 6Hospital Clinic Barcelona, Barcelona 08036, Spain, 7Economics Dpt. Hospital Clinic Universitari, Barcelona, Spain

Purpose/Objective(s): To analyze the direct economic impact of 2 postoperative vaginal-cuff brachytherapy (VBT) schedules in endometrial carcinoma (EC) with similar vaginal control and toxicity results. Hypothesis: A lesser number of fractions should allow savings in VBT.

Materials/Methods: From 2006-2015, 397 postoperative EC patients were treated with VBT with a mean of 40 patients/year; 70% of patients received EBI+VBT and the 30% exclusive VBT. Schedule 1: 3 fractions after external beam irradiation (EBI) and 6 fractions in exclusive BT (4-6Gy per fraction); Schedule 2: 1 fraction of 7Gy after EBI and 3 fractions of 6Gy exclusive BT. The differential cost analysis between the 2 schedules was performed retrospectively. The following were considered as a direct cost in each schedule: 1) Personnel costs (technicians in radiotherapy, nurses, medical physicists, administrative personnel, orderlies); the time dedicated by each professional during: CT Planning acquisitions and vagina and OAR delineation, dosimetric study, dosimetry evaluation, auto-radiography, procedure reporting time during and after treatment, removal of bladder and rectal tubes, removal and cleaning of applicators, sterilization procedures and transportation of material for sterilization; 2) Health care material (gels, gauzes, among others); 3) Imputation of treatment equipment costs (length of time of equipment use). The differential between the 2 schedules was estimated. A limitation of the study was that indirect costs and evaluation of quality of life adjusted costs were not considered in the present analysis.

Results: In schedule 2 the savings in treatment time per year was of 4.185 minutes (70 hours).The estimated savings in personnel was of 290€ per patient while that of sanitary material and equipments was of 23€ per patient treated. The overall savings per patient was 313€. Thus, the total savings per year with the use of schedule 2 in 40 patients was of 12,520€.

Conclusion: A reduction of one third in the number of fractions in VBT of postoperative EC allowed an economic savings per patient of 313€ or 12520€ per year (40 patients). Other possible benefits of a reduction in the number of fractions include patient comfort and fewer treatment visits allowing investment in other patient benefits. Grant: Spanish Association Against Cancer (AECC) Foundation.

Author Disclosure: A. Rovirosa: None. C. Ascaso: None. J. Sola: None. S. Garrido: None. Y. Zhang: None. Y. Li: None.

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