Taylor Prince, Castilho Marcus Simões, Marta Gustavo Nader
Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.
Department of Global Health, McMaster University, Hamilton, ON, Canada.
Lancet Reg Health Am. 2022 Jun 9;13:100292. doi: 10.1016/j.lana.2022.100292. eCollection 2022 Sep.
Estimates show that breast cancer, the leading cause of cancer death in females worldwide, will continue to increase in incidence, highlighting the need for increased treatment capacity. While postoperative radiation therapy (RT) is commonly used to reduce recurrence and mortality, research has shown that moderately hypofractionated radiation therapy (HFRT) and 5-fraction HFRT are equally safe and effective and can reduce treatment costs. This study aimed to compare the cost of conventional RT (50Gy/25), moderately HFRT (40.05Gy/15), and 5-fraction HFRT (26Gy/5) for breast cancer patients in Brazil.
The cost of each RT regimen was calculated using the International Atomic Energy Agency's Radiotherapy Cost Estimator Tool. The potential annual savings were then estimated by applying the cost of each regime to the 2020 Brazilian cancer incidence rates.
The average costs per patient for 25 fractions, 15 fractions, and 5 fractions are $2,699.20, $1,711.98, and $929.81, respectively. The annual cost savings associated with treating 70% of patients with 15 fraction HFRT and 30% of patients with 5 fraction HFRT as compared to treating all patients with 25 fraction RT is $72,929,315.40. The estimated annual productivity of 1 LINAC machine for 25 fractions, 15 fractions, and 5 fractions is 338, 647, and 1,310 patients, respectively.
The cost analysis revealed decreased patients' costs and potential for increased EBRT access associated with HFRT in the Brazilian perspective.
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据估计,乳腺癌是全球女性癌症死亡的主要原因,其发病率将持续上升,这凸显了提高治疗能力的必要性。虽然术后放射治疗(RT)通常用于降低复发率和死亡率,但研究表明,中等程度的超分割放射治疗(HFRT)和5次分割的HFRT同样安全有效,并且可以降低治疗成本。本研究旨在比较巴西乳腺癌患者接受常规RT(50Gy/25次)、中等程度HFRT(40.05Gy/15次)和5次分割HFRT(26Gy/5次)的成本。
使用国际原子能机构的放射治疗成本估算工具计算每种RT方案的成本。然后,通过将每种方案的成本应用于2020年巴西癌症发病率来估计潜在的年度节省费用。
25次分割、15次分割和5次分割的每位患者平均成本分别为2699.20美元、1711.98美元和929.81美元。与用25次分割RT治疗所有患者相比,用15次分割HFRT治疗70%的患者和用5次分割HFRT治疗30%的患者相关的年度成本节省为72929315.40美元。1台直线加速器每年治疗25次分割、15次分割和5次分割患者的估计生产率分别为338例、647例和1310例。
从巴西的角度来看,成本分析显示HFRT可降低患者成本,并有可能增加外照射放疗的可及性。
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