Lozares-Cordero Sergio, González-Pérez Víctor, Sánchez-Casi Marta, González-González Tomás, Peña Paula Castillo, Pallarés-Ripollés Mireia, Herreros-Martínez Antonio, Pellejero-Pellejero Santiago
Physics and Radiation Protection Department, Miguel Servet University Hospital, Zaragoza, Spain.
Department of Microbiology, Pediatrics, Radiology, and Public Health, Faculty of Medicine, University of Zaragoza, Zaragoza, Spain.
J Contemp Brachytherapy. 2025 Jun;17(3):160-167. doi: 10.5114/jcb.2025.152539. Epub 2025 Jun 30.
To compare the economic and dosimetric aspects of electronic brachytherapy (eBT) and high-dose-rate (HDR) iridium-192 (Ir) brachytherapy for exclusive vaginal cuff treatment in post-operative endometrial cancer patients.
This retrospective observational study was conducted among 115 patients treated with eBT and 70 patients treated with HDR Ir between 2019 and 2023 at two institutions. All patients underwent 3 fractions of 7 Gy prescribed to a uniform target volume. Dosimetric parameters, including D, V, and V for high-risk clinical target volume (HR-CTV) as well as D, D, and D for organs at risk (OARs), such as bladder, rectum, and sigmoid colon, were compared. Economic analysis focused solely on cost differences related to source replacement and maintenance, as all other procedural factors (i.e., personnel, clinical workflow, and logistics) were identical for both modalities. The cost of bunker was not considered in the analysis.
Dosimetric analysis revealed comparable target volume coverage between eBT and HDR Ir. The economic evaluation was focused on cost differences and their relative contributions. The relative average cost per patient under these assumptions was 18.4% lower for eBT (€273.9) than for HDR Ir, based on Spanish pricing, largely due to differences in source-related expenditures.
While Ir HDR remains the standard in brachytherapy due to its versatility, eBT presents a cost-benefit alternative for exclusive vaginal cuff treatments, particularly in settings where infrastructure limitations restrict isotope-based brachytherapy. These findings support the complementary role of eBT in clinical practice, optimizing resource allocation without compromising dosimetric quality.
比较电子近距离放射治疗（eBT）和高剂量率（HDR）铱-192（Ir）近距离放射治疗在子宫内膜癌术后单纯阴道残端治疗中的经济和剂量学方面。
这项回顾性观察研究在2019年至2023年期间于两家机构对115例接受eBT治疗的患者和70例接受HDR Ir治疗的患者进行。所有患者均接受3次分割，每次7 Gy，处方剂量至统一靶区体积。比较了高风险临床靶区（HR-CTV）的剂量学参数，包括D、V和V，以及膀胱、直肠和乙状结肠等危及器官（OARs）的D、D和D。经济分析仅关注与放射源更换和维护相关的成本差异，因为两种治疗方式的所有其他程序因素（即人员、临床工作流程和后勤）均相同。分析中未考虑防护室的成本。
剂量学分析显示eBT和HDR Ir在靶区体积覆盖方面相当。经济评估重点关注成本差异及其相对贡献。基于西班牙定价，在这些假设下，eBT每位患者的相对平均成本（273.9欧元）比HDR Ir低18.4%，这主要是由于与放射源相关的支出差异。
虽然Ir HDR因其多功能性仍是近距离放射治疗的标准，但eBT为单纯阴道残端治疗提供了一种具有成本效益的替代方案，特别是在基础设施限制限制基于同位素的近距离放射治疗的情况下。这些发现支持了eBT在临床实践中的补充作用，在不影响剂量学质量的情况下优化资源分配。
