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Item Type Journal Article
Title Cost and Toxicity Comparisons of Two IMRT Techniques for Prostate Cancer: A Micro-Costing Study and Weighted Propensity Score Analysis Based on a Prospective Study
Creator Masson et al.
Author Ingrid Masson
Author Martine Bellanger
Author Geneviève Perrocheau
Author Marc-André Mahé
Author David Azria
Author Pascal Pommier
Author Nathalie Mesgouez-Nebout
Author Philippe Giraud
Author Didier Peiffert
Author Bruno Chauvet
Author Philippe Dudouet
Author Naji Salem
Author Georges Noël
Author Jonathan Khalifa
Author Igor Latorzeff
Author Catherine Guérin-Charbonnel
Author Stéphane Supiot
Abstract BACKGROUND: Intensity modulated radiation therapy (IMRT) combined with androgen deprivation therapy (ADT) has become the standard treatment for patients with high-risk prostate cancer. Two techniques of rotational IMRT are commonly used in this indication: Volumetric Modulated Arc Therapy (VMAT) and helical tomotherapy (HT). To the best of our knowledge, no study has compared their related costs and clinical effectiveness and/or toxicity in prostate cancer. We aimed to assess differences in costs and toxicity between VMAT and HT in patients with high-risk prostate cancer with pelvic irradiation. MATERIAL AND METHODS: We used data from the "RCMI pelvis" prospective multicenter study (NCT01325961) including 155 patients. We used a micro-costing methodology to identify cost differences between VMAT and HT. To assess the effects of the two techniques on total actual costs per patient and on toxicity we used stabilized inverse probability of treatment weighting. RESULTS: The mean total cost for HT, ?2019 3,069 (95% CI, 2,885-3,285) was significantly higher than the mean cost for VMAT ?2019 2,544 (95% CI, 2,443-2,651) (p <.0001). The mean ± SD labor and accelerator cost for HT was ?2880 (± 583) and ?1978 (± 475) for VMAT, with 81 and 76% for accelerator, respectively. Acute GI and GU toxicity were more frequent in VMAT than in HT (p = .021 and p = .042, respectively). Late toxicity no longer differed between the two groups up to 24 months after completion of treatment. CONCLUSION: Use of VMAT was associated with lower costs for IMRT planning and treatment than HT. Similar stabilized long-term toxicity was reported in both groups after higher acute GI and GU toxicity in VMAT. The estimates provided can benefit future modeling work like cost-effectiveness analysis.
Publication Frontiers in Oncology
Volume 11
Pages 781121
Date 2021
Journal Abbr Front Oncol
Language eng
DOI 10.3389/fonc.2021.781121
ISSN 2234-943X
Short Title Cost and Toxicity Comparisons of Two IMRT Techniques for Prostate Cancer
Library Catalog PubMed
Extra PMID: 35087753 PMCID: PMC8787862
Tags clinic, France, helical tomotherapy (HT), high risk prostate cancers, inverse probability of treatment weighting (IPTW), micro-costing, Volumetric Arc Therapy (VMAT)
Date Added 2023/11/23 - 12:48:11
Date Modified 2024/12/15 - 11:28:51
Notes and Attachments PubMed entry (Attachment)
Texte intégral (Attachment)


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