Cost and toxicity comparisons of two IMRT techniques for prostate cancer: a micro-cost study and a weighted propensity score analysis based on a prospective study

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Front oncol. 2022 Jan 11;11:781121. doi: 10.3389/fonc.2021.781121. eCollection 2021.

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 rotational IMRT techniques are commonly used in this indication: volumetric modulated arc therapy (VMAT) and helical tomotherapy (HT). To our knowledge, no study has compared their costs and their clinical efficacy and/or their toxicity in prostate cancer. We sought to assess cost and toxicity differences between VMAT and HT in patients with high-risk prostate cancer with pelvic irradiation.

Materials and methods We used data from the prospective multicenter study “RCMI pelvis” (NCT01325961) including 155 patients. We used a micro-cost methodology to identify cost differences between VMAT and HT. To assess the effects of the two techniques on the total true costs per patient and on toxicity, we used the 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

CONCLUSION: The 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 such as cost-effectiveness analysis.

PMID:35087753 | PMC: PMC8787862 | DOI:10.3389/fonc.2021.781121

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