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Expanding Global Radiotherapy Access by Adopting Hypofractionated Radiotherapy and Combination Immunotherapy for Breast and Prostate Cancer

W Swanson1*, O Irabor2, J Wirtz3, S Yasmin-Karim2, W Ngwa4, (1) University of Massachusetts Lowell, Lowell, MA, (2) Dana-Farber Cancer Institute, Boston, MA, (3) University of Ulm, Ulm, Germany, (4) Brigham and Womens Hospital, Boston, MA

Presentations

(Sunday, 7/12/2020)   [Eastern Time (GMT-4)]

Room: AAPM ePoster Library

Purpose: Previous studies demonstrate non-inferior clinical outcomes using hypofractionation (HF) EBRT for breast and prostate cancer cases. The purpose of this work is to estimate the percentage cost-savings per radiotherapy course and increased radiotherapy (RT) access in low and middle income countries (LMIC) after adopting HF for breast and prostate radiotherapy. For perspective, results are compared with high-income countries and when using a single fraction of RT with immunotherapy (SF), as a viable new approach under development.


Methods: Conventional Fractionation (CF), HF, and SF treatment regimen costs for breast and prostate RT in LMIC in Africa were calculated using the Radiotherapy Cost Estimator (RTE) tool developed by the International Atomic Energy Agency (IAEA). The model was based on a single linear accelerator facility at full operation. The potential maximum cost-savings in each country over 7 years for breast and prostate radiotherapy were then estimated using cancer incidences from the Global Cancer Observatory database with utilization rates applied. The increase in radiotherapy access was estimated by current national capacities from the IAEA directory.


Results: The RTE model shows that, for LMIC, a HF-RT course could be delivered at less than 67% of the cost for breast and 57% of the cost for prostate CF-RT treatments and increase treatment access by up to 25% and 36% for LMIC African Countries for breast and prostate RT respectively. SF-RT treatment would reduce the cost even further to less than 30% the typical treatment cost with even greater expected access increases.


Conclusion: Such a significant cost reduction for RT delivery in LMICs means major savings in wide adoption of HF-RT or SF-RT. Additionally, by significantly reducing RT fractions, more patients can be treated in the same amount of time, increasing treatment accessibility in LMIC-clinics with high patient burden.

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