Open Access

ARTICLE

Patient costs associated with external beam radiotherapy treatment for localized prostate cancer: the benefts of hypofractionated over conventionally fractionated radiotherapy

Perakaa Sethukavalan¹, Patrick Cheung^1,2, Colin I. Tang^3,4, Harvey Quon^1,2, Gerard Morton^1,2, Robert Nam^1,2, D. Andrew Loblaw^1,2

1 Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
2 University of Toronto, Toronto, Ontario, Canada
3 Department of Radiation Oncology, Calvary Mater Newcastle, Newcastle, Australia
4 University of Newcastle, Newcastle, Australia
Address correspondence to Dr. D. Andrew Loblaw, Odette Cancer Centre, 2075 Bayview Avenue, Toronto, ON M4N 3M5 Canada

Canadian Journal of Urology 2012, 19(2), 6165-6169.

Abstract

Introduction: To estimate the out-of-pocket costs for patients undergoing external beam radiotherapy (EBRT) for prostate cancer and calculate the patient-related savings of being treated with a 5-fraction versus a standard 39-fraction approach.
Materials and methods: Seventy patients accrued to the pHART3 (n = 84) study were analyzed for out-of-pocket patient costs as a result of undergoing treatment. All costs are in Canadian dollars. Using the postal code of the patient's residence, the distance between the hospital and patient home was found using Google Maps. The Canada Revenue Agency automobile allowance rate was then applied to determine the cost per kilometer driven.
Results: The average cost of travel from the hospital and pHART3 patient's residence was $246 per person after five trips. In a standard fractionation regimen, pHART3 patients would have incurred an average cost of $1921 after 39 visits. The patients receiving hypofractionated radiotherapy would have paid an average of $38 in parking while those receiving conventional treatment would have paid $293. The difference in out-of-pocket costs for the patients receiving a standard versus hypofractionated treatment was $1930.
Conclusions: Medium term prospective data shows that hypofractionated radiotherapy is an effective treatment method for localized prostate cancer. Compared to standard EBRT, hypofractionated radiotherapy requires significantly fewer visits. Due to the long distance patients may have to travel to the cancer center and the expense of parking, the short course treatment saves each patient an average of $1900. A randomized study of standard versus hypofractionated accelerated radiotherapy should be conducted to confirm a favorable efficacy and tolerability profile of the shorter fractionation scheme.

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