title: A cost-minimising analysis of standard radiotherapy and two experimental therapies in glioblastoma.
abstract: OBJECTIVE
  Accelerated radiotherapy (ART) and intracavity brachytherapy (ICBT) have been introduced in the primary treatment of glioblastoma. Our objective was to determine total treatment costs, hospitalisation time, and treatment outcome in these two experimental therapies compared to standard treatment.
  
  
  METHODS
  In the time period 1985 to 1st May 1999, a total of 174 patients with histologically confirmed glioblastoma multiforme were given postoperative radiotherapy according to three different treatment schedules at three different time intervals. A conventional regime of external radiotherapy (54Gy/30 fractions) was given to 58 patients (group I), 75 patients were treated with ART (48Gy/twice daily 30 fractions) (group II), and 41 patients were given ICBT (60Gy/ten fractions) (group III). Treatment costs including surgery, hospital stay, hospital hotel stay, and radiotherapy were calculated.
  
  
  RESULTS
  The total mean costs employing the three treatment alternatives were calculated to $25,618 (group I), $23,442 (group II), and $14,534 (group III). Total mean stay in hospital for the whole primary treatment was 48.8, 41.6, and 19 days for groups I, II, and III respectively. Median survival figures were 16, 14, and 13 months for groups I, II, and III, respectively.
  
  
  CONCLUSIONS
  The total cost of postoperative radiotherapy in glioblastoma is comparable to other health care services. ART did not improve the total treatment cost or influence the need for hospitalisation compared to standard treatment. ICBT seemed to have economic benefits with less need for hospitalisation.
authors.affiliation: Department of Radiotherapy and Oncology, The Norwegian Radium Hospital, Oslo, Norway.
authors.forename: Tom B
authors.initials: TB
authors.lastname: Johannesen
authors.forename: Jan
authors.initials: J
authors.lastname: Norum
authors.forename: Knut
authors.initials: K
authors.lastname: Lote
authors.forename: David
authors.initials: D
authors.lastname: Scheie
authors.forename: Henry
authors.initials: H
authors.lastname: Hirschberg
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001918:Brachytherapy / Q000191:economics*; D003362:Cost-Benefit Analysis; D005260:Female; D005909:Glioblastoma / Q000532:radiotherapy* / Q000601:surgery; D017048:Health Care Costs; D006801:Humans; D007902:Length of Stay / Q000191:economics; D008297:Male; D008875:Middle Aged; D009664:Norway; D019057:Quality-Adjusted Life Years; D011882:Radiotherapy, High-Energy / Q000191:economics*; D012189:Retrospective Studies; D016896:Treatment Outcome