A cost-minimising analysis of standard radiotherapy and two experimental therapies in glioblastoma.
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.
Johannesen
Tom B
TB
Department of Radiotherapy and Oncology, The Norwegian Radium Hospital, Oslo, Norway.
Norum
Jan
J
Lote
Knut
K
Scheie
David
D
Hirschberg
Henry
H
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