title: Patient costs associated with external beam radiotherapy treatment for localized prostate cancer: the benefits of hypofractionated over conventionally fractionated radiotherapy.
abstract: BACKGROUND
  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.
  
  
  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.
authors.affiliation: Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
authors.forename: Perakaa
authors.initials: P
authors.lastname: Sethukavalan
authors.forename: Patrick
authors.initials: P
authors.lastname: Cheung
authors.forename: Colin I
authors.initials: CI
authors.lastname: Tang
authors.forename: Harvey
authors.initials: H
authors.lastname: Quon
authors.forename: Gerard
authors.initials: G
authors.lastname: Morton
authors.forename: Robert
authors.initials: R
authors.lastname: Nam
authors.forename: Andrew
authors.initials: A
authors.lastname: Loblaw
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002170:Canada; D017281:Cost of Illness; D003365:Costs and Cost Analysis; D019583:Dose Fractionation, Radiation; D006297:Health Services Accessibility / Q000191:economics; D006801:Humans; D008297:Male; D008875:Middle Aged; D011471:Prostatic Neoplasms / Q000191:economics* / Q000532:radiotherapy*; D014186:Transportation / Q000191:economics*