title: Cost of prostate image-guided radiation therapy: results of a randomized trial.
abstract: OBJECTIVE
  This cost analysis aimed to quantify the cost of IGRT in relation to IGRT frequency and modality with Cone Beam Computed Tomography (CBCT) or orthogonal electronic portal imaging with fiducial markers (EPI-FM).
  
  
  METHODS
  Patients undergoing IGRT for localized prostate cancer were randomized into two prostate control frequencies (daily or weekly). Costs were calculated based on the micro-costing results according to hospitals' perspectives (in Euros, 2009) and the time horizon was radiation therapy.
  
  
  RESULTS
  A total of 208 patients were enrolled in seven French cancer centers. A total of 6865 fractions were individually analyzed. The mean total treatment fraction duration was 21.0 min for daily CBCT and 18.3 min for daily EPI-FM. Increasing the control frequency from weekly to daily increased the mean treatment fraction duration by 7.3 min (+53%) for CBCT and 1.7 min (+10%) for EPI-FM (p ≤ 0.01). The mean additional cost per patient of daily controls compared with weekly controls was €679 and €187 for CBCT and EPI-FM, respectively (p<0.0001).
  
  
  CONCLUSIONS
  The incremental costs due to different prostate IGRT strategies are relatively moderate, suggesting that daily IGRT combined with intensity-modulated RT (IMRT) could be administered in cases of high-dose radiation delivery to the prostate.
authors: Léon Bérard Cancer Center, Lyon, France.
authors: Lionel
authors: L
authors: Perrier
authors: Magali
authors: M
authors: Morelle
authors: Pascal
authors: P
authors: Pommier
authors: Jean-Léon
authors: JL
authors: Lagrange
authors: Agnès
authors: A
authors: Laplanche
authors: Philippe
authors: P
authors: Dudouet
authors: Stéphane
authors: S
authors: Supiot
authors: Bruno
authors: B
authors: Chauvet
authors: Tan-Dat
authors: TD
authors: Nguyen
authors: Gilles
authors: G
authors: Crehange
authors: Véronique
authors: V
authors: Beckendorf
authors: Françoise
authors: F
authors: Pene
authors: Xavier
authors: X
authors: Muracciole
authors: Jean-Marc
authors: JM
authors: Bachaud
authors: Elisabeth
authors: E
authors: Le Prisé
authors: Renaud
authors: R
authors: de Crevoisier
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D054893:Cone-Beam Computed Tomography / Q000379:methods*; D017048:Health Care Costs; D006801:Humans; D008297:Male; D008875:Middle Aged; D011471:Prostatic Neoplasms / Q000000981:diagnostic imaging / Q000532:radiotherapy*; D061089:Radiotherapy, Image-Guided / Q000191:economics*