Economic evaluation and assessment of early toxicity of hypofractionated radiotherapy compared to standard fractionation in breast cancer.

Chandralekha, K (2015) Economic evaluation and assessment of early toxicity of hypofractionated radiotherapy compared to standard fractionation in breast cancer. Masters thesis, Christian Medical College, Vellore.


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Introduction: Breast cancer is the most frequent cancer among women with the global incidence in women to be 25.2% of all reported new cancers. In India, breast cancer is the most common cancer at 27% of all new cancers . Breast cancer is associated with substantial medical and economic burden and henceforth the management of breast cancer accounts for a large percentage of health care budget. Radiation therapy as an integral part in the multimodality management of breast cancer significantly reduces the locoregional recurrence and also improves the overall survival. To overcome the economic burden related to radiotherapy in breast cancer various hypofractionated schedules like 39 Gy in 13 fractions, 40 Gy in 15 fractions were tried and have proven to achieve similar local control rates, survival rates and cosmetic outcome. This study aims to do the economic evaluation and to assess the acute toxicities associated with 40 Gy in 15 fraction(hypofractionated regimen). Aims and objectives: To analyse the cost difference in breast cancer radiotherapy between conventional fractionation and hypofractionated radiotherapy. The study also aims at assessing the early toxicities of patients receiving post mastectomy radiotherapy. Methods and materials: This Prospective study group consisted of 30 consecutive patients seen in the Radiation therapy department of Christian Medical College, Vellore from February to August 2014, treated with standard fractionation and hypofractionated post mastectomy radiotherapy by conventional technique. Each patient was interviewed using a pilot tested questionnaire to collect data on the health economics. The costs imparted to the patient were classified as direct and indirect costs. The cost effect for each was assessed at the end of the treatment. The occurrence of early toxicity in patients treated with standard and hypofractionated radiotherapy was recorded and analysed using RTOG acute skin toxicity criteria. Results: Twenty three patients were included in the 40 Gy in 15 fractions arm and 7 patients were in the 50 Gy in 25 fractions arm. Of the 30 patients 15 were treated in the Cobalt and 15 were treated in Linear accelerator. The analysis showed that there was significant reduction in costs in hypofractionation with conventional treatment in Cobalt 60. The difference in Linear accelerator was not found to be significant. Conclusion : Adoption of hypofractionated radiotherapy in breast cancer treatment can lead to significant reduction in resource utilisation and is especially pronounced for conventional radiotherapy settings with high patient loads.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Carcinoma Breast; PostMastectomy Radiotherapy; Hypofractionation
Subjects: MEDICAL > Radio Therapy
Depositing User: Punitha K
Date Deposited: 28 Mar 2018 06:05
Last Modified: 28 Mar 2018 06:05

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