Proton therapy shown to be less costly than some alternative radiotherapy techniques

October 31, 2014, University of Texas M. D. Anderson Cancer Center
Proton therapy shown to be less costly than some alternative radiotherapy techniques
Total Medicare allowable charges for APBI and WBI. Credit: MD Anderson Cancer Center

In terms of duration of treatment and cost, patients with early stage breast cancer may benefit from accelerated partial breast irradiation (APBI) with proton therapy versus whole breast irradiation (WBI), according to new research from The University of Texas MD Anderson Proton Therapy Center.

In a cost analysis study based on typical patient characteristics, researchers used Medicare reimbursement codes to analyze allowable charges for eight different types of partial and whole breast irradiation therapies and treatment schedules available to early stage . Taken together, these represent roughly 98% of the treatment options available to these patients. The cost of proton therapy when used for APBI, introduced to decrease overall treatment time and toxicity, was estimated at $13,833. Comparatively, WBI using IMRT (x-ray) therapy resulted in the highest Medicare charges at $19,599. The average charges across the eight treatment regimens were $12,784; thus, proton costs were similar to that of other types of radiation.

The findings were presented at the inaugural North America meeting of the Particle Therapy Co-Operative Group (PTCOG) held at MD Anderson Proton Therapy Center. A manuscript detailing the study findings is underway.

"It is often suggested that trials of proton APBI are irrelevant due to the modality's presumed high cost, but our data shows that this perception is false. Correcting this perpetual assumption is an important step in helping patients obtain the necessary health coverage to participate in clinical research," said Valentina Ovalle, M.D., postdoctoral research fellow and principal investigator. "Further, we anticipate that because charges vary proportionately across payers, the estimated Medicare reimbursement costs likely reflect relative charges to other third-party payers."

The American Cancer Society estimates that 232,670 patients will be diagnosed with invasive this year. Early breast cancer (stage I or II) is the most common invasive breast cancer in the U.S. With treatment, these patients generally have a good prognosis. Standard treatment approaches typically include breast-conserving surgery (BCS) followed by radiation therapy for the entire breast – five days per week, for up to six weeks, including one week of "boost" radiation to the area where the initial tumor was removed.

The role of APBI for early stage breast cancer is still being evaluated, but its intent is to deliver a highly effective dose of radiation while greatly reducing treatment time – 10 treatments twice per day over one week. Further, on average it spares at least two-thirds of breast tissue from a full dose of radiation.

"The biggest drawback to WBI is that it is inconvenient, interrupting lives," said Eric A. Strom, M.D, F.A.C.R., study co-author and professor in Radiation Oncology. Strom is the principal investigator of a clinical trial sponsored by the National Cancer Institute on proton APBI.

APBI is delivered via two approaches – brachytherapy and external beam. Proton therapy is offered as a type of external beam APBI and, according to Strom, is unique in its ability to provide the full dose of radiation precisely to the tumor site and nowhere else, eliminating radiation to the remaining breast, lung and heart. To date, research on proton APBI has shown effective tumor control, limited side effects and good cosmetic outcomes.

"This cost analysis must be interpreted in light of clinical evidence for proton APBI, which while still in nascent stages, is promising," said Ovalle. "The findings counter the presumption that proton APBI is so expensive that even excellent clinical results would be immaterial. If the payment barrier for is removed so that current and future research can proceed, the outcomes may ultimately benefit patients, physicians and insurers: better treatments at lower costs."

Explore further: APBI associated with more mastectomies, toxicities, complications, compared to traditional radiation

Related Stories

APBI associated with more mastectomies, toxicities, complications, compared to traditional radiation

May 1, 2012
Accelerated partial breast irradiation (APBI) brachytherapy, the localized form of radiation therapy growing increasingly popular as a treatment choice for women with early-stage breast cancer, is associated with higher rate ...

Study finds side effects, complications, mastectomy more likely after partial breast irradiation

December 7, 2011
Accelerated partial breast irradiation (APBI) brachytherapy, the localized form of radiation therapy growing increasingly popular as a treatment choice for women with early-stage breast cancer, is associated with higher rate ...

Extended outcomes from APBI show tumor control, breast cosmesis and minimal late toxicity

January 29, 2014
Long-term (five-year) outcomes of breast cancer patients receiving adjuvant accelerated partial breast irradiation (APBI) after breast-conserving surgery show excellent tumor control and breast cosmesis (cosmetic outcomes) ...

Highly targeted irradiation as good as whole breast radiotherapy in early stage cancer

May 11, 2012
Barcelona, Spain: Using a concentrated, highly targeted dose of radiation to the breast has equally good results as irradiating the whole area, with no adverse effects on survival and a much better cosmetic outcome, Hungarian ...

Outcomes similar with partial, whole breast irradiation

August 24, 2012
(HealthDay)—Accelerated partial breast irradiation (APBI) yields five-year clinical outcomes and patterns of failure similar to those achieved with whole breast irradiation (WBI), with excellent three-year survival for ...

Chest radiation to treat childhood cancer increases patients' risk of breast cancer

October 27, 2014
A new study has found that patients who received chest radiation for Wilms tumor, a rare childhood cancer, face an increased risk of developing breast cancer later in life due to their radiation exposure. Published early ...

Recommended for you

Surgery unnecessary for many prostate cancer patients

December 13, 2018
Otherwise healthy men with advanced prostate cancer may benefit greatly from surgery, but many with this diagnosis have no need for it. These conclusions were reached by researchers after following a large group of Scandinavian ...

Combining three treatment strategies may significantly improve melanoma treatment

December 12, 2018
A study by a team led by a Massachusetts General Hospital (MGH) investigator finds evidence that combining three advanced treatment strategies for malignant melanoma—molecular targeted therapy, immune checkpoint blockade ...

An integrated approach to finding new treatments for breast cancer

December 12, 2018
Unraveling the complexity of cancer biology can lead to the identification new molecules involved in breast cancer and prompt new avenues for drug development. And proteogenomics, an integrated, multipronged approach, seems ...

Lethal combination: Drug cocktail turns off the juice to cancer cells

December 12, 2018
A widely used diabetes medication combined with an antihypertensive drug specifically inhibits tumor growth—this was discovered by researchers from the University of Basel's Biozentrum two years ago. In a follow-up study, ...

Researchers use computer model to predict prostate cancer progression

December 12, 2018
An international team of cancer researchers from Denmark and Germany have used cancer patient data to develop a computer model that can predict the progression of prostate cancer. The model is currently being implemented ...

New insight into stem cell behaviour highlights therapeutic target for cancer treatment

December 12, 2018
Research led by the University of Plymouth and Technische Universität Dresden has identified a new therapeutic target for cancer treatment and tissue regeneration – a protein called Prominin-1.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.