355P - Cost analysis and overview of single versus multiple fraction palliative radiotherapy for painful bone metastasis

Background

Radiotherapy is an effective treatment for pain palliation in cancer patients with bone metastasis. Although both single and multiple fractionation schedules are equally effacious in pain control, various factors like re-irradiation rate, cost involved, opioid usage and radiotherapy machine load differs between the two schedules. Here, we have done a retrospective review of patients receiving palliative radiotherapy in our institute.

Methods

Case records, radiotherapy treatment plans and charts of patients who received palliative radiotherapy for painful bone metastasis in our institute between June 2017 to May 2018 were reviewed. The demographic features, sites of primary, metastatic bone sites, fractionation schedule used, re-irradiation rates and cost analysis were studied.

Results

The study included 60 patients. Median age was 54 years (25-78). Male to female ratio was 1.1:1. Most common site of primary was lung (40%), followed by breast (21.66%) and site of bone metastasis was vertebra (51.8%), followed by pelvis (16.4%) and long bones (31.8%). Two-third of patients had metastasis to multiple bones. Multi-fraction radiotherapy was more preferred than single fraction (33.3%). Out of 60 patients, 4 were irradiated for second time and 7 underwent re-irradiation subsequently. Among single fraction RT, only 2 patients required re-irradiation. Average cost for single fraction RT is Rs.13500. Whereas for multi-fraction schedules, the treatment cost ranges from Rs.20000 to 30000 and an additional cost for hospital stay, food and transportation ranges from Rs.10000 to Rs. 65000 based fractionation size, type of radiation, in patient ward charges.

Conclusions

In a high volume center, single fractionation can be a cost-effective alternative for pain palliation with reduced rates of re-irradiation and radiotherapy machine load.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.