Cost-effectiveness of the modifications in the quality assurance system in radiotherapy in the example of in-vivo dosimetry |
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| Authors: | Julian Malicki Marcin Litoborski Marta Bogusz-Czerniewicz Adam Swiezewski |
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| Institution: | 1. Medical Physics Department, Greater Poland Cancer Centre, Poznan, Poland;2. Training, Scientific Cooperation and Quality Assurance Department, Greater Poland Cancer Centre, Poznan, Poland;3. Costs Analysis Department, Greater Poland Cancer Centre, Poznan, Poland;4. Department of Electroradiology, University of Medical Sciences, Poznan, Poland;5. Department of Medical Physics, Institute of Physics, Adam Mickiewicz University, Poznan, Poland;1. Biochemistry, Biochemical Analysis & Matrix Pathobiology Research Group, Laboratory of Biochemistry, Department of Chemistry, University of Patras, Patras, Greece;2. Foundation for Research and Technology, Institute of Chemical Engineering Sciences (FORTH/ICE-HT), Patras, Greece;3. Faculdade de Medicina, disciplina de Imunologia, Universidade Federal do Rio de Janeiro, Campus Macaé, Brazil;4. Laboratório de Bioquímica e Biologia Cellular de Glicoconjugados, Programa de Glicobiologia, Instituto de Bioquímica Médica Leopoldo De Meis and Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Brazil;5. Center of Toxicology Science & Research, Medical School, University of Crete, Heraklion, Crete, Greece;1. Centre for Nuclear and Radiation Physics, Department of Physics, University of Surrey, Guildford, Surrey, GU2 7XH, UK;2. Radiology Department, Faculty of Medicine, Kabul Medical University, Kabul, Afghanistan;3. Radiotherapy Physics, Level B, Queen Alexandra Hospital, Portsmouth, PO6 3LY, UK;4. Department of Medical Physics, Royal Surrey County Hospital NHS Trust, Guildford, Surrey, GU2 7XX, UK;5. Department of Physics, University of Malaya, 50603 Kuala Lumpur, Malaysia;1. V.N. Karasin Kharkiv National University, 4 Svobody Sq., 61022, Kharkiv, Ukraine;2. Institute of Nuclear Chemistry and Technology, 16 Dorodna str., 03-195 Warsaw, Poland;1. Department of Mathematics, Xi''an Polytechnic University, Xi''an 710048, China;2. Departamento de Análisis Matemático, Facultad de Matemáticas, Universidad de Santiago de Compostela, 15782, Santiago de Compostela, Spain;3. Department of Mathematics, Faculty of Science, King Abdulaziz University, P.O. Box 80203, Jeddah 21589, Saudi Arabia |
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| Abstract: | PurposeTo present the methodology for the evaluation of cost-effectiveness of the quality assurance protocol modifications associated with increasing demands on accuracy and reliability in radiotherapy and to present results on cost-effectiveness of in-vivo dosimetry as the chosen example of a technical procedure.Material and methodsIn-vivo dosimetry was used as an example of a quality assurance procedure, whose modifications have an impact on several procedures in the QA system and thus on the cost of radiotherapy. An analysis of 6864 patients, treated between 2001 and 2005 for tumours in the head and neck, breast, pelvis, or lung, was performed. The quality of radiotherapy was expressed as the accuracy of dose delivery and the cost was estimated from labour, equipment and materials.ResultsModifications implemented in the quality assurance protocol have gradually improved the quality of irradiation. Mean deviations between measured and calculated doses, recorded for several groups of treatment sites, were reduced from ?1.5% to 0.5%, 3.4% to 1.4%, 3.9% to 0.1% and ?2.1% to 1.8% for head and neck, breast, pelvis and lung respectively. The standard deviations of the measured values decreased also consistently. Total monthly cost in radiotherapy (related to in-vivo dosimetry) increased from € 4376 to € 10,696 while the unitary cost of radiotherapy procedures remained at the same level. The predominant cost component of in-vivo dosimetry was labour, limited at first to physics staff and later extended to quality assurance personnel and technicians.ConclusionThe application of the presented methodology revealed cost-effectiveness relationships in tested technical procedures. |
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