by David Douglas

Last Updated: 2009-06-24 16:23:04 -0400 (Reuters Health)

NEW YORK (Reuters Health) - Accelerated partial-breast irradiation (PBI) appears to be a particularly cost-effective treatment for certain patients with early-stage breast cancer.

"Our study," lead investigator Dr. David J. Sher told Reuters Health, "shows that for postmenopausal women with small, favorable breast cancers, external beam accelerated partial breast irradiation is clearly the most cost-effective treatment."

In the June issue of the International Journal of Radiation Oncology, Biology, Physics, Dr. Sher of the Harvard Radiation Oncology Program, Boston and colleagues observe that a typical course of PBI involves twice-daily treatments over 4 to 5 days, whereas whole-breast radiation therapy (WBRT) involves 5 to 7 weeks of daily treatment.

In order to compare incremental cost effectiveness in estrogen receptor-positive postmenopausal women, the researchers developed a Markov model to simulate outcome 15 years after breast radiotherapy. Among the assumptions were that the patients received tamoxifen but not chemotherapy.

The team found that the incremental cost-effectiveness ratio for WBRT compared with external beam-PBI was $630,000 per quality-adjusted life-year. The approach continued to be the most cost-effective technique over a wide range of assumptions and societal willingness-to-pay values.

"More data are accumulating that short-course breast radiotherapy regimens are comparable in efficacy to conventional 6 week treatments," Dr. Sher continued.

"Physicians and health care systems need to determine when patients would be best served by treatment in 1, 3 or 6 weeks, and cost-effectiveness is one consideration in this decision," he concluded.

Int J Radiation Oncology Biol Phys 2009;74:440-446.

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