Intensity Modulated Radiation Therapy (IMRT) Reduces Late Toxicity Without Increasing Cost Compared to Conventional 3D-RT in Patients With Human Papillomavirus–Associated (HPV+) Oropharyngeal Carcinoma Treated With Chemoradiation Therapy (CRT)

Abstract

inferior or superior and (iii) quicker to deliver (even at the conventional dose-rate and including on-board, image-guidance for every fraction). Compared to conventionally fractionated 3D technique, the VMAT hypofractionation was overall about one-third (w34%) resource expensive to deliver, with one combination of planning/delivery system (TPS3/linac2 in high-rate mode) as low as one-quarter (w23%) of overall costs. Detailed results for all combinations (VMAT by three planning systems, image-guided delivery by two linac models including the high-dose rate option) is reported with statistical significance of the overall costs difference. Conclusions: Hypofractionated radiation therapy for early-staged lung cancer, as per RTOG0236, already reported superior clinical outcomes. We now document genuine cost-effectiveness: by using the combination of flexible TPSs and modern linacs, simultaneously lower cost and better results can be achieved, a rare combination in modern medicine. Implications for three cancer sites (lung, breast, prostate) will be discussed. Author Disclosure: D.A. Dimitroyannis: None.