INTRODUCTION OF LOW DOSE RATE GYNECOLOGIC BRACHYTHERAPY IN A GENERAL HOSPITAL IN CHILE

Introduction: Low Dose Rate Gynecologic Brachytherapy (BCT LDR) in a General Hospital represents a challenge as a development pole and an opportunity for improvement. We summarize the first year of attention of this BCT in a General Hospital, we analyze therapy protraction time compared to the immediately previous period (referrals to another center / city for your attention). Objective Main: To assess the impact of the implementation of gynecologic BCT in a General Hospital in relation to the protraction of treatment (from the first day of teletherapy to the last day of BCT). Secondary: To evaluate if there is a greater demand for a local treatment offer, projected cost effectiveness (compared to referral to a third party). Method: Non-interventional descriptive retrospective study, authorized by local ethics committee. Records of patients with cervical cancer with indication of BCT between July 2017-June 2018 and between July 2018-June 2019 were reviewed. Data were collected in an Excel spreadsheet (BCT LDR implementation cost, diagnosis, teletherapy treatment performed and BCT LDR dates). We analyzed 2 groups of patients: 1) referred to another center to perform BCT 2) Treated locally since its implementation in July 2018. Results: The cost of the implementation project was USD110,000. The first group was 9 patients, with an average protraction time: 69 days, estimated cost of tickets / stay per patient: USD570. The second group consisted of 12 patients, with an average protraction time of 53 days without cost associated tickets / stay. Conclusion: The local implementation of BCT in a General Hospital impacts positively in relation to total treatment time. The reduction of 16 days on average justifies implementing it, since each day of protraction, after 56 days, impacts negatively on the survival of patients (0.8-1.2% OS). There is an increase in the indication of BCT for the period observed (25% more in relation to the same previous period), but it may be due to chance, so more follow-up is required for a longer period. Finally, the cost-effectiveness analysis is complex because it is multivariable, directly affecting the number of patients / year and useful life given by the authorities to the sources of BCT (approx. 30 years). However, when the care burden is less than 20 patients / year and with an estimated useful life of 10 years, the balance of spending justifies the investment.

Publication History

Article published online:
23 October 2019