The ROI selected K. Ranh Voong, MD, MPH, to receive the Outstanding Article Award and Melissa Vyfhuis, MD, PhD, to receive the Excellence Award in its first ever Publication Awards in partnership with Advances in Radiation Oncology. The manuscripts are being recognized for their important contributions to the growing body of evidence supporting the value of radiation therapy.
Dr. Voong’s article “Long-term Economic Value of Hypofractionated Prostate Radiation: Secondary Analysis of a Randomized Trial” was chosen for the Outstanding Article Award. It is adding to the much-needed quantitative evidence base supporting the value of using an accelerated radiation treatment approach with advanced planning techniques in prostate cancer, and her novel approach is moving methodology within this field of study forward.
Dr. Voong became interested in health economics while she was working on her MPH as a radiation oncology resident at MD Anderson Cancer Center, and she decided to undertake this study on hypofractionation for prostate cancer as her dissertation. “We are such a technology driven field with a high cost associated with it. If we don’t show the value of advances in our field, then who will?” says Dr. Voong. “I hope my manuscript is a model for how we can show that hypofractionated radiation, if delivered appropriately with low toxicity, can provide a long-term cost savings benefit even when accounting for management of late treatment side effects.”
Dr. Voong used data from a randomized clinical trial of approximately 200 men receiving either dose-escalated moderately hypofractionated intensity modulated radiation therapy (HIMRT) or conventional intensity modulated radiation therapy (CIMRT) to treat localized prostate cancer at MD Anderson. There was a median follow-up time of six years. Since a number of studies were showing an increased risk of late toxicities associated with HIMRT, Dr. Voong wanted to know how that would affect the overall costs of the two treatments.
Using the 2014 national payment rates for hospital based outpatient care, Dr. Voong analyzed the costs of the radiation treatment and planning as well as the costs of managing the toxicities, including drugs, clinic visits, and emergency room visits. Radiation therapy accounted for most of the total cost, while managing the toxicities was generally less than 10 percent of the total cost. Dr. Voong found that the 2014 payment rates of CIMRT and its associated toxicities was $30,241 compared to $22,957 for HIMRT and its associated toxicities, for a savings of $7,284 per patient. Given the large number of men diagnosed and treated with external beam radiation for prostate cancer each year, this paper provides the evidence to show that using HIMRT instead of CIMRT uniformly could save the United States billions of dollars annually.
In honor of her outstanding manuscript on the cost savings benefit of hypofractionated prostate radiation, Dr. Voong received a $5,000 grant to continue her research on the value of RT and the open access fee for her article was paid by the ROI. Now an attending physician and instructor at the Johns Hopkins School of Medicine and Kimmel Cancer Center, Dr. Voong is interested in pursuing research on the value of RT that takes into account the patient perspective. “I think it could be very powerful to combine patient preferences with cost analyses to show patients the benefits and value of radiation as a treatment option,” says Dr. Voong.
The ROI selected Dr. Vyfhuis, a resident in radiation oncology at the University of Maryland School of Medicine, to receive the Excellence Award for her article “Oncological Outcomes from Trimodality Therapy Receiving Definitive Doses of Neoadjuvant Chemoradiation (≥60 Gy) and Factors Influencing Consideration for Surgery in Stage III Non-small Cell Lung Cancer.” The ROI paid the open access fee for Dr. Vyfhuis’s manuscript, which demonstrates a significant overall survival and free-from-recurrence advantage for patients who had surgery in addition to chemoradiation when compared with patients who received only chemoradiation in a carefully selected population of patients with locally advanced NSCLC.
The complete manuscripts for both ROI Value of RT Publication Award winners appear in the July – September 2017 issue of Advances in Radiation Oncology.