Metodologia para avaliação dos benefícios clínicos e socioeconômicos do uso da técnica de IMRT em tumores da próstata
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Data
2018-02-23
Autores
Nunes, Isabella Paziam Fernandes [UNESP]
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Universidade Estadual Paulista (Unesp)
Resumo
O presente estudo consiste na análise da viabilidade econômica e financeira da implantação da radioterapia de intensidade modulada (IMRT) no tratamento do câncer de próstata e comparar seus benefícios clínicos frente aos procedimentos similares custeados pelos sistemas de saúde públicos e privados. Para tanto, foram analisadas as distribuições de dose de radiação preconizadas nos planejamentos radioterápicos com as técnicas de radioterapia conformacional tridimensional (3D-CRT) e de intensidade modulada (IMRT), prescrita para 20 pacientes com câncer de próstata tratados em um serviço de radioterapia privado. Para verificação da qualidade da distribuição de dose de radiação no volume de tratamento, foram analisados os índices de homogeneidade (IH) e de conformidade (IC) de cada um dos planos radioterápicos estudados. Em comparação com a técnica 3D-CRT, a técnica de IMRT permitiu uma melhor cobertura e conformação da dose prescrita no volume alvo de planejamento (PTV), porém distribuída de forma mais heterogênea. Além disso, avaliou-se os custos financeiros para aquisição dos equipamentos de irradiação e manutenção dos tratamentos, bem como os valores de repasses feitos pelos sistemas de saúde para os procedimentos de radioterapia em próstata.
The present study consists in analyzing the economic and financial viability to establish the intensity modulated radiotherapy (IMRT) in the treatment for prostate cancer and compare its clinical benefits to similar procedures funded by public and private health systems. In order to do so, the radiation absorbed-dose distributions recommended in the radiotherapy plans with three-dimensional conformal radiotherapy (3D-CRT) and intensity-modulated radiotherapy (IMRT) techniques, prescribed for 20 patients with prostate cancer treated in a private radiotherapy clinic, were evaluated. To verify the quality of the radiation dose distribution in the treatment volume, the homogeneity index (HI) and the conformity index (CI) of each radiotherapy plans studied were analyzed. In contrast to the 3D-CRT technique, the IMRT technique allowed a better coverage and conformation of the radiation dose prescribed in the planning target volume (PTV), but distributed in a more heterogeneous way. It was also evaluated the financial costs for the acquisition of the irradiation equipment and for the maintenance of the treatments, as well as the values of the on-lending made by the health systems for the radiotherapy procedures for the prostate.
The present study consists in analyzing the economic and financial viability to establish the intensity modulated radiotherapy (IMRT) in the treatment for prostate cancer and compare its clinical benefits to similar procedures funded by public and private health systems. In order to do so, the radiation absorbed-dose distributions recommended in the radiotherapy plans with three-dimensional conformal radiotherapy (3D-CRT) and intensity-modulated radiotherapy (IMRT) techniques, prescribed for 20 patients with prostate cancer treated in a private radiotherapy clinic, were evaluated. To verify the quality of the radiation dose distribution in the treatment volume, the homogeneity index (HI) and the conformity index (CI) of each radiotherapy plans studied were analyzed. In contrast to the 3D-CRT technique, the IMRT technique allowed a better coverage and conformation of the radiation dose prescribed in the planning target volume (PTV), but distributed in a more heterogeneous way. It was also evaluated the financial costs for the acquisition of the irradiation equipment and for the maintenance of the treatments, as well as the values of the on-lending made by the health systems for the radiotherapy procedures for the prostate.
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Palavras-chave
câncer de próstata, física médica, radioterapia conformacional tridimensional, radioterapia de intensidade modulada, sistema de planejamento computacional, intensity-modulated radiotherapy, medical physics, prostate cancer, three-dimensional conformal radiotherapy, treatment planning system