Session Item

Radiation-induced cardiotoxicity is an important health concern for clinicians during the treatment of breast cancer (BC) patients. Underlying mechanisms are well-documented, whereas little is known about the societal impact of this long-term effect. This study aimed to quantify the additional burden of radiation-induced cardiovascular (CV) diseases in BC survivors.

Conventional health economic modelling techniques were used to estimate incremental CV-related costs and disutility -expressed in quality adjusted life years (QALYs)- in a hypothetical cohort of BC survivors. A situation in which radiotherapy caused an additional CV risk was compared with a situation in which this risk was not taken into account. Uncertainty was assessed via sensitivity analyses.

Radiation-induced cardiotoxicity evokes a mean expected incremental cost of €283.41 per woman over a time horizon of 20 years after BC treatment. An mean expected decrement of 0.018 QALYs (per woman) might be estimated when the radiation-induced cardiotoxic risk is taken into account in BC survivors. Incremental costs and disutility increased with index age (see figure 1). A scenario analysis showed that these results were more profound in women with more advanced staging.

In the past decades, strong emphasis has been placed on strategies to counteract radiation-induced cardiotoxic effects in BC patients. To date, there is a general belief that continuing efforts should be made to lower mean heart doses. On the contrary, our analyses suggest that with current radiation doses, minor costs and disutility are to be expected from radiation-induced cardiotoxicity in BC survivors. With regard to the opportunity costs of further efforts and investments on counteract radiation-induced cardiotoxic effects, this new insight should encourage radiation-oncologists to consider other priorities to tackle long-term comorbidities in cancer survivors.