Cost-benefit analysis of 3D conformal radiation therapy - Treatment of prostate cancer as a model

Three-dimensional conformal radiation therapy (3D-CRT) is a promising new t reatment technique based on the principle that improved precision in both t umor definition and dose delivery will enhance outcomes by maximizing dose to the tumor area while minimizing dose to normal tissue. Using a cost-bene fit analysis, in terms of outcomes, we first examined the overall risks and benefits of 3D-CRT. We then used the treatment of prostate cancer as a mod el to compare actual clinical outcomes reported between 3D-CRT and standard radiation therapy (SRT). Our analysis shows that application of 3D-CRT to the clinical setting remains difficult because of the continual difficultie s of target definition, and that dose escalation cannot yet be justified on the basis of the lack of benefit found, and suggested increased late toxic ity, in most of the dose escalation series compared with SRT.