AUTHOR=Sholklapper Tamir N. , Creswell Michael L. , Payne Alexandra T. , Markel Michael , Pepin Abigail , Carrasquilla Michael , Zwart Alan , Danner Malika , Ayoob Marilyn , Yung Thomas , Collins Brian , Kumar Deepak , Aghdam Nima , Suy Simeng , Hankins Ryan A. , Kowalczyk Keith , Collins Sean P. 

TITLE=Patient-Reported Financial Burden Following Stereotactic Body Radiation Therapy for Localized Prostate Cancer

JOURNAL=Frontiers in Oncology

VOLUME=Volume 12 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2022.852844

DOI=10.3389/fonc.2022.852844

ISSN=2234-943X

ABSTRACT=Introduction and Objectives: In patients with localized prostate cancer, 5-fraction, Stereotactic Body Radiation Therapy (SBRT) has been found to offer comparable oncologic outcomes and potential for improved treatment compliance compared to conventional, 40-plus fraction radiation therapy (RT). Recent studies of oncologic patient experiences have highlighted both the impact of therapy-associated financial toxicity (FT) on treatment adherence and health-related quality of life (HRQOL).
Methods: Cross-sectional assessment of FT after SBRT using the 12-item COST questionnaire. Total questionnaire score (range 0-44) to evaluate FT grade (0-3), with higher COST value representing lower grade. Patient zip code used to approximate distance from index hospital. Univariate and multivariate analyses of average COST score (0-4).
Results: Response rate of 57.5% (332 of 575 consented patients) with 90.7%, 8.2%, and 1.1% experiencing grade 0, 1, and 2 FT, respectively, with no grade 3. Unemployment or disability, non-white race, low income, and concurrent hormonal therapy associated with a statistically significant worse FT (lower COST value) on univariate and multivariate analysis (p<0.05). Education level and insurance status significant on univariate analysis only. Non-statistically significant difference in age, marital status, time since treatment, and distance from index hospital.
Conclusions: SBRT associated with low FT. However, statistically significant socioeconomic disparities in FT remain despite ultra-hypofractionated treatment.