Abstract
PURPOSE Disparities in radiation oncology (RO) can be attributed to geographic location, socioeconomic status, race, sex, and other societal factors. One potential solution is to implement a fully mobile (FM) RO system to bring radiotherapy to rural areas and reduce barriers to access. We use Monte Carlo simulation to quantify techno-economic feasibility with uncertainty, using two rural Missouri scenarios. METHODS Recently, a semimobile RO system has been developed by building an o-ring linear accelerator (linac) into a mobile coach that is used for temporary care, months at a time. Transitioning to a more FM-RO system, which changes location within a given day, presents technical challenges including logistics and quality assurance. This simulation includes cancer census in both northern and southeastern Missouri, multiple treatment locations within a given day, and associated expenditures and revenues. A subset of patients with lung, breast, and rectal diseases, treated with five fractions, was simulated in the FM-RO system. RESULTS The FM-RO can perform all necessary quality assurance tests as suggested in national medical physics guidelines within 1.5 hours, thus demonstrating technological feasibility. In northern and southeastern Missouri, five-fraction simulations' net incomes were, in US dollars (USD), $1.55 ± 0.17 million (approximately 74 patients/year) and $3.65 USD ± 0.25 million (approximately 98 patients/year), respectively. The number of patients seen had the highest correlation with net income as well as the ability to break-even within the simulation. The model does not account for disruptions in care or other commonly used treatment paradigms, which may lead to differences in estimated economic return. Overall, the mobile system achieved a net benefit, even for the most negative simulation scenarios. CONCLUSION Our simulations suggest technologic success and economic viability for a FM-RO system within rural Missouri and present an interesting solution to address other geographic disparities in access to radiotherapy.
Recommended Citation
A. T. Price et al., "Techno-Economic Feasibility Analysis of a Fully Mobile Radiation Oncology System using Monte Carlo Simulation," JCO Global Oncology, vol. 8, article no. e2100284, American Society of Clinical Oncology, May 2022.
The definitive version is available at https://doi.org/10.1200/GO.21.00284
Department(s)
Engineering Management and Systems Engineering
Second Department
Psychological Science
International Standard Serial Number (ISSN)
2687-8941
Document Type
Article - Journal
Document Version
Final Version
File Type
text
Language(s)
English
Rights
© 2023 American Society of Clinical Oncology, All rights reserved.
Publication Date
01 May 2022
PubMed ID
35609229
