000162301 001__ 162301 000162301 005__ 20251017144606.0 000162301 0247_ $$2doi$$a10.5114/jcb.2025.152539 000162301 0248_ $$2sideral$$a144896 000162301 037__ $$aART-2025-144896 000162301 041__ $$aeng 000162301 100__ $$0(orcid)0000-0002-1530-5662$$aLozares-Cordero, Sergio$$uUniversidad de Zaragoza 000162301 245__ $$aA comparative cost-benefit analysis of electronic brachytherapy vs. high-dose-rate iridium-192 for exclusive vaginal cuff treatment in post-operative endometrial cancer 000162301 260__ $$c2025 000162301 5060_ $$aAccess copy available to the general public$$fUnrestricted 000162301 5203_ $$aPurpose: To compare the economic and dosimetric aspects of electronic brachytherapy (eBT) and high-dose-rate (HDR) iridium-192 (192Ir) brachytherapy for exclusive vaginal cuff treatment in post-operative endometrial cancer patients. Material and methods: This retrospective observational study was conducted among 115 patients treated with eBT and 70 patients treated with HDR 192Ir between 2019 and 2023 at two institutions. All patients underwent 3 fractions of 7 Gy prescribed to a uniform target volume. Dosimetric parameters, including D90, V150, and V200 for high-risk clinical target volume (HR-CTV) as well as D2cc, D1cc, and D0.1cc for organs at risk (OARs), such as bladder, rectum, and sigmoid colon, were compared. Economic analysis focused solely on cost differences related to source replacement and maintenance, as all other procedural factors (i.e., personnel, clinical workflow, and logistics) were identical for both modalities. The cost of bunker was not considered in the analysis. Results: Dosimetric analysis revealed comparable target volume coverage between eBT and HDR 192Ir. The economic evaluation was focused on cost differences and their relative contributions. The relative average cost per patient under these assumptions was 18.4% lower for eBT (€273.9) than for HDR 192Ir, based on Spanish pricing, largely due to differences in source-related expenditures. Conclusions: While 192Ir HDR remains the standard in brachytherapy due to its versatility, eBT presents a cost-benefit alternative for exclusive vaginal cuff treatments, particularly in settings where infrastructure limitations restrict isotope-based brachytherapy. These findings support the complementary role of eBT in clinical practice, optimizing resource allocation without compromising dosimetric quality. 000162301 540__ $$9info:eu-repo/semantics/openAccess$$aby-nc-sa$$uhttps://creativecommons.org/licenses/by-nc-sa/4.0/deed.es 000162301 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/publishedVersion 000162301 700__ $$aGonzález-Pérez, Víctor 000162301 700__ $$aSánchez-Casi, Marta 000162301 700__ $$aGonzález-González, Tomás 000162301 700__ $$aCastillo Peña, Paula 000162301 700__ $$aPallarés-Ripollés, Mireia 000162301 700__ $$aHerreros-Martínez, Antonio 000162301 700__ $$aPellejero-Pellejero, Santiago 000162301 7102_ $$11011$$2770$$aUniversidad de Zaragoza$$bDpto. Microb.Ped.Radio.Sal.Pú.$$cÁrea Radiol. y Medicina Física 000162301 773__ $$g17, 3 (2025), 160-167$$pJ. contemp. brachytherapy$$tJournal of Contemporary Brachytherapy$$x1689-832X 000162301 8564_ $$s209213$$uhttps://zaguan.unizar.es/record/162301/files/texto_completo.pdf$$yVersión publicada 000162301 8564_ $$s2619521$$uhttps://zaguan.unizar.es/record/162301/files/texto_completo.jpg?subformat=icon$$xicon$$yVersión publicada 000162301 909CO $$ooai:zaguan.unizar.es:162301$$particulos$$pdriver 000162301 951__ $$a2025-10-17-14:15:42 000162301 980__ $$aARTICLE