Techno-Economic Feasibility Analysis of a Fully Mobile Radiation Oncology System Using Monte Carlo Simulation

Area of Science:

• Medical Physics
• Health Services Research
• Oncology

Background:

• Radiation oncology (RO) access disparities exist due to geographic, socioeconomic, and racial factors.
• A fully mobile (FM) RO system offers a potential solution to deliver radiotherapy to rural and underserved areas.
• Transitioning from semi-mobile to FM-RO systems presents logistical and quality assurance challenges.

Purpose of the Study:

• To quantify the techno-economic feasibility of a fully mobile radiation oncology (FM-RO) system.
• To assess the potential of FM-RO to reduce geographic disparities in radiotherapy access.
• To evaluate the economic viability of FM-RO in rural Missouri using Monte Carlo simulations.

Main Methods:

• Monte Carlo simulation was employed to model a FM-RO system.
• Simulations incorporated cancer demographics for northern and southeastern Missouri.
• Techno-economic feasibility was assessed for a subset of patients with lung, breast, and rectal cancers treated with five fractions.

Main Results:

• The FM-RO system demonstrated technological feasibility by completing quality assurance tests within 1.5 hours.
• Simulated net incomes in rural Missouri ranged from $1.55 ± 0.17 million to $3.65 ± 0.25 million.
• Patient volume was the primary driver of net income and break-even point, with the system achieving net benefit across scenarios.

Conclusions:

• Simulations indicate that a FM-RO system is technologically successful and economically viable in rural settings.
• FM-RO presents a promising solution for addressing geographic disparities in radiotherapy access.
• The study highlights the potential of mobile healthcare solutions to improve equitable access to cancer treatment.