Radiotherapy is used extensively in the treatment of many cancers. It is often used alone as the primary therapy, or in conjunction with other forms of treatment such as surgery and chemotherapy, both on a curative and palliative basis. In many instances, there are choices to be made between competing therapies and with regard to the optimum duration and intensity of the chosen treatment. In order to make properly informed and efficient choices that maximise benefits to patients, decision makers need access to information regarding both the relative effectiveness of treatment in treating the cancer and the relative costs of providing the therapies. This paper directly addresses the question of establishing the costs of radiotherapy, one of the main cancer treatments available today. In doing so it reviews existing studies and attempts to account for their apparent inconsistencies. Most are found to be limited in their treatment of costs and difficult to compare due to methodological variations in the calculation of costs. Two of the more comprehensive studies are reanalysed in order to provide a measure of relativity of costs in departments of varying sizes, and a preferred methodology for costing is outlined. If choices are to be properly informed, more and better cost information for all types of cancer treatment is needed. Additionally, there is a need for knowledge of the benefits of therapies for the patients. Detailed effectiveness data, focusing on quantity as well as quantity of survival would complete the basis for well-informed and efficient choices to be made.
