OBJECTIVES: A cost analysis investigating TomoTherapy^®(Accuray), Elekta Volumetric-modulated Arc Therapy (VMAT^®) and Varian RapidArc^®was conducted in patients with head and neck cancer. METHODS: The cost-analysis, funded by the National Institute of Cancer (INCa), was performed prospectively based on a multicenter study. Cost calculations were strictly based on a micro costing approach according to the hospitals’ point of view. Only resources which are likely to vary between the strategies being compared were considered. Data on consumption of resources were collected from the treatment planning until the end of the last irradiation session. Productivity losses of radiotherapy involved personnel related to organisational constraints or absenteeism, costs of administrative personnel, costs of logistics and general management were not taken into account. All costs were given in 2013 euros. Numbers of irradiation sessions were compared using Kruskal-Wallis test. Uncertainty was captured by one-way and probabilistic sensitivity analyses using a non-parametric bootstrap method. RESULTS: