Stereotactic Radiosurgery and Stereotactic Body Radiation Therapy Cost-Effectiveness Results

Abstract

Objective: To describe and synthesize the current stereotactic radiosurgery (SRS) and stereotactic body radiation therapy (SBRT) cost-effectiveness research to date across several common SRS and SBRT applications.Methods: This review was limited to comparative economic evaluations of SRS, SBRT, and alternative treatments (e.g., other radiotherapy techniques or surgery). Based on PubMed searches using the terms, “stereotactic,” “SRS,” “stereotactic radiotherapy,” “stereotactic body radiotherapy,” “SBRT,” “stereotactic ablative radiotherapy,” “economic evaluation,” “quality adjusted life year (QALY),” “cost,” “cost-effectiveness,” “cost-utility,” and “cost analysis,” published studies of cost-effectiveness and health economics were obtained. Included were articles in peer-reviewed journals that presented a comparison of costs between treatment alternatives from January 1997 to November 2012. Papers were excluded if they did not present cost calculations, therapeutic cost comparisons, or health economic endpoints.Results: Clinical outcomes and costs of SRS and SBRT were compared to other therapies for treatment of cancer in the brain, spine, lung, prostate, and pancreas. Treatment outcomes for SRS and SBRT are usually superior or comparable, and cost-effective, relative to alternative techniques.Conclusion: Based on the review of current SRS and SBRT clinical and health economic literature, from a patient perspective, SRS and SBRT provide patients a clinically effective treatment option, while from the payer and provider perspective, SRS and SBRT demonstrate cost savings.

Stereotactic body radiotherapy: A critical review for nonradiation oncologists

“…The relative cost-effectiveness of SBRT is an issue. [132][133][134][135] Clearly, the conclusion depends on the technique to which is SBRT is compared. For example, in spinal SBRT a single 8-Gy fraction delivered via 2 opposed fields will clearly have a lower treatment cost than SBRT.…”

The role of radiotherapy in bone metastases: A critical review of current literature

“…Despite these encouraging results, to date there are no phase III studies available to define the role of SBRT for bone metastases compared to conventional radiation techniques. Moreover, according to cos‐effectiveness studies, SBRT provides similar efficacy with EBRT, but with a higher cost (Bijlani, Aguzzi, Schaal & Romanelli, ; Haley et al., ). The latter emerge the necessity of targeting patients which may most benefit by the SBRT.…”

SBRT and extreme hypofractionation: A new era in prostate cancer treatments?

“…Nevertheless, many studies have concluded that SBRT is cost effective, as it allows a better organ sparing and dose escalation on the target volume, and they are also cost saving. [19][20][21] Although SBRT in PC could not be considered yet a standard option, due to the small number of patients treated worldwide and the relatively short follow-up of most of the published experiences, its preliminary results are promising and SBRT adoption is rapidly increasing in the radiation oncology departments. 1, 18,22 Moreover, technological innovations should not replace the clinical aspects of PC, and indications for SBRT should be reserved to those patients who would really benefit from this treatment.…”