Cost-Effectiveness of Stereotactic Radiosurgery and Stereotactic Body Radiation Therapy in Treating Brain Metastases.

ABSTRACT

Single-fraction stereotactic radiosurgery (SRS) is a highly used tool in managing brain metastases, alongside its multifraction counterpart - stereotactic body radiation therapy (SBRT). These radiation therapy techniques have been associated with excellent clinical outcomes, such as decreased local recurrence, increased survival, and improved palliative effects. However, present literature concerning the cost-effectiveness of these techniques remain scarce. Based on the current procedure terminology codes involving services provided during radiation consultation, treatment, and follow-up in our institution, 3-fraction SBRT with a 3-dimensional plan and intensity modulated radiation therapy cost 27% and 17% more than SRS, respectively. A 32% and 34% price increase can, respectively, be seen in 5-fraction SBRT with 3-dimensional plan and intensity modulated radiation therapy delivery sessions relative to 3-fraction SBRT administration. Cost savings between these procedures were associated with the radiation therapy delivery sessions instead of the treatment planning process. These analyses indicate that SRS appears to be a less expensive and time-intensive option than SBRT in our institution. However, additional comparative analyses regarding SRS and SBRT are needed to explore the clinical and financial benefits of these radiation therapy techniques.