Cost-effectiveness of stereotactic body radiotherapy in the treatment of non-small-cell lung cancer (NSCLC): a systematic review

Expert Rev Pharmacoecon Outcomes Res. 2022 Jul;22(5):723-734. doi: 10.1080/14737167.2022.2050217. Epub 2022 Mar 10.

Abstract

Objectives: This study aims to systematically review the studies on the cost-effectiveness of stereotactic body radiotherapy (SBRT) in the treatment of non-small-cell lung cancer (NSCLC).

Methods: A systematic literature search was performed in databases from 2000 through April 2021. The search terms included 'economics,' 'cost,' 'cost effectiveness,' 'SBRT,' and all names for NSCLC. Two reviewers independently screened the titles, abstracts and full texts to determine the studies for the final sample. The quality of the included studies was assessed using the Quality of Health Economic Studies checklist.

Results: Eleven studies were identified and included in our final review. SBRT was reported to be a cost-effective (5 of 5) option compared to conventional radiotherapy, radiofrequency ablation, and best supportive care for medically inoperable, early-stage NSCLC. However, the identified studies revealed that no single treatment was found to be more cost-effective than others between SBRT and surgical interventions. The key drivers of this cost-effectiveness were the cost of the treatment, utility value, and the rate of surgical mortality.

Conclusions: SBRT may be considered a more cost-effective strategy for medically inoperable, early-stage NSCLC. Considering the limited studies available, more related research should be conducted to further validate these results.

Keywords: Non-small cell lung cancer; cost-effectiveness; stereotactic ablative body radiotherapy; systematic review.

Publication types

  • Systematic Review

MeSH terms

  • Carcinoma, Non-Small-Cell Lung* / radiotherapy
  • Carcinoma, Non-Small-Cell Lung* / surgery
  • Cost-Benefit Analysis
  • Humans
  • Lung Neoplasms* / radiotherapy
  • Lung Neoplasms* / surgery
  • Neoplasm Staging
  • Radiosurgery*
  • Small Cell Lung Carcinoma*