A comparative cost analysis suggests single-fraction spine stereotactic radiosurgery is associated with lower total resource utilization among other radiation therapy (RT) options, according to recent research.
“We quantified institutional costs associated with RT for spinal metastases, using a time-driven activity-based costing model,” wrote David Boyce-Fappiano, MD, of the University of Texas MD Anderson Cancer Center, Houston, and colleagues. Their report is in the Journal of Oncology Practice.
The researchers compared resource utilization across four common RT regimens: single-fraction spine stereotactic radiosurgery (to 18 Gy), 3-fraction spine stereotactic radiosurgery (to 27 Gy), 10-fraction three-dimensional RT (3D-RT) (to 30 Gy), and 10-fraction intensity-modulated RT (IMRT) (to 30 Gy).
The analysis framework involved the creation of both process maps and process times, which included a detailed outline to map the complete clinical care process, while expert panel interviews were used to establish process times.
Other measures, such as the capacity cost rate, were calculated for each resource, and subsequently used to estimate total costs.
After analysis, the researchers found that across the four RT regimens, full-cycle care costs for single-fraction spine stereotactic radiosurgery were 17% less and 17% more than IMRT and 3D-RT, respectively. However, technical costs for IMRT were 50% and 77% more than 3-fraction and single-fraction SSRS, respectively.
Overall, the analysis “supports the institutional resource efficiency of single-fraction stereotactic radiosurgery for spinal metastases,” Dr. Boyce-Fappiano and associates said.
One key limitation of the analysis was the single-center design of the study. As a result, the findings may not be applicable to all clinical settings.
“Additional research can incorporate these data alongside toxicity and retreatment rates to evaluate the long-term cost effectiveness of spine stereotactic radiosurgery over a full cycle of care,” they concluded.
No funding sources were reported in the manuscript. The authors reported financial affiliations with AbbVie, AstraZeneca, Boston Scientific, Bristol-Myers Squibb BTG, Coleman Consulting, US Oncology, Oscar Health, RefleXion Medical, and several others.
SOURCE: Boyce-Fappiano D et al. J Oncol Pract. 2019 Nov 25. doi: 10.1200/JOP.19.00480.