Table 3.
Cost effectiveness of hypofractionation and SBRT versus conventional radiotherapy
| Study | Country | Study details | Economic evaluation |
|---|---|---|---|
| Hodges et al.125 (2012) | USA | Cost–utility; 10-year time horizon; IMRT vs SBRT | Cost per treatment: SBRT US$ 22,152, IMRT US$ 35,431; mean QALY of 7.9 for both modalities |
| Parthan et al.126 (2012) | USA | Cost–utility; lifetime time horizon; IMRT vs protons vs SBRT | Lifetime cost: SBRT US$ 25,097, IMRT US$ 35,088, proton therapy US$ 71,657; SBRT strongly dominates IMRT and protons |
| Sher et al.124 (2014) | USA | Cost–utility; lifetime time horizon; IMRT vs SBRT | ICER (per QALY): robotic SBRT vs IMRT US$ –285,000, non-robotic SBRT vs IMRT US$ –591,100 |
| Sharieff et al.123 (2016) | Canada | Cost–utility; lifetime time horizon (20 years); IMRT vs HF-IMRT vs SBRT (Robotic vs LINAC vs arc-based) | Cost per QALY (fixed arc-LINAC based): conventional CAD$ 5,935–7,992, HF-IMRT CAD$ 4,956–6,462, SBRT CAD$ 4,368–6,333 |
| Voong et al.122 (2017) | USA | Cost-minimization; lifetime time horizon; IMRT vs HF-IMRT | Cost per treatment: IMRT US$ 30,241, HF-IMRT US$ 22,957 |
| Zemplenyi et al.121 (2018) | Hungary | Cost–utility; 10-year time horizon; 3D-CRT vs IMRT vs HF-IMRT | ICER (per QALY): IMRT vs 3D-CRT €–1,624, HF-IMRT vs 3DCRT €–5,600; both strongly dominating |
3D-CRT, three-dimensional conformal radiotherapy; HF-IMRT, hypofractionated intensity-modulated radiotherapy; ICER, incremental cost effectiveness ratio; IMRT, intensity-modulated radiotherapy; LINAC, linear accelerator; QALY, quality-adjusted life year; SBRT, stereotactic body radiotherapy.