Cost-Effectiveness Analysis of Stereotactic Body Radiation Therapy Compared With Radiofrequency Ablation for Inoperable Colorectal Liver Metastases

摘要: Purpose To conduct a cost-effectiveness analysis to determine whether stereotactic body radiation therapy (SBRT) is cost-effective compared with radiofrequency ablation (RFA) for patients unresectable colorectal cancer (CRC) liver metastases. Methods and Materials A was conducted using Markov model 1-month cycle over lifetime horizon. Transition probabilities, quality of life utilities, costs associated SBRT RFA were captured in the on basis comprehensive literature review Medicare reimbursements 2014. Strategies incremental ratio, effectiveness measured quality-adjusted years (QALYs). To account uncertainty, 1-way probabilistic sensitivity analyses performed. evaluated willingness-to-pay threshold $100,000 per QALY gained. Results In base case analysis, treatment 3 fractions 1 procedure $13,000 $4397, respectively. Median survival assumed same both strategies (25 months). The $8202 more than while gaining 0.05 QALYs, resulting an ratio $164,660 analyses, results most sensitive variation median from treatments. Stereotactic economically reasonable if better presumed (>1 month gain) or used large tumors (>4 cm). Conclusions If equal assumed, not inoperable However, local control leads small gains SBRT, this strategy becomes cost-effective. Ideally, these should be confirmed prospective comparative data.