Stereotactic radiation surgery and stereotactic body radiation therapy
Over the past ten years, significant advances have been made in the techniques available to deliver EBRT including stereotactic radiation surgery (SRS) limited to the central nervous system and a single dose, stereotactic body radiation therapy (SBRT), intensity modulated radiation therapy (IMRT), and proton or particle beam radiation therapy. For SRS and SBRT, the technical goals are to 1) improve the targeting of the radiation to the tumor to minimize damage of normal tissue and 2) increase the dose of radiation (fraction) delivered to improve outcomes and decrease the number of fractions (doses) and length of treatment.
These topics were first reviewed by the HTCC in 2012.
- In 2022, the HCA director selected SBRT for rereview based on newly available published evidence that could change the original coverage decision.
Status: Decision complete
Why are SRS/SBRT being reviewed?
There is increasing use of SRS/SBRT for a variety of cancers. The impact of this technology on patient-important outcomes compared to current conventional (coronal or standard) EBRT is unclear.
Primary criteria ranking
- Safety = Medium
- Efficacy = High
- Cost = High
Documentation
| Type | Materials |
|---|---|
| Current final determinations |
Stereotactic body radiation therapy for localized prostate cancer, non-small cell and small cell lung cancer, renal cancer, pancreatic adenocarcinoma, oligometastatic disease, hepatocellular carcinoma, and cholangiocarcinoma Stereotactic radiation surgery and SBRT for cancers of spine/paraspinal structures |
| Assessment (2023) | |
| Update literature (2022) | |
| Update literature (2018) | |
| Update literature (2017) | |
| Assessment (2012) |
Assessment timeline
- Draft key questions published: July 27, 2022
- Public comment period: July 27 to August 12, 2022
- Final key questions published: September 21, 2022
- Draft report published: February 15, 2023
- Public comment period: February 15 to March 16, 2023
- Final report published: April 12, 2023
- HTCC public meeting: May 19, 2023
- HTCC public meeting (continued): June 23, 2023
- Draft findings and decision published: June 30 2023
- Public comment period: June 30 to July 14, 2023
- Final findings and decision published: July 27, 2023