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Stereotactic Body Radiotherapy for Oligometastatic Cancer: A Review of Clinical Effectiveness and Cost-Effectiveness

Last updated: February 6, 2019
Project Number: RC1071-000
Product Line: Rapid Response
Research Type: Devices and Systems
Report Type: Summary with Critical Appraisal
Result type: Report

Question

  1. What is the clinical effectiveness of stereotactic body (or stereotactic ablative) radiotherapy for the treatment of oligometastatic cancer?
  2. What is the cost effectiveness of stereotactic body (or stereotactic ablative) radiotherapy for the treatment of oligometastatic cancer?

Key Message

Clinical evidence of limited quality from three retrospective cohort studies involving patients with oligometastatic cancer suggest that the use of stereotactic body (ablative) radiotherapy may not improve overall survival rates compared to other cancer treatments. No evidence of a difference was found between stereotactic ablative radiotherapy and other cancer treatments for progression-free survival, freedom from failure of local strategy or freedom from local progression. One study found real-time tumor-tracking radiotherapy was significantly more effective than stereotactic body radiotherapy for local control of adrenal metastasis in patients with oligometastasis, but the stereotactic body radiotherapy patients had fewer adverse events (zero versus four events).One relevant cost-effectiveness study was identified on the use of stereotactic body radiotherapy for patients with oligometastatic cancer. This study found that stereotactic body radiotherapy and video-assisted thoracic surgery wedge resection may be cost-effective in select patients with pulmonary oligometastases; effectiveness of either treatment option depended on histology, efficacy, and tolerability of the treatment as well as patient preferences.Given the limited availability and low quality evidence, the effectiveness and use of stereotactic ablative radiotherapy for oligometastatic cancer remains uncertain.