title: The technique and cost of radiosurgery for the treatment of 1-3 brain metastases.
abstract: BACKGROUND
  Radiosurgery can be delivered through a variety of modalities including robotic and fixed gantry Linac-based systems. They appear equally effective and safe. Thus, community need and costs remain the main determinants for choosing a given modality. We performed an economic evaluation to identify settings in which one modality could be preferred over the other.
  
  
  METHODS
  Using local estimates of resource volumes and unit prices, we computed the incremental cost/patient of robotic radiosurgery compared to fixed-gantry radiosurgery from a payer's perspective. By varying parameters of resource volumes, we performed a probabilistic analysis stratified by number of brain lesions. in addition, we performed sensitivity analyses to examine the effect of patient volume on cost/patient.
  
  
  RESULTS
  The cost of robotic radiosurgery was $4,783/patient, and cost of fixed-gantry radiosurgery was $5,166/patient. The mean incremental cost was $-383 (95% interval: $-670, $110) for all lesions, $78 ($23, $123) for solitary lesions, and $-610 ($-679, $-534) for multiple lesions. The cost/patient of robotic radiosurgery varied from $5,656 (low volume setting) to $4,492 (high volume setting).
  
  
  CONCLUSIONS
  in settings of moderate to high volume (6-10 hours of daily operation), and in multiple lesions, robotic radiosurgery is more cost effective than fixed-gantry radiosurgery.
  
  
  
  Technique utilisée et coût de la radiochirurgie pour le traitement de 1 à 3 métastases cérébrales.
authors.forename: Waseem
authors.initials: W
authors.lastname: Sharieff
authors.forename: Anthony
authors.initials: A
authors.lastname: Whitton
authors.forename: Tom
authors.initials: T
authors.lastname: Chow
authors.forename: Doug
authors.initials: D
authors.lastname: Wyman
authors.forename: James
authors.initials: J
authors.lastname: Wright
authors.forename: Jeffrey N
authors.initials: JN
authors.lastname: Greenspoon
mesh_terms: D001921:Brain; D001932:Brain Neoplasms / Q000601:surgery; D003362:Cost-Benefit Analysis; D006801:Humans; D016634:Radiosurgery; D016896:Treatment Outcome