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: Review in progress

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

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

 

All future dates are estimates and subject to change.