The micro-simulation study entitled “Cost-effectiveness of stereotactic body radiation therapy versus video assisted thoracic surgery in medically operable stage I non-small cell lung cancer: A modeling study” has been published in Lung Cancer.

This study aimed to asses how the choice between stereotactic body radiation therapy (SBRT) and video assisted thoracic surgery (VATS) affects a patients prognosis and quality of life, and how much this costs.

Historically, only patients that are not fit enough to be eligible for surgery were considered for radiotherapy. Because of medical advancements in this field, techniques such as SBRT give comparable results as surgery. However, the patients that are selected for SBRT are still less healthy on average, which is considered selection bias.

Obtained clinical data was therefore propensity score matched and a microsimulation model with underlying tumour growth was developed to predict how two identical groups of patients would be affected by their treatment choice.

The presented findings show that the difference between SBRT and VATS in terms of QALYs is small. However, VATS results in a larger proportion of patients that are hospitalized or die after treatment because of complications, which makes VATS surgery more expensive and less effective.