{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T07:14:01Z","timestamp":1788506041279,"version":"build-2803163510"},"reference-count":27,"publisher":"Springer Science and Business Media LLC","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,9,3]]},"DOI":"10.7759\/cureus.115754","type":"journal-article","created":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T06:47:54Z","timestamp":1788504474000},"source":"Crossref","is-referenced-by-count":0,"title":["Comparative Cost Modeling of Out-of-Pocket Costs for External Beam Radiation Therapy Versus Stereotactic Body Radiation Therapy in Metastatic Spine Cancer"],"prefix":"10.7759","author":[{"given":"Victoria","family":"Wu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martha","family":"Khlopin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shearwood","family":"McClelland III","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1038\/nrc867","article-title":"Metastasis to bone: causes, consequences and therapeutic opportunities","volume":"2","author":"Mundy GR","year":"2002","unstructured":"Mundy GR. Metastasis to bone: causes, consequences and therapeutic opportunities. Nat Rev Cancer. 2002, 2:584-93. 10.1038\/nrc867","journal-title":"Nat Rev Cancer"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1177\/2192568217694016","article-title":"Spine sterotactic body radiotherapy: indications, outcomes, and points of caution","volume":"7","author":"Tseng CL","year":"2017","unstructured":"Tseng CL, Eppinga W, Charest-Morin R, et al.. Spine sterotactic body radiotherapy: indications, outcomes, and points of caution. Global Spine J. 2017, 7:179-97. 10.1177\/2192568217694016","journal-title":"Global Spine J"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbo.2022.100446","article-title":"Epidemiology of spinal metastases, metastatic epidural spinal cord compression and pathologic vertebral compression fractures in patients with solid tumors: a systematic review","volume":"35","author":"Van den Brande R","year":"2022","unstructured":"Van den Brande R, Cornips EM, Peeters M, Ost P, Billiet C, Van de Kelft E. Epidemiology of spinal metastases, metastatic epidural spinal cord compression and pathologic vertebral compression fractures in patients with solid tumors: a systematic review. J Bone Oncol. 2022, 35:100446. 10.1016\/j.jbo.2022.100446","journal-title":"J Bone Oncol"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2020.09.019","article-title":"CCTG SC.24\/TROG 17.06: a randomized phase II\/III study comparing 24Gy in 2 stereotactic body radiotherapy (SBRT) fractions versus 20Gy in 5 conventional palliative radiotherapy (CRT) fractions for patients with painful spinal metastases","volume":"108","author":"Sahgal A","year":"2020","unstructured":"Sahgal A, Myrehaug SD, Siva S, et al.. CCTG SC.24\/TROG 17.06: a randomized phase II\/III study comparing 24Gy in 2 stereotactic body radiotherapy (SBRT) fractions versus 20Gy in 5 conventional palliative radiotherapy (CRT) fractions for patients with painful spinal metastases. Int J Radiat Oncol Biol Phys. 2020, 108:1397-8. 10.1016\/j.ijrobp.2020.09.019","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1016\/j.jocn.2017.08.007","article-title":"Spinal stereotactic body radiotherapy in the United States: a decade-long nationwide analysis of patient demographics, practice patterns, and trends over time","volume":"46","author":"McClelland S 3rd","year":"2017","unstructured":"McClelland S 3rd, Kim E, Passias PG, Murphy JD, Attia A, Jaboin JJ. Spinal stereotactic body radiotherapy in the United States: a decade-long nationwide analysis of patient demographics, practice patterns, and trends over time. J Clin Neurosci. 2017, 46:109-12. 10.1016\/j.jocn.2017.08.007","journal-title":"J Clin Neurosci"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1097\/COC.0000000000001091","article-title":"Early experience with two-fraction spine stereotactic body radiation therapy in treating spinal metastases","volume":"47","author":"Ekpunobi IO","year":"2024","unstructured":"Ekpunobi IO, McClelland S 3rd. Early experience with two-fraction spine stereotactic body radiation therapy in treating spinal metastases. Am J Clin Oncol. 2024, 47:289-90. 10.1097\/COC.0000000000001091","journal-title":"Am J Clin Oncol"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(21)00196-0","article-title":"Stereotactic body radiotherapy versus conventional external beam radiotherapy in patients with painful spinal metastases: an open-label, multicentre, randomised, controlled, phase 2\/3 trial","volume":"22","author":"Sahgal A","year":"2021","unstructured":"Sahgal A, Myrehaug SD, Siva S, et al.. Stereotactic body radiotherapy versus conventional external beam radiotherapy in patients with painful spinal metastases: an open-label, multicentre, randomised, controlled, phase 2\/3 trial. Lancet Oncol. 2021, 22:1023-33. 10.1016\/S1470-2045(21)00196-0","journal-title":"Lancet Oncol"},{"key":"ref8","unstructured":"NCCN central nervous system cancers guidelines. (2024). Accessed. September 2026: https:\/\/www.nccn.org\/guidelines\/guidelines-detail."},{"key":"ref9","unstructured":"CPT overview and code approval. (2023). Accessed. September 2026: https:\/\/seed.nih.gov\/sites\/default\/files\/2023-09\/CPT-Codes-Presentation.pdf."},{"key":"ref10","unstructured":"Healthcare Common Procedure Coding System (HCPCS). (2023). Accessed. September 2026: https:\/\/www.cms.gov\/medicare\/coding-billing\/healthcare-common-procedure-system."},{"key":"ref11","unstructured":"The Ohio Department of Medicaid. (2023). Accessed. September 2026: https:\/\/medicaid.ohio.gov\/."},{"key":"ref12","unstructured":"Overview of the Medicare physician fee schedule. (2026). Accessed. September 2026: https:\/\/www.cms.gov\/medicare\/payment\/fee-schedules\/physician."},{"key":"ref13","unstructured":"AARP medicare plans. Medicare plan drug cost estimator. (2026). Accessed: September 2026: https:\/\/www.aarpmedicareplans.com\/health-plans\/estimate-drug-costs.html."},{"key":"ref14","unstructured":"What\u2019s Medicare?. (2023). Accessed. February 25, 2023: https:\/\/www.medicare.gov\/about-us."},{"key":"ref15","unstructured":"How original Medicare works. (2023). Accessed. February 25, 2023: https:\/\/www.medicare.gov\/providers-services\/original-medicare."},{"key":"ref16","unstructured":"What's Medicare Supplement Insurance (Medigap)?. (2023). Accessed. September 2026: https:\/\/www.medicare.gov\/health-drug-plans\/medigap."},{"key":"ref17","unstructured":"Medicare statistics 2024. (2024). Accessed. August 29, 2026: https:\/\/www.medicareadvantage.com\/resources\/medicare-statistics."},{"key":"ref18","unstructured":"Medicaid primer. (2025). Accessed. August 29, 2026: https:\/\/www.congress.gov\/crs_external_products\/IF\/HTML\/IF10322.html."},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1016\/j.prro.2021.12.012","article-title":"Cost-effectiveness of treatment strategies for spinal metastases","volume":"12","author":"Kowalchuk RO","year":"2022","unstructured":"Kowalchuk RO, Mullikin TC, Kim DK, et al.. Cost-effectiveness of treatment strategies for spinal metastases. Pract Radiat Oncol. 2022, 12:236-44. 10.1016\/j.prro.2021.12.012","journal-title":"Pract Radiat Oncol"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.5603\/rpor.101991","article-title":"An inpatient metastatic spine neoplasm score for assessing the appropriate modality of radiation therapy intervention","volume":"29","author":"McClelland S 3rd","year":"2024","unstructured":"McClelland S 3rd. An inpatient metastatic spine neoplasm score for assessing the appropriate modality of radiation therapy intervention. Rep Pract Oncol Radiother. 2024, 29:527-9. 10.5603\/rpor.101991","journal-title":"Rep Pract Oncol Radiother"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2023.109969","article-title":"Efficacy and safety of SBRT for spine metastases: a systematic review and meta-analysis for preparation of an ESTRO practice guideline","volume":"190","author":"Guninski RS","year":"2024","unstructured":"Guninski RS, Cuccia F, Alongi F, et al.. Efficacy and safety of SBRT for spine metastases: a systematic review and meta-analysis for preparation of an ESTRO practice guideline. Radiother Oncol. 2024, 190:109969. 10.1016\/j.radonc.2023.109969","journal-title":"Radiother Oncol"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.1016\/j.prro.2021.07.004","article-title":"A volumetric dosimetry analysis of vertebral body fracture risk after single fraction spine stereotactic body radiation therapy","volume":"11","author":"Lee MY","year":"2021","unstructured":"Lee MY, Ouyang Z, LaHurd D, et al.. A volumetric dosimetry analysis of vertebral body fracture risk after single fraction spine stereotactic body radiation therapy. Pract Radiat Oncol. 2021, 11:480-7. 10.1016\/j.prro.2021.07.004","journal-title":"Pract Radiat Oncol"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2013.50.1411","article-title":"Vertebral compression fracture after spine stereotactic body radiotherapy: a multi-institutional analysis with a focus on radiation dose and the spinal instability neoplastic score","volume":"31","author":"Sahgal A","year":"2013","unstructured":"Sahgal A, Atenafu EG, Chao S, et al.. Vertebral compression fracture after spine stereotactic body radiotherapy: a multi-institutional analysis with a focus on radiation dose and the spinal instability neoplastic score. J Clin Oncol. 2013, 31:3426-31. 10.1200\/JCO.2013.50.1411","journal-title":"J Clin Oncol"},{"key":"ref24","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2014.10.055","article-title":"Cost-effectiveness analysis of single fraction of stereotactic body radiation therapy compared with single fraction of external beam radiation therapy for palliation of vertebral bone metastases","volume":"91","author":"Kim H","year":"2015","unstructured":"Kim H, Rajagopalan MS, Beriwal S, Huq MS, Smith KJ. Cost-effectiveness analysis of single fraction of stereotactic body radiation therapy compared with single fraction of external beam radiation therapy for palliation of vertebral bone metastases. Int J Radiat Oncol Biol Phys. 2015, 91:556-63. 10.1016\/j.ijrobp.2014.10.055","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"ref25","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2023.12.052","article-title":"An economic analysis of SC24 in Canada: a randomized study of SBRT compared with conventional palliative RT for spinal metastases","volume":"119","author":"Kerba M","year":"2024","unstructured":"Kerba M, Lourenco RA, Sahgal A, et al.. An economic analysis of SC24 in Canada: a randomized study of SBRT compared with conventional palliative RT for spinal metastases. Int J Radiat Oncol Biol Phys. 2024, 119:1061-8. 10.1016\/j.ijrobp.2023.12.052","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"ref26","doi-asserted-by":"publisher","DOI":"10.5603\/RPOR.a2023.0037","article-title":"Spine Patient Optimal Radiosurgery Treatment for Symptomatic Metastatic Neoplasms (SPORTSMEN): a randomized phase II study protocol","volume":"28","author":"McClelland S 3rd","year":"2023","unstructured":"McClelland S 3rd, Sun Y, Spratt DE. Spine Patient Optimal Radiosurgery Treatment for Symptomatic Metastatic Neoplasms (SPORTSMEN): a randomized phase II study protocol. Rep Pract Oncol Radiother. 2023, 28:379-88. 10.5603\/RPOR.a2023.0037","journal-title":"Rep Pract Oncol Radiother"},{"key":"ref27","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2022.05.043","article-title":"Mature local control and reirradiation rates comparing spine stereotactic body radiation therapy with conventional palliative external beam radiation therapy","volume":"114","author":"Zeng KL","year":"2022","unstructured":"Zeng KL, Myrehaug S, Soliman H, et al.. Mature local control and reirradiation rates comparing spine stereotactic body radiation therapy with conventional palliative external beam radiation therapy. Int J Radiat Oncol Biol Phys. 2022, 114:293-300. 10.1016\/j.ijrobp.2022.05.043","journal-title":"Int J Radiat Oncol Biol Phys"}],"container-title":["Cureus"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cureus.com\/articles\/379322-comparative-cost-modeling-of-out-of-pocket-costs-for-external-beam-radiation-therapy-versus-stereotactic-body-radiation-therapy-in-metastatic-spine-cancer","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T06:47:55Z","timestamp":1788504475000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cureus.com\/articles\/379322-comparative-cost-modeling-of-out-of-pocket-costs-for-external-beam-radiation-therapy-versus-stereotactic-body-radiation-therapy-in-metastatic-spine-cancer"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,3]]},"references-count":27,"URL":"https:\/\/doi.org\/10.7759\/cureus.115754","relation":{},"ISSN":["2168-8184"],"issn-type":[{"value":"2168-8184","type":"print"}],"subject":[],"published":{"date-parts":[[2026,9,3]]}}}