I know that Medicare covers SBRT, but some private insurers consider it experimental even though there is 6 years of data. Their refusal makes even less sense to me because the cost is about
half of IMRT. Go figure!
Last year ASTRO (American Society of Radiation Oncologists) endorsed SBRT. NCCN just gave it a cautious endorsement in their new physician guidelines (Version 1.2014):
Extremely hypofractionated image-guided IMRT/SBRT (6.5 Gy per fraction or greater) are an emerging treatment modality with single institutional and pooled reports of similar efficacy and toxicity to conventionally fractionated regimens. They can be considered as a cautious alternative to conventionally fractionated regimens at clinics with appropriate technology, physics, and clinical expertise." (PROS D 1 of 2)
So if your insurance company has turned it down, you may want to resubmit/appeal with this new information.
Allen - not an MD
•PSA=7.3, prostate volume=55cc, 8/17 cores G6 5-35% involvement
•SBRT 6 year results
treated 10/2010 at age 57 at UCLA
•PSA since treatment:
1/11:3.9 5/11:3.0 8/11:3.7 5/12:1.2 9/12:1.3 5/13:0.4
• SEs of treatment:
after 2 wks: mild urinary & rectal - last 1 wk
1 yr after: mild urinary - last 2 months