The Role of Stereotactic Radiosurgery in the Management of Brain Metastases From a Health-Economic Perspective: A Systematic Review.

Abstract:

BACKGROUND:Stereotactic radiosurgery (SRS) is an effective option in the management of brain metastases, offering improved overall survival to whole-brain radiation therapy (WBRT). However, given the need for active surveillance and the possibility of repeated interventions for local/distant brain recurrences, the balance between clinical benefit and economic impact must be evaluated. OBJECTIVE:To conduct a systematic review of health-economic analyses of SRS for brain metastases, compared with other existing intervention options, to determine the cost-effectiveness of this treatment across different clinical scenarios. METHODS:The MEDLINE, EMBASE, Cochrane, CRD, and EconLit databases were searched for health-economic analyses, according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, using terms relevant to brain metastases and radiation-based therapies. Simple cost analysis studies were excluded. Quality analysis was based on BMJ Consolidated Health Economics Reporting Standards (CHEERS) checklist. RESULTS:Eleven eligible studies were identified. For lesions with limited mass effect, SRS was more cost-effective than surgical resection (6 studies). In patients with Karnofsky performance scale (KPS) >70 and good predicted survival, SRS was cost-effective compared to WBRT (7 studies); WBRT became cost-effective with poor performance status or low anticipated life span. Following SRS, routine magnetic resonance imaging surveillance saved $1326/patient compared to symptomatic imaging due to reduced surgical salvage and hospital stay (1 study). CONCLUSION:Based on our findings, SRS is cost-effective in the management of brain metastases, particularly in high-functioning patients with longer expected survival. However, before an optimal care pathway can be proposed, emerging factors such as tumor molecular subtype, diagnosis-specific graded prognostic assessment, neuroprognostic score, tailored surveillance imaging, and patient utilities need to be studied in greater detail.

journal_name

Neurosurgery

journal_title

Neurosurgery

authors

Warsi NM,Karmur BS,Brar K,Moraes FY,Tsang DS,Laperriere N,Kondziolka D,Mansouri A

doi

10.1093/neuros/nyaa075

subject

Has Abstract

pub_date

2020-09-01 00:00:00

pages

484-497

issue

3

eissn

0148-396X

issn

1524-4040

pii

5823788

journal_volume

87

pub_type

杂志文章
  • Clinical role of magnetic resonance imaging in the neurosurgical patient.

    abstract::The results of magnetic resonance (MR) evaluation in 18 patients with common neurosurgical problems, including cerebrovascular lesions, intracranial tumors, and craniovertebral junction pathological conditions, are presented. The results are compared with those of routine diagnostic studies. Overall, MR imaging was eq...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:

    authors: Spetzler RF,Zabramski JM,Kaufman B

    更新日期:1985-04-01 00:00:00

  • Design and Physical Properties of 3-Dimensional Printed Models Used for Neurointervention: A Systematic Review of the Literature.

    abstract:BACKGROUND:Three-dimensional (3D) printing has revolutionized training, education, and device testing. Understanding the design and physical properties of 3D-printed models is important. OBJECTIVE:To systematically review the design, physical properties, accuracy, and experimental outcomes of 3D-printed vascular model...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1093/neuros/nyaa134

    authors: Waqas M,Mokin M,Lim J,Vakharia K,Springer ME,Meess KM,Ducharme RW,Ionita CN,Nagesh SVS,Gutierrez LC,Snyder KV,Davies JM,Levy EI,Siddiqui AH

    更新日期:2020-09-15 00:00:00

  • Superior Prognostic Value of Cumulative Intracranial Tumor Volume Relative to Largest Intracranial Tumor Volume for Stereotactic Radiosurgery-Treated Brain Metastasis Patients.

    abstract:BACKGROUND:Two intracranial tumor volume variables have been shown to prognosticate survival of stereotactic-radiosurgery-treated brain metastasis patients: the largest intracranial tumor volume (LITV) and the cumulative intracranial tumor volume (CITV). OBJECTIVE:To determine whether the prognostic value of the Score...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1093/neuros/nyx225

    authors: Hirshman BR,Wilson B,Ali MA,Proudfoot JA,Koiso T,Nagano O,Carter BS,Serizawa T,Yamamoto M,Chen CC

    更新日期:2018-04-01 00:00:00

  • Effects of cytokines on cultured microvascular endothelial cells derived from gerbil brain.

    abstract::Microvascular endothelial cells were isolated from gerbil brain and cultured. These cells retained an endothelial-specific marker, FVIII-related antigen. Alkaline phosphatase activity was also present in early passage. Two weeks after plating, these cells were attached to the culture dishes and had become like cobbles...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1097/00006123-198909000-00009

    authors: Yoshida S,Minakawa T,Takai N,Tanaka R

    更新日期:1989-09-01 00:00:00

  • Infantile chronic subdural hematoma with local protrusion of the skull in a case of osteogenesis imperfecta.

    abstract::Osteogenesis imperfecta with infantile chronic subdural hematoma is extremely rare and has not been previously described in the literature. Our patient was a baby girl suffering from osteogenesis imperfecta tarda (Type I) who had an acute subdural hematoma at birth and who developed a progressive chronic subdural hema...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/00006123-198803000-00029

    authors: Tokoro K,Nakajima F,Yamataki A

    更新日期:1988-03-01 00:00:00

  • The dorsolateral, suboccipital, transcondylar approach to the lower clivus and anterior portion of the craniocervical junction.

    abstract::The authors review their experience with a dorsolateral approach to the anterior rim of the foramen magnum and adjacent region. The operative technique includes exposure of the vertebral artery at C1, partial resection of the occipital condyle and lateral atlantal mass, and extradural drilling of the jugular tubercle....

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1097/00006123-199112000-00002

    authors: Bertalanffy H,Seeger W

    更新日期:1991-12-01 00:00:00

  • Cerebral arterial revascularization: the value of repeated angiography in selection of patients for operation.

    abstract::Three patients with occlusive cerebrovascular disease were evaluated for possible extracranial-intracranial arterial anastomosis. Cerebral angiography repeated at a later date revealed disappearance of the initial vascular stenosis or occlusion and development of extensive collateral circulation. It was concluded in t...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/00006123-197805000-00003

    authors: Fox JL

    更新日期:1978-05-01 00:00:00

  • Endoscopic extradural anterior clinoidectomy via supraorbital keyhole: a cadaveric study.

    abstract:BACKGROUND:Anterior clinoidectomy is an essential preliminary step for parasellar and pericavernous sinus surgery. Endoscopy is a widely accepted modality for neurosurgical strategies and is becoming more important in treating conditions involving the cranial base. OBJECTIVE:To determine the feasibility of endoscopic ...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/NEU.0b013e31821144e5

    authors: Komatsu F,Komatsu M,Inoue T,Tschabitscher M

    更新日期:2011-06-01 00:00:00

  • Prediction of obliteration after gamma knife surgery for cerebral arteriovenous malformations.

    abstract:OBJECTIVE:To define the factors of importance for the obliteration of cerebral arteriovenous malformations (AVMs), thus making a prediction of the probability for obliteration possible. METHODS:In 945 AVMs of a series of 1319 patients treated with the gamma knife during 1970 to 1990, the relationship between patient, ...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1097/00006123-199703000-00001

    authors: Karlsson B,Lindquist C,Steiner L

    更新日期:1997-03-01 00:00:00

  • The juxtaposition of a capillary telangiectasia, cavernous malformation, and developmental venous anomaly in the brainstem of a single patient: case report.

    abstract:OBJECTIVE AND IMPORTANCE:Capillary telangiectasias, cavernous malformations, and developmental venous anomalies are all vascular malformations that occur on the capillary-venous side of the cerebral circulation. The associations of capillary telangiectasias with venous malformations, cavernous malformations with venous...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1097/00006123-200111000-00044

    authors: Clatterbuck RE,Elmací I,Rigamonti D

    更新日期:2001-11-01 00:00:00

  • Haptoglobin 2-2 Genotype Is Associated With Cerebral Salt Wasting Syndrome in Aneurysmal Subarachnoid Hemorrhage.

    abstract:BACKGROUND:Haptoglobin (Hp) genotype has been shown to be a predictor of clinical outcomes in subarachnoid hemorrhage. Cerebral salt wasting (CSW) has been suggested to precede the development of symptomatic vasospasm. OBJECTIVE:To determine if Hp genotype was associated with CSW and subsequent vasospasm after aneurys...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/NEU.0000000000001000

    authors: Murthy SB,Caplan J,Levy AP,Pradilla G,Moradiya Y,Schneider EB,Shalom H,Ziai WC,Tamargo RJ,Nyquist PA

    更新日期:2016-01-01 00:00:00

  • Anosmia after anterior communicating artery aneurysm surgery: comparison between the anterior interhemispheric and basal interhemispheric approaches.

    abstract::The olfactory function could be examined in 101 of 138 patients with anterior communicating artery aneurysms, whom we treated during a recent 6-year period. Among them, 49 patients underwent surgery by the anterior interhemispheric approach and 52 underwent surgery by the basal interhemispheric approach. Fifteen patie...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1097/00006123-199602000-00017

    authors: Fujiwara H,Yasui N,Nathal-Vera E,Suzuki A

    更新日期:1996-02-01 00:00:00

  • Circumferential Wall Enhancement on Magnetic Resonance Imaging is Useful to Identify Rupture Site in Patients with Multiple Cerebral Aneurysms.

    abstract:BACKGROUND:Identification of rupture sites in patients with multiple intracranial aneurysms is largely based on aneurysm size, location, and shape. Finding circumferential enhancement along the aneurysm wall (CEAW) on magnetic resonance (MR) vessel wall imaging was recently shown to be indicative of ruptured aneurysm. ...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1093/neuros/nyx267

    authors: Omodaka S,Endo H,Niizuma K,Fujimura M,Endo T,Sato K,Sugiyama SI,Inoue T,Tominaga T

    更新日期:2018-05-01 00:00:00

  • Intratumoral Heterogeneity of Glioblastoma Infiltration Revealed by Joint Histogram Analysis of Diffusion Tensor Imaging.

    abstract:BACKGROUND:Glioblastoma is a heterogeneous disease characterized by its infiltrative growth, rendering complete resection impossible. Diffusion tensor imaging (DTI) shows potential in detecting tumor infiltration by reflecting microstructure disruption. OBJECTIVE:To explore the heterogeneity of glioblastoma infiltrati...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1093/neuros/nyy388

    authors: Li C,Wang S,Yan JL,Piper RJ,Liu H,Torheim T,Kim H,Zou J,Boonzaier NR,Sinha R,Matys T,Markowetz F,Price SJ

    更新日期:2019-10-01 00:00:00

  • Deep venous thrombosis and thromboembolism in patients with cervical spinal cord injuries.

    abstract:STANDARDS:Prophylactic treatment of thromboembolism in patients with severe motor deficits due to spinal cord injury is recommended. The use of low-molecular-weight heparins, rotating beds, adjusted dose heparin, or a combination of modalities is recommended as a prophylactic treatment strategy. Low-dose heparin in com...

    journal_title:Neurosurgery

    pub_type: 杂志文章,评审

    doi:10.1097/00006123-200203001-00014

    authors: Hadley MN,Walters BC,Grabb PA,Oyesiku NM,Przybylski GJ,Resnick DK,Ryken TC

    更新日期:2002-03-01 00:00:00

  • Nuclear magnetic resonance of the spine: clinical potential and limitation.

    abstract::Magnetic resonance can visualize the vertebral bodies, discs, neural structures, cerebrospinal fluid (CSF), neural foramina, and extradural structures in the sagittal, axial, and coronal planes. The normal nucleus pulposus can be differentiated from the anulus and changes associated with degeneration. Infection, traum...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/00006123-198410000-00022

    authors: Modic MT,Hardy RW Jr,Weinstein MA,Duchesneau PM,Paushter DM,Boumphrey F

    更新日期:1984-10-01 00:00:00

  • Successful laser-assisted excision of a metastatic midbrain tumor.

    abstract::Metastatic lesions to the midbrain are rare. They are found in 1 to 3% of autopsy series of solitary brain metastases. The consensus of opinion in the current literature is that they are inoperable lesions and should be treated by radiation therapy alone. This is the first case report of a completely excised metastati...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/00006123-198606000-00022

    authors: Tobler WD,Sawaya R,Tew JM Jr

    更新日期:1986-06-01 00:00:00

  • A comparison of fluoroscopy and computed tomography-derived volumetric multiple exposure transmission holography for the guidance of lumbar pedicle screw insertion.

    abstract::Holographic technology has recently been modified in such a manner that it may now provide clinical use. It allows the visualization of complex structures in three dimensions and permits clinician interaction with the image, which, in turn, provides significant additional geometric and anatomic information. To objecti...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/00006123-199510000-00015

    authors: Benzel EC,Rupp FW,McCormack BM,Baldwin NG,Anson JA,Adams MS

    更新日期:1995-10-01 00:00:00

  • Nitrous oxide suppresses the electromyographic response evoked by electrical stimulation of the motor cortex.

    abstract::The influence of nitrous oxide on motor evoked potential (MEP) elicited in rats by cortical and midcervical electrical stimulation was studied and compared with early components of somatosensory evoked potential (SEP) following stimulation of the posterior tibial nerve in 6 rats. We found that nitrous oxide gradually ...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/00006123-198901000-00009

    authors: Zentner J,Ebner A

    更新日期:1989-01-01 00:00:00

  • The current role of microsurgery for posterior circulation aneurysms: a selective approach in the endovascular era.

    abstract:OBJECTIVE:During the past decade, management of posterior circulation aneurysms has shifted away from microsurgery. Currently, microsurgical clipping is considered a primary, competitive alternative to endovascular coiling, or more commonly, a secondary alternative when endovascular therapy is unfavorable. We present a...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/01.neu.0000333295.59738.de

    authors: Sanai N,Tarapore P,Lee AC,Lawton MT

    更新日期:2008-06-01 00:00:00

  • Reinnervation of extraocular muscles by facial-to-oculomotor nerve anastomosis in rats: anatomic nuclear changes.

    abstract:OBJECTIVE:Oculomotor nerve palsy greatly impairs the patient's daily life. After oculomotor nerve injury, when the central nerve stump is not available, neurotization of the distal nerve stump with a donor nerve may be performed. Here, we present an experimental anatomic study in rats related to the motor nuclear organ...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/01.neu.0000073988.28813.77

    authors: Fernandez E,Di Rocco F,Lauretti L,Gangitano C,Del Fà A,Massimi L,Maira G,Pallini R

    更新日期:2003-08-01 00:00:00

  • Feasibility, safety, and periprocedural complications associated with endovascular treatment of selected ruptured aneurysms under conscious sedation and local anesthesia.

    abstract:BACKGROUND:Endovascular coil embolization of ruptured aneurysms is performed under general anesthesia at most centers for perceived improved image quality and patient safety. OBJECTIVE:To report the feasibility of and outcomes associated with endovascular treatment of subarachnoid hemorrhage (SAH) patients with ruptur...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/NEU.0b013e31827b9183

    authors: Kan P,Jahshan S,Yashar P,Orion D,Webb S,Siddiqui AH,Hopkins LN,Levy EI

    更新日期:2013-02-01 00:00:00

  • Stent remodeling technique for coiling of ruptured wide-neck cerebral aneurysms: case report.

    abstract:OBJECTIVE:To describe a novel stent remodeling technique for the coiling of ruptured wide-neck cerebral aneurysms. CLINICAL PRESENTATION:A 46-year-old man presented with acute subarachnoid hemorrhage (Hunt and Hess grade IV), intracerebral hemorrhage, and hydrocephalus. Cerebral angiography revealed a wide-neck small ...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/01.NEU.0000350984.86323.61

    authors: Lopes DK,Wells K

    更新日期:2009-11-01 00:00:00

  • Protection of the cortical mantle in premature infants with posthemorrhagic hydrocephalus.

    abstract::Premature infants weighing under 1500 g are now surviving because of technical and medical advances in the field of neonatology. Up to 70% of these babies will have intracranial hemorrhages. The management of posthemorrhagic hydrocephalus in these children with multiple other medical problems has thus become quite sig...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/00006123-198011000-00007

    authors: Marlin AE

    更新日期:1980-11-01 00:00:00

  • The asleep-awake-asleep anesthetic technique for intraoperative language mapping.

    abstract:OBJECTIVE:We evaluated a combined technique designed for procedures requiring intraoperative language mapping. We planned to induce general anesthesia with endotracheal intubation and hyperventilation and then to awaken and extubate the patient for speech testing. After the latter, endotracheal reintubation and general...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1097/00006123-199806000-00069

    authors: Huncke K,Van de Wiele B,Fried I,Rubinstein EH

    更新日期:1998-06-01 00:00:00

  • Of Bubbles and Layers: Which Cerebral Cavernous Malformations are Most Difficult to Dissect From Surrounding Eloquent Brain Tissue?

    abstract:BACKGROUND:Cerebral cavernous malformations (CCM) may lead to repetitive intracerebral hemorrhage. In selected cases, a surgical resection is indicated. OBJECTIVE:To identify magnetic resonance imaging (MRI) features of CCM that correlate with the difficulty of dissection and postoperative outcome. METHODS:This study...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1093/neuros/nyx025

    authors: Dammann P,Wrede K,Jabbarli R,Müller O,Mönninghoff C,Forsting M,Sure U

    更新日期:2017-09-01 00:00:00

  • A clinical evaluation of the Camino subdural screw and ventricular monitoring kits.

    abstract::The aim of this study was to compare readings of intracranial pressure from a ventricular catheter with those obtained from a Camino catheter-tipped transducer. The Camino transducer was evaluated in two ways: firstly, when it was inserted by a subdural screw, and secondly, when it was inserted into a ventricular cath...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1097/00006123-199003000-00007

    authors: Chambers IR,Mendelow AD,Sinar EJ,Modha P

    更新日期:1990-03-01 00:00:00

  • Ultrashort Echo Time Magnetic Resonance Angiography in Follow-up of Intracranial Aneurysms Treated With Endovascular Coiling: Comparison of Time-of-Flight, Pointwise Encoding Time Reduction With Radial Acquisition, and Contrast-Enhanced Magnetic Resonance

    abstract:BACKGROUND:The optimal magnetic resonance angiography (MRA) sequence for assessing the aneurysm occlusion state or in-stent flow after endovascular coiling is not well established. OBJECTIVE:To evaluate the diagnostic performance of pointwise encoding time reduction with radial acquisition (PETRA)-MRA in patients who ...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1093/neuros/nyaa467

    authors: You SH,Kim B,Yang KS,Kim BK,Ryu J

    更新日期:2021-01-13 00:00:00

  • Multilevel lumbar laminotomies for focal spinal stenosis: case report.

    abstract::We describe a case of spondylotic lumbar spinal stenosis in an infirm elderly patient successfully treated with multilevel laminotomies. This procedure is less stressful to patients than a full laminectomy. In a selected subgroup of patients with "hourglass" spondylotic stenosis, it may provide adequate decompression....

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/00006123-198807000-00021

    authors: Aryanpur J,Ducker T

    更新日期:1988-07-01 00:00:00

  • Carpal tunnel syndrome: correlation of magnetic resonance imaging, clinical, electrodiagnostic, and intraoperative findings.

    abstract::We undertook a prospective study of 43 wrists in 32 patients who had been clinically diagnosed as having carpal tunnel syndrome (study group) and 5 wrists in people who had no symptoms (control group), correlating the clinical, electrodiagnostic, intraoperative, and magnetic resonance imaging (MRI) findings. MRI of th...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/00006123-199512000-00009

    authors: Britz GW,Haynor DR,Kuntz C,Goodkin R,Gitter A,Kliot M

    更新日期:1995-12-01 00:00:00