Abstract:
:This study aims to evaluate the cost-effectiveness of surgical resection (S) and Cesium-131 (Cs-131) [S + Cs-131] intraoperative brachytherapy versus S and stereotactic radiosurgery (SRS) [S + SRS] for the treatment of brain metastases. Treatment records as well as hospital and outpatient charts of 49 patients with brain metastases between 2008 and 2012 who underwent S + Cs-131 (n = 24) and S + SRS (n = 25) were retrospectively reviewed. Hospital charges were compared for the single treatment in question. Means and curves of survival time were defined by the Kaplan-Meier estimator, with the cost analysis focusing on the time period of the relevant treatment. Quality adjusted life years (QALY) and Incremental cost-effectiveness ratios (ICER) were calculated for each treatment option as a measure of cost-effectiveness. The direct hospital costs of treatments per patient were: S + Cs131 = $19,271 and S + SRS = $44,219. The median survival times of S + Cs-131 and S + SRS were 15.5 and 11.3 months, and the 12 month survival rates were 61 % and 49 % (P = 0.137). The QALY for S + SRS when compared to S + Cs-131 yielded a p < 0.0001, making it significantly more cost-effective. The ICER also revealed that when compared to S + Cs-131, S + SRS was significantly inferior (p < 0.0001). S + Cs-131 is more cost-effective compared with S + SRS based on hospital charges as well as QALYs and ICER. Cost effectiveness, in addition to efficacy and risk, should factor into the comparison between these two treatment modalities for patients with surgically resectable brain metastases.
journal_name
J Neurooncoljournal_title
Journal of neuro-oncologyauthors
Wernicke AG,Yondorf MZ,Parashar B,Nori D,Clifford Chao KS,Boockvar JA,Pannullo S,Stieg P,Schwartz THdoi
10.1007/s11060-015-2026-4subject
Has Abstractpub_date
2016-03-01 00:00:00pages
145-53issue
1eissn
0167-594Xissn
1573-7373pii
10.1007/s11060-015-2026-4journal_volume
127pub_type
杂志文章abstract::Our previous investigations correlated the degree of cytogenetic and immunophenotypic heterogeneity of cultured normal glia, astrocytomas and malignant gliomas. The possible significance was suggested by the statistical correlation of individual antigens with diagnosis and patient survival. The present study has estab...
journal_title:Journal of neuro-oncology
pub_type: 杂志文章
doi:10.1007/BF02341157
更新日期:1990-12-01 00:00:00
abstract::A 44 year-old man with subcutaneous meningioma and rare combination of spinal lesions, consisting of dermal sinus and lipoma of the filum terminale. The literature concerning the subcutaneous meningioma is reviewed and the embryogenesis of these lesions is discussed. ...
journal_title:Journal of neuro-oncology
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doi:10.1023/a:1005981110128
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abstract::The basic mechanism of cell death induced by 5-aminolevulinic acid (5-ALA)-mediated photodynamic therapy (PDT) (ALA-PDT) in glioma cells has not been fully elucidated. In this study, the details of the cell death mechanism induced by ALA-PDT were investigated in three human glioma cell lines (U251MG, U87MG, and U118MG...
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journal_title:Journal of neuro-oncology
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abstract::Cell differentiation agent-2 (CDA-2) is an extraction from healthy human urine consisting of primary organic acids and peptides, and it has been demonstrated to inhibit growth and induce differentiation in glioma and other cell lines. But the mechanism of CDA-2 remains unclear. In this study, we demonstrated that CDA-...
journal_title:Journal of neuro-oncology
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doi:10.1007/s11060-012-0961-x
更新日期:2012-11-01 00:00:00
abstract::Central nervous system (CNS) involvement is a rare complication of chronic lymphocytic leukemia (CLL) with varied outcomes. We contribute two additional cases of CLL with CNS involvement. The clinical course and response to treatment are described. All 78 previously reported cases of CLL with CNS involvement are prese...
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doi:10.1007/s11060-020-03488-7
更新日期:2020-05-01 00:00:00
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journal_title:Journal of neuro-oncology
pub_type: 杂志文章
doi:10.1007/s11060-009-0083-2
更新日期:2010-07-01 00:00:00
abstract::Treatment of infant hypothalamic chiasmatic glioma (iCHG) is challenging, about 30% of the children progress during chemotherapy. Despite subsequent treatments the 5 year overall-survival rate is only 70%. This study investigates treatment strategies currently applied for progressive iCHG. A web-based questionnaire wa...
journal_title:Journal of neuro-oncology
pub_type: 杂志文章
doi:10.1007/s11060-017-2630-6
更新日期:2018-01-01 00:00:00
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journal_title:Journal of neuro-oncology
pub_type: 杂志文章
doi:10.1007/s11060-011-0653-y
更新日期:2012-01-01 00:00:00
abstract::Developing and conducting gene therapy clinical trials poses unique challenges which must be addressed to satisfy regulatory requirements and, most importantly, to protect human subjects. Experimental products used for gene transfer studies, such as viral vectors, are often complex and cannot be sterilized or complete...
journal_title:Journal of neuro-oncology
pub_type: 杂志文章,评审
doi:10.1023/b:neon.0000003659.04633.6e
更新日期:2003-12-01 00:00:00
abstract::Five quantitative histologic factors, differing linear combinations of 26 reliably recognized histologic features, account for much of the histologic variance in 1068 children with infratentorial neuroglial tumors in the Childhood Brain Tumor Consortium (CBTC) database. In this study, we used the scores on the Spongy,...
journal_title:Journal of neuro-oncology
pub_type: 杂志文章,多中心研究
doi:10.1023/a:1005984531474
更新日期:1998-08-01 00:00:00
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journal_title:Journal of neuro-oncology
pub_type: 杂志文章,评审
doi:10.1007/s11060-011-0793-0
更新日期:2012-05-01 00:00:00
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journal_title:Journal of neuro-oncology
pub_type: 杂志文章
doi:10.1007/s11060-018-2753-4
更新日期:2018-05-01 00:00:00
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journal_title:Journal of neuro-oncology
pub_type: 杂志文章
doi:10.1007/s11060-007-9328-0
更新日期:2007-07-01 00:00:00
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journal_title:Journal of neuro-oncology
pub_type: 杂志文章
doi:10.1007/s11060-015-1959-y
更新日期:2016-01-01 00:00:00
abstract::Radiation therapy (RT) for brain tumors is associated with neurocognitive toxicity which may be a result of damage to neural progenitor cells (NPCs). We present a novel technique to limit the radiation dose to NPC without compromising tumor coverage. A study was performed in mice to examine the rationale and another w...
journal_title:Journal of neuro-oncology
pub_type: 杂志文章
doi:10.1007/s11060-011-0530-8
更新日期:2011-09-01 00:00:00
abstract::Glioblastoma (GBM) is the most common adult CNS malignancy but its impact on quality of life (QOL) is poorly understood. In other patient populations, illness intrusiveness (the extent to which disease and treatment disrupts valued activities and interests) is associated with low subjective well-being, after controlli...
journal_title:Journal of neuro-oncology
pub_type: 杂志文章
doi:10.1007/s11060-015-1943-6
更新日期:2016-01-01 00:00:00
abstract::To characterize a population of pediatric high-grade astrocytoma (HGA) patients by confirming the proportion with a correct diagnosis, and determine prognostic factors for survival in a subset diagnosed with uniform pathologic criteria. Sixty-three children diagnosed with HGA were treated at the Johns Hopkins Hospital...
journal_title:Journal of neuro-oncology
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journal_title:Journal of neuro-oncology
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journal_title:Journal of neuro-oncology
pub_type: 临床试验,杂志文章
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journal_title:Journal of neuro-oncology
pub_type: 杂志文章
doi:10.1023/b:neon.0000013497.04322.fc
更新日期:2004-01-01 00:00:00
abstract::This study investigated the effects of the intracarotid infusion of etoposide in combination with angiotensin II (AT II)-induced hypertension on the blood-brain barrier (BBB) and brain tissue in rats. Eighty rats were divided into five groups: Group 1, intravenous infusion of AT II to increase arterial blood pressure;...
journal_title:Journal of neuro-oncology
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更新日期:1992-06-01 00:00:00
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journal_title:Journal of neuro-oncology
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更新日期:2013-08-01 00:00:00
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journal_title:Journal of neuro-oncology
pub_type: 杂志文章
doi:10.1007/s11060-008-9648-8
更新日期:2008-11-01 00:00:00
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journal_title:Journal of neuro-oncology
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journal_title:Journal of neuro-oncology
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journal_title:Journal of neuro-oncology
pub_type: 杂志文章,评审
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abstract::Calcification is a rare phenomenon in high grade glioma (HGG). CT scans are sensitive to mineralization but used infrequently for tumor assessment in the MRI era. The presence of calcification can be overlooked on routine MRI. Calcification may reflect chronicity and natural changes in the tumor or its milieu over tim...
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