Cost-effectiveness of stereoctatic radiosurgery for brain metastasis: a systematic review

Authors

  • Leandro Frederico Luís Mestrado em Gestão e Avaliação de Tecnologias da Saúde, Escola Superior de Tecnologia da Saúde de Lisboa, Instituto Politécnico de Lisboa/Escola Superior de Saúde da Universidade do Algarve. Lisboa, Portugal. Enfermeiro, Serviço de Medicina 1.3, Hospital de S. José (Centro Hospitalar de Lisboa Central, EPE). Lisboa, Portugal. Grupo de Coordenação MERS-CoV (Síndroma Respiratória do Médio Oriente), Direção-Geral da Saúde. Lisboa, Portugal.

DOI:

https://doi.org/10.25758/set.1461

Keywords:

Economic analysis, Cost-effectiveness, Stereotactic radiosurgery, Brain metastasis

Abstract

Introduction – Brain metastases are a problem due to the oncologic disease, which significantly limits patient survival and their quality of life. The stereotactic radiosurgery discloses a non-invasive removal of brain metastases. Objectives – Verify if stereotactic radiosurgery is more cost-effective than alternative treatments for brain metastases in cancer patients. Methods – We conducted a systematic review of the literature using EBSCO host and PubMed between 2005 and 2015. The search terms were ‘radiosurgery’, ‘brain’, ‘metastasis’, ‘economics’, and ‘cost-benefit analysis’. The survey revealed 57 potentially eligible articles for the review, which were subject to an evaluation in accordance with the defined selection criteria. Three articles were included in the review. Results and Discussion – The review showed stereotactic radiosurgery dominance in relation to the two alternatives studied (total radiation of the brain and traditional surgery for resection of metastases). This superiority is associated with lower costs and equal or better effects (effectiveness or utility) of stereotactic radiosurgery. The cost of stereotactic radiosurgery seems to be the key differentiator relative to alternative treatments, lower than those in the three studies. Conclusion – The associated costs and effects of using stereotactic radiosurgery suggest that this will be the best option for a more rational treatment of patients with brain metastases. However, the findings are limited because of the scarcity of evaluated studies in the review.

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References

Stafinski T, Jhangri GS, Yan E, Menon D. Effectiveness of stereotactic radiosurgery alone or in combination with whole brain radiotherapy compared to conventional surgery and/or whole brain radiotherapy for the treatment of one or more brain metastases: a systematic review and meta-analysis. Cancer Treat Rev. 2006;32(3):203-13.

Andrews DW, Scott CB, Sperduto PW, Flanders AE, Gaspar LE, Schell MC, et al. Whole brain radiation therapy with or without stereotactic radiosurgery boost for patients with one to three brain metastases: phase III results of the RTOG 9508 randomised trial. Lancet. 2004;363(9422):1665-72.

International Agency for Research on Cancer. Cancer today: data visualization tools that present current national estimates of cancer incidence, mortality, and prevalence [Internet]. Lyon: IARC; 2015. Available from: http://gco.iarc.fr/today/home

Soffietti R, Cornu P, Delattre JY, Grant R, Graus F, Grisold W, et al. Brain metastases. In: Gilhus NE, Barnes MR, Brainin M, editors. European handbook of neurological management (Vol. 1). 2nd ed. Singapura: Blackwell Publishing; 2011. p. 437-45. ISBN 9781444328394

Mehta M, Noyes W, Craig B, Lamond J, Auchter R, French M, et al. A cost-effectiveness and cost-utility analysis of radiosurgery vs resection for single brain metastases. Int J Radiat Oncol Biol Phys. 1997;39(2):445-54.

Lunsford LD. Image-guided radiosurgery using the gamma knife. In: Sindou M, editor. Practical handbook of neurosurgery: from leading neurosurgeons (Vol. 1). Wien: Springer-Verlag; 2009. p. 49-61. ISBN 9783211848203

American Association of Neurological Surgeons. New brain metastases treatment guidelines [Internet]. J Neuro-Oncol. 2009 Dec 2. Available from: https://www.cns.org/sites/default/files/guideline-pdf/137.pdf

Tsao MN, Rades D, Wirth A, Lo SS, Danielson BL, Gaspar LE, et al. Radiotherapeutic and surgical management for newly diagnosed brain metastasis(es): an American Society for Radiation Oncology evidence-based guideline. Pract Radiat Oncol. 2012;2(3):210-25.

Mascarenhas F, Costa MS, Ortiz M, Almeida A, Carvalho H, Gonçalves A, et al. A radiocirurgia estereotáxica em tumores benignos e malignos do sistema nervoso central [Stereotactic radiosurgery in the intracranial benign neoplasms and malignant tumors of the brain]. Acta Med Port. 2005;18(1):45-60. Portuguese

Drummmond MF, Sculpher MJ, Torrance GW, O’Brien BJ, Stoddart GL. Methods for the economic evaluation of health care programmes. 3rd ed. New York: Oxford University Press; 2005. ISBN 9780198529453

Centre for Reviews and Dissemination. Systematic reviews: CRD’s guidance for undertaking reviews in health care [Internet]. York: University of York; 2009 [cited 2015 Feb 22]. Available from: https://www.york.ac.uk/media/crd/Systematic_Reviews.pdf

Müller-Riemenschneider F, Bockelbrink A, Ernst I, Schwarzbach C, Vauth C, von der Schulenburg JM, et al. Stereotactic radiosurgery for the treatment of brain metastases. Radiother Oncol. 2009;91(1):67-74.

Lee WY, Cho DY, Lee HC, Chuang HC, Chen CC, Liu JL, et al. Outcomes and cost-effectiveness of gamma knife radiosurgery and whole brain radiotherapy for multiple metastatic brain tumors. J Clin Neurosci. 2009;16(5):630-4.

Vuong DA, Rades D, Le NA, Busse R. The cost-effectiveness of stereotactic radiosurgery versus surgical resection in the treatment of brain metastasis in Vietnam from the perspective of patients and families. World Neurosurg. 2012;77(2):321-8.

Vuong DA, Rades D, Van Eck AT, Horstmann GA, Busse R. Comparing the cost-effectiveness of two brain metastasis treatment modalities from a payer’s perspective: stereotactic radiosurgery versus surgical resection. Clin Neurol Neurosurg. 2013;115(3):276-84.

Published

2022-09-06

Issue

Section

Artigos de Revisão

How to Cite

Cost-effectiveness of stereoctatic radiosurgery for brain metastasis: a systematic review. (2022). Saúde & Tecnologia, 16, 16-23. https://doi.org/10.25758/set.1461