Outcomes and cost-effectiveness of gamma knife radiosurgery and whole brain radiotherapy for multiple metastatic brain tumors

Lee, Wen Yuen; Cho, Der Yang; Lee, Han Chung; Chuang, Hao Che; Chen, Chun-Chung; Liu, Jun Lin; Yang, Shih Neng; Liang, Ji An; Ho, Li Hwei

doi:10.1016/j.jocn.2008.06.021

Cited by 25 publications

(8 citation statements)

References 39 publications

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“…Rutigliano et al reported similar findings in a separate retrospective study [70]. More recently, Lee et al examined the outcomes and cost-effectiveness of treating 156 patients with multiple brain metastases, randomized to receive radiosurgery or WBRT [68]. The follow-up time in this study was 3.3 years.…”

Section: Emerging Trends In Treatment Of Bmsupporting

confidence: 66%

“…Nevertheless, they provide compelling support for repeat or salvage SRS being effective in treating locally progressive or new lesions after initial SRS. Arguably, this strategy should be considered in favourable RPA class patients in order to minimize morbidity, maximize patient quality of life and perception of disease burden [60], and to reduce cost [68–71]. Prospective trials are needed to determine the clinical value and compare SRS and WBRT salvage modalities at the time of local or distant failure.…”

Section: Emerging Trends In Treatment Of Bmmentioning

confidence: 99%

See 1 more Smart Citation

Current Standards in the Management of Cerebral Metastases

Goetz

Ebinu

Roberge

et al. 2012

International Journal of Surgical Oncology

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Section: Emerging Trends In Treatment Of Bmsupporting

confidence: 66%

Section: Emerging Trends In Treatment Of Bmmentioning

confidence: 99%

Current Standards in the Management of Cerebral Metastases

Goetz

Ebinu

Roberge

et al. 2012

International Journal of Surgical Oncology

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“…1,6,11) A partial cost-utility analysis of medical interventions in the other countries is shown in the Table 6. 5,[7][8][9]15) In Japan, reports to date recognize treatments of 6 million yen/QALY as giving excellent cost performance. 13,14) To date, few reports have undertaken cost-utility analysis of stroke treatment in Japan, the main reason being that there has been no accurate picture of chronic-phase stroke treatment.…”

Section: Discussionmentioning

confidence: 99%

Medical Care for Chronic-Phase Stroke in Japan

Hattori

Hirayama

Katayama

2012

Neurol. Med. Chir.(Tokyo)

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Stroke leaves serious neurological sequelae, which require long-term medical and social care, imposing financial and mental burdens on the patients and their families, and causing enormous losses to society. It is currently required that medical resources be used efficiently and the cost-effectiveness of treatment be analyzed carefully. We conducted a follow-up survey of stroke patients admitted to the hospital attached to our university in order to build a picture of the current status of chronic-phase stroke medical treatment. In total, 330 patients were analyzed in this study. We evaluated utility and medical cost at one year after onset. To investigate the relationship between activities of daily living (ADL) classified according to the modified Rankin scale (mRS) and quality of life (QOL), utility was calculated for each ADL level. Utility at 1 year post-onset for each mRS level was: ADL0, 0.89; ADL1, 0.79; ADL2, 0.65; ADL3, 0.58; ADL4, 0.36; and ADL5, 0.09. A significant correlation was seen between utility and mRS. Direct monthly medical costs at 1 year post-onset were 61,536 yen in the ADL0 group and 383,444 yen in the ADL5 group, indicating that a worse ADL score required higher medical costs. Direct monthly costs were significantly different between ADL levels. This present study has clarified the QOL and medical costs of chronic-phase stroke patients, and many cost-utility analyses will be based on our data in the future in Japan.

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“…In an analysis of WBRT, resection and radiosurgery for single brain metastases radiosurgery was considered to be the more cost-effective procedure [56] . A similar study for multiple brain metastases showed that radiosurgery resulted in higher cost-effectiveness than WBRT [57] . In order to improve the speed of health care delivery, the disruptive innovation in medicine must be matched with an innovative business model [58] .…”

Section: Implications Of Disruptive Innovations For Medical Industrymentioning

confidence: 92%

Intracranial Radiosurgery: An Effective and Disruptive Innovation in Neurosurgery

Niranjan

Madhavan²,

Pc³

et al. 2011

Stereotact Funct Neurosurg

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Physicians are guided by the teachings of their chosen field, standards of accepted practice, peer pressure, prior training, and other sources of bias. When potential bias begins to impact recommendations for care in the field of tumor management, physicians may fail to realize the importance of emerging medical innovations. Some of these ultimately turn out to be ‘disruptive innovations.’ These innovations are more often than not both low risk and cost effective. But the leaders in the field often initially ignore these newer technologies in favor of more mature existing technologies. However, over time these technologies gradually improve and become mainstream management practices. Intracranial radiosurgery is one such innovation which was not embraced by the neurosurgical community in the beginning. Nowadays, a wide variety of brain and body disorders are treated with radiosurgery. Acoustic neuromas and brain metastases are examples of rapidly growing indications of radiosurgery. In this report, the authors describe the emergence of stereotactic radiosurgery as a disruptive innovation in the field of medicine.

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Outcomes and cost-effectiveness of gamma knife radiosurgery and whole brain radiotherapy for multiple metastatic brain tumors

Cited by 25 publications

References 39 publications

Current Standards in the Management of Cerebral Metastases

Current Standards in the Management of Cerebral Metastases

Medical Care for Chronic-Phase Stroke in Japan

Intracranial Radiosurgery: An Effective and Disruptive Innovation in Neurosurgery

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