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Abstract(s)
Introdução – As metástases cerebrais são um problema decorrente da doença oncológica que limita significativamente a sobrevida e a qualidade de vida dos doentes. A radiocirurgia estereotáxica permite uma eliminação não invasiva das metástases cerebrais. Objetivos – Pretende-se verificar se a radiocirurgia estereotáxica apresenta maior custo-efetividade que os tratamentos alternativos para metástases cerebrais nos doentes oncológicos. Método – Efetuou-se uma revisão sistemática de literatura utilizando o servidor EBSCO e a PubMed, no período de tempo compreendido entre 2005 e 2015. Foi feito o cruzamento dos termos MeSH de pesquisa: ‘radiosurgery’, ‘brain’, ‘metastasis’, ‘economics’ e ‘cost-benefit analysis’. A pesquisa revelou 57 artigos potencialmente elegíveis para a revisão que foram submetidos a avaliação de acordo com os critérios de seleção definidos. Resultaram três artigos que foram incluídos na revisão. Resultados e Discussão – A revisão revelou a dominância da radiocirurgia estereotáxica face às duas alternativas estudadas (radioterapia total do cérebro e a cirurgia tradicional para resseção das metástases). Esta superioridade está associada a custos inferiores da radiocirurgia estereotáxica e efeitos (efetividade ou utilidade) iguais ou superiores. O custo da radiocirurgia estereotáxica parece ser o principal diferenciador relativamente às alternativas, sendo inferior nos três estudos. Conclusão – Os custos e efeitos associados da utilização da radiocirurgia estereotáxica sugerem que esta poderá ser a melhor opção para um tratamento mais racional dos doentes com metástases cerebrais. Todavia, as conclusões são limitadas devido à escassez de estudos avaliados na revisão.
ABSTRACT - Introduction – Brain metastases are a problem due to the oncologic disease, which significantly limit 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 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 them 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.
ABSTRACT - Introduction – Brain metastases are a problem due to the oncologic disease, which significantly limit 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 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 them 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.
Description
Keywords
Análise económica Custo-efetividade Radiocirurgia estereotáxica Metástases cerebrais Economic analysis Cost-efectiveness Stereotactic radiosurgery Brain metastases
Citation
Luís LF. Custo-efetividade da radiocirurgia estereotáxica no tratamento de metástases cerebrais: revisão sistemática. Saúde & Tecnologia. 2016;(16):16-23.
Publisher
Instituto Politécnico de Lisboa, Escola Superior de Tecnologia da Saúde de Lisboa