Custo-efetividade da radiocirurgia estereotáxica no tratamento de metástases cerebrais: revisão sistemática

Abstract

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 stereotacticradiosurgery 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.