Comparing options for stereotactic radiosurgery

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Comparando opções para o radiosurgery stereotactic

por Gus Iversen, Editor in Chief | February 24, 2015
From the January/February issue of HealthCare Business News magazine


It’s not the car, it’s the driver
When analyzing the differences between these modalities it’s easy to lose sight of the big picture. “In terms of outcomes, if you used the same doses and had the same target, whether you treat on the Edge, Novalis, CyberKnife, or Gamma Knife, your outcomes should basically be the same,” says Siddiqui, who emphasizes that all these cutting edge modalities can universally outperform anything from just a few years ago.

What matters most of all is the experience of the team performing the procedures, and their level of knowledge and expertise with the system they use. “If you imagine a racecar, you can have the best car but you need the best driver and the best pit crew to make it work,” says Siddiqui, “Good technology has to be in great hands.”

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Chang takes the car analogy a step further saying, “If you give a NASCAR driver a Honda and give you or me a Ferrari, the NASCAR driver would still beat us.” Meaning the experience of the team goes a long way, and for patients, it’s important to choose facilities that practice a high volume of the treatment technique that they are seeking.

Ma, from UCSF, warns that patients looking at treatment options should be mindful of the studies they are presented with and make sure the information is not being provided with a particular manufacturer’s interests in mind. “You have to look at academic and multi-institutional studies,” says Ma. “Were the physicians involved experienced and were the modalities equivalent and state-of-the-art?”

Economic factors will also inform a hospital’s choice of modality. Each machine has something special that sets it apart from the others and, if they had the space and the budget, there is no reason a hospital would not elect to have all of them at their disposal. Winker, with Alliance Oncology, emphasizes the role of the physician in selecting the best course of treatment for each individual patient. “Our hospital and physician partners are integral in the choice of equipment,” she says, however, the palliative and curative needs of the center’s patients are the ultimate deciding factors.

A recent partnership between the American Association of Neurological Surgeons (AANS) and the American Society for Radiation Oncology (ASTRO) should yield even more insight into maximizing positive outcomes in SRS. The two groups are building a national registry that will log data from 30 diverse, high-volume, stereotactic radiosurgery centers for a three-year time period. The data from this registry will be aggregated and analyzed in order to ensure safe, high-quality care and to help define treatment guidelines.

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