World Neurosurg
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This study investigated the outcomes and prognostic factors of fractionated stereotactic radiosurgery (FSRS) for treatment of brain metastases (BMs) ≥20 mm and determined whether FSRS could replace surgery, the primary treatment for large BMs. ⋯ FSRS for BMs ≥20 mm achieved good local control. Only 3.4% of patients required surgery after FSRS, suggesting that FSRS is a potential alternative to surgery. For FSRS, a higher maximum tumor dose was useful for local control.
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Review Meta Analysis
MRI-negative Cushing's disease: A review on therapeutic management.
In this systematic review and meta-analysis, we review the literature regarding patients with Cushing's disease (CD) with negative or inconclusive magnetic resonance imaging (MRI). ⋯ Surgery has a good prognosis in patients with MRI-negative CD in terms of remission, and EETS has a lower rate of disease recurrence than METS; therefore, EETS seems to be the potential recommended treatment technique, while to confirm the therapeutic method of choice, further investigations should be done.
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Neurosurgery is a medical field that requires specialized professionals and equipment, 2 important but scarce resources in low- and middle-income countries. Our goal was to report our experience with the replacement and implementation of linear accelerators with radiosurgery capabilities at "Sociedad de Lucha Contra el Cáncer" (SOLCA) Hospital in Quito, Ecuador, and give some recommendations for future technological replacements (TRs). ⋯ The TR in SOLCA had similarities with other experiences in low- and middle-income countries, but the pandemic brought additional limitations, mainly complicating the staff training. Nevertheless, those limitations can be resolved with a structured training program and international collaboration. Overall, the benefits obtained from a TR result in exponentially better medical care and accessibility to novel treatments.
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Review Meta Analysis
Diagnostic and Prognostic Utility of Optical Coherence Tomography in Patients With Sellar/Suprasellar Lesions with Chiasm Impingement: A Systematic Review/ Meta-Analyses.
In this review, we appraised the current literature on the utility of optical coherence tomography (OCT) as a diagnostic and predictive factor for postoperative visual function outcomes in patients with sellar/suprasellar lesions with chiasmal impingement. ⋯ Our findings provide promising support for the growing evidence that OCT parameters can be utilized as both a diagnostic and prognostic tool for patients with compression of the optic apparatus. There is a need for further studies to gain a better understanding of OCTs and to improve patient outcomes.