Authors' objectives:

To assess the clinical value of extra-cranial stereotactic radiotherapy (ESR) in order to advise French National Health Insurance (NHI) on reimbursement.

Authors' results and conclusions: According to the 42 selected studies (11 prospective, 31 retrospective): (i)spinal and paraspinal tumours (15 studies, 467 patients, median follow-up 8-25 months): pain was decreased in 25-100% of patients (8 studies), there were fewer symptoms in 42-100% of patients (4 studies), and the local control rate was 87-100% (7 studies). No toxicity was observed (9 studies); (ii)bronchopulmonary tumours (16 studies, 659 patients, median follow-up 8-36 months): the overall control rate was 72-100% (13 studies), the 1-year actuarial control rate was 76-100% (6 studies), and the 1-year survival rate was 48-100% (8 studies). Grade 3 complications were observed in 0-16% of patients (14 studies); (iii)hepatic tumours (4 studies, 109 patients; median follow-up 7-12 months): the local control rate was72-95%. No grade 3 toxicity was observed. Further indications were also discussed by the working group.

Authors' recommendations: HAS' opinion was that NHI should reimburse ESR for spinal tumours, primary T1,T2,N0,M0 bronchopulmonary tumours, and slow-growing bronchopulmonary metastases when the primary tumour is under control. It advised conditional coverage of ESR for hepatic tumours. Further research/reviews required: -long-term follow-up -further information on the type, volume and topography of the tumour -information on therapeutic use compared to other treatments -a health economics assessment in France -confirmation of the safety and efficacy in indications with a conditional coverage.

Authors' methods: Review

Project Status: Completed

URL for project: http://www.has-sante.fr

Year Published: 2007

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: France

Organisation Name: Haute Autorité de Santé

Contact Address: 2 avenue du Stade de France, 93218 Saint-Denis La Plaine Cedex, France. Tel: +33 01 55 93 71 88; Fax: +33 01 55 93 74 35;

Contact Name: has.seap.secretariat@has-sante.fr

Contact Email: has.seap.secretariat@has-sante.fr

Copyright: Haute Autorite de sante/French National Authority for Health (HAS)