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Reporting standards for endovascular chemotherapy of head, neck and CNS tumors
  1. Justin F Fraser1,
  2. M Shazam Hussain2,
  3. Cliff Eskey3,
  4. Todd Abruzzo4,
  5. Ketan Bulsara5,
  6. Joey English6,
  7. Kristine Blackham7,
  8. Huy M Do8,
  9. Charles Prestigiacomo9,
  10. Mahesh V Jayaraman10,
  11. Athos Patsalides11,
  12. Michael Kelly12,
  13. Jeffrey L Sunshine13,
  14. Philip Meyers14,
  15. on behalf of the Society for NeuroInterventional Surgery
  1. 1Department of Neurological Surgery, University of Kentucky, Lexington, Kentucky, USA
  2. 2Cerebrovascular Center, Cleveland Clinic, Cleveland, Ohio, USA
  3. 3Departments of Radiology, Neurology and Neurosurgery, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, UK
  4. 4Department of Neurosurgery, University of Cincinnati, Cincinnati, Ohio, USA
  5. 5Department of Neurosurgery, Yale University School of Medicine, New Haven, Connecticut, USA
  6. 6Departments of Neurology and Radiology, UCSF, San Francisco, California, USA
  7. 7Department of Radiology, University Hospitals, Case Western Reserve University, Cleveland, Ohio, USA
  8. 8Departments of Radiology and Neurosurgery, Stanford University Medical Center, Stanford, California, USA
  9. 9Department of Neurological Surgery, New Jersey Medical School, University of Medicine and Dentistry of New Jersey, Newark, New Jersey, USA
  10. 10Departments of Diagnostic Imaging and Neurosurgery, Warren Alpert School of Medical at Brown University, Providence, Rhode Island, USA
  11. 11Department of Neurological Surgery, New York Presbyterian Hospital, Weill Cornell Medical College, New York, USA
  12. 12Department of Neurosurgery, Royal University Hospital, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
  13. 13Department of Radiology, University Hospitals-Case Medical Center, Cleveland, Ohio, USA
  14. 14Departments of Radiology and Neurological Surgery, Columbia University, New York, USA
  1. Correspondence to Dr Mahesh V Jayaraman, Warren Alpert School of Medical at Brown University, 593 Eddy St, Room 377, Providence, Rhode Island 2903, USA; MJayaraman{at}Lifespan.org

Abstract

Background The goal of this article is to provide expert consensus recommendations for reporting standards, terminology and definitions when reporting on neurointerventional chemotherapy administration for head and neck tumors. These criteria may be used to design clinical trials, to provide definitions for patient stratification and to permit robust analysis of published data.

Methods This publication represents a consensus document by the Society for Neurointerventional Surgery. A PubMed search was conducted and included articles published in 2002–2011, with the search strategy designed to identify all studies of intra-arterial chemotherapy for tumors of neck and head. Articles were evaluated for evidence class, and recommendations were made using guidelines for evidence-based medicine proposed by a joint committee of the American Association of Neurological Surgeons and the Congress of Neurological Surgeons. Specifically, technical methods, outcome variables and reported complications were highlighted.

Results Thirty-five publications were included in the review. While most studies represent class III evidence, there was sufficient concordance to justify level 2 recommendations regarding technical methods for administration of intra-arterial chemotherapy. The data also support level 2 recommendations regarding reporting of particular outcome variables subsumed within broad categories entitled ‘Procedure-related’, ‘Disease control’ and ‘Survival’. The data support recommendations for the reporting of access site-related, neurologic, head and neck, ocular, hematologic and systemic complications, and also complications related to the percutaneous access site.

Conclusions Intra-arterial chemotherapy is a growing field in interventional neuroradiology. It is important to adopt uniform technical and reporting standards that will allow cross-publication comparisons and facilitate homogeneous practice standards. Published data support such standards, which are vital for the consistent evaluation of future published research.

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