Practical Challenges and Perspectives for the Development of Neurosurgery in a Peripheral East African Hospital During a One-Volunteer Midterm Mission.

Background: Several strategies have been proposed for developing and spreading surgical specialties in Sub-Saharan East Africa. Regarding neurosurgery, improvements are coming from the cooperation between Western and African institutes by means of the World Federation of Neurological Surgeons and independent organizations but, far from big cities and more equipped hospitals, shortcomings in the delivery of services persist.

Methods: Through the application of 1 formally trained neurosurgeon volunteer, the Foundation for International Education in Neurological Surgery and Neurocirugía, Educación y Desarrollo coordinated a 2-month neurosurgical project at Mathari Consolata Hospital in Nyeri (Kenya), designed to analyze critical points and to find suggestions for initiating and developing a neurosurgical service, providing in the meantime clinical and surgical care for patients.

The treatment of patients with 1-3 brain metastases: is there a place for whole brain radiotherapy alone, yet? A retrospective analysis.

Aim: To evaluate the efficacy of whole brain radiotherapy (WBRT) with or without other treatments in patients (pts) with 1-3 brain metastases (BM).

Materials And Methods: Toxicities and survival of 134 pts treated between 2009 and 2013 with WBRT alone (58 pts), WBRT plus surgery (SUR-WBRT: 42 pts) or WBRT followed by stereotactic or integrated boost radiotherapy (SRT-WBRT: 34 pts) were analyzed. Differences in toxicity (acute and late) incidence and in overall (OS), disease-free (DFS) and disease-specific survival (DSS) were evaluated (χ(2)-test, uni- and multivariate analysis).