Untoward global effects of current guideline formulation of stereotactic radiotherapy for symptomatic brain metastases by international medical societies.

The quality of evidence leading to new oncological treatments suffers shortcomings, as has recently been addressed for drug approvals. In this 'Personal view', we evaluate the unintended effects of adopting stereotactic radiosurgery as the standard of care for patients with limited number of symptomatic brain metastases and favourable prognostic factors in international guidelines in view of the limitations in the evidence of efficacy and effectiveness, with special focus on countries with relatively limited resources.

A systematic review on cell-seeded tissue engineering of penile corpora.

Tissue engineering of corporal tissue is a new development in otherwise untreatable erectile dysfunction and in urethral reconstructions to treat hypospadias or severe urethral stricture disease. Multiple complications can arise with the current treatments, whereas engineered tissue, if well vascularized and existing of autologous cells, may lead to better results. The aim of this review was to provide an overview of literature on cell-seeded-based tissue engineering of corporal penile tissue. A literature search was performed following the PRISMA guidelines. Papers describing cell-seeded tissue engineering of corporal tissue were included. Studies using different techniques, such as intracavernous injection were excluded. Fifteen articles were included in the review. Twelve of these studies described engineering of the corpus cavernosum in animal models. Two articles were found on engineering of animal corpus spongiosum and one article on engineering of the human glans. Both synthetic scaffolds and biological scaffolds were used. The advantage of a biological, acellular scaffold was that the native, complex architecture of corporal tissue was maintained. Most studies used endothelial and smooth muscle cells from corporal origin, but stem cells were also investigated. Furthermore, dynamic culturing achieved an improved cell content and functionality. This review has summarized the developments in tissue engineering of corpus cavernosum and spongiosum tissue. Functional tissue has been developed in animal studies with the use of seeded cells on scaffolds. This knowledge will form a basis for the development of tissue engineering of corporal tissue for clinical applications.