TY - JOUR
T1 - A Multidisciplinary Central Nervous System Clinic Model for Radiation Oncology and Neurosurgery (RADIANS)
T2 - three-year experience with brain and skull base lesions in a community hospital setting
AU - Paez, Wencesley A.
AU - Gheewala, Rohi
AU - McClelland, Shearwood
AU - Lucke-Wold, Brandon
AU - Jaboin, Jerry J.
AU - Thomas, Charles R.
AU - Mitin, Timur
AU - Ciporen, Jeremy N.
N1 - Publisher Copyright:
© 2021 EDIZIONI MINERVA MEDICA.
PY - 2023/8
Y1 - 2023/8
N2 - BACKGROUND: Subspecialty, multidisciplinary care within community hospital settings are limited and remains a challenge. Improving outcomes for central nervous system (CNS) disease rely on integrated subspecialty care between radiation oncology (RadOnc) and neurosurgery (NS). Three-year experience with simultaneous patient evaluation with RadOnc and NS physicians in a community hospital-based CNS clinic model (RADIANS) for brain and skull base lesions (BSBL) are reported. METHODS: Clinical and demographic data were prospectively collected for patients evaluated in RADIANS. Surveys administered and three-year data reviewed. Descriptive statistics reported as mean and percentages for patient characteristics, diagnosis, treatment and outcomes. RESULTS: Sixty-seven patients with confirmed BSBL were evaluated between August 2016 and August 2019. Mean age and distance traveled was 61.0 years and 66.5 miles, respectively. Female (N.=39, 58.2%) and male (N.=28, 41.8%) patients had mean Patient Satisfaction Score of 4.77 (0-5 Scale, where 5 is very satisfied; 26 respondents). Forty-three patients had malignant disease (28 brain mets; six with both brain/spine; nine with primary brain), and 24 had benign disease. Post-evaluation treatment: radiation therapy (RT) only (N.=16), neurosurgery (NS) only (N.=12), both RT and NS (N.=15), and no RT/NS intervention (N.=24). Fractionated stereotactic radiosurgery was most common RT delivered; craniotomy with tumor resection was most common NS performed. Treatment outcomes: local control in 33 of 38 (86.8%); radiation necrosis in one of 31 (3.2%). CONCLUSIONS: The multidisciplinary community hospital-based CNS clinic continues its high patient approval at extended follow-up. Results demonstrate the clinic serves as a regional referral center where patients with BSBL with varying degrees of co-morbidities, systemic disease status, and oncologic staging can be treated with evidence-based treatment modalities yielding high rates of local control and low rates of grade 3 and 4 radiation-induced toxicity, while having access to on-going clinical trials.
AB - BACKGROUND: Subspecialty, multidisciplinary care within community hospital settings are limited and remains a challenge. Improving outcomes for central nervous system (CNS) disease rely on integrated subspecialty care between radiation oncology (RadOnc) and neurosurgery (NS). Three-year experience with simultaneous patient evaluation with RadOnc and NS physicians in a community hospital-based CNS clinic model (RADIANS) for brain and skull base lesions (BSBL) are reported. METHODS: Clinical and demographic data were prospectively collected for patients evaluated in RADIANS. Surveys administered and three-year data reviewed. Descriptive statistics reported as mean and percentages for patient characteristics, diagnosis, treatment and outcomes. RESULTS: Sixty-seven patients with confirmed BSBL were evaluated between August 2016 and August 2019. Mean age and distance traveled was 61.0 years and 66.5 miles, respectively. Female (N.=39, 58.2%) and male (N.=28, 41.8%) patients had mean Patient Satisfaction Score of 4.77 (0-5 Scale, where 5 is very satisfied; 26 respondents). Forty-three patients had malignant disease (28 brain mets; six with both brain/spine; nine with primary brain), and 24 had benign disease. Post-evaluation treatment: radiation therapy (RT) only (N.=16), neurosurgery (NS) only (N.=12), both RT and NS (N.=15), and no RT/NS intervention (N.=24). Fractionated stereotactic radiosurgery was most common RT delivered; craniotomy with tumor resection was most common NS performed. Treatment outcomes: local control in 33 of 38 (86.8%); radiation necrosis in one of 31 (3.2%). CONCLUSIONS: The multidisciplinary community hospital-based CNS clinic continues its high patient approval at extended follow-up. Results demonstrate the clinic serves as a regional referral center where patients with BSBL with varying degrees of co-morbidities, systemic disease status, and oncologic staging can be treated with evidence-based treatment modalities yielding high rates of local control and low rates of grade 3 and 4 radiation-induced toxicity, while having access to on-going clinical trials.
KW - Brain neoplasms
KW - Central nervous system
KW - Neoplasm metastasis
KW - Neurosurgery
KW - Radiation oncology
KW - Radiotherapy
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U2 - 10.23736/S0390-5616.21.05304-2
DO - 10.23736/S0390-5616.21.05304-2
M3 - Article
C2 - 33940778
AN - SCOPUS:85121905829
SN - 0390-5616
VL - 67
SP - 408
EP - 413
JO - Journal of Neurosurgical Sciences
JF - Journal of Neurosurgical Sciences
IS - 4
ER -