Management evaluation of metastasis in the brain (MEMBRAIN)-a United Kingdom and Ireland prospective, multicenter observational study.
BNTRC
brain tumor, metastasis
multidisciplinary team
Journal
Neuro-oncology practice
ISSN: 2054-2577
Titre abrégé: Neurooncol Pract
Pays: England
ID NLM: 101640528
Informations de publication
Date de publication:
Jun 2020
Jun 2020
Historique:
entrez:
16
6
2020
pubmed:
17
6
2020
medline:
17
6
2020
Statut:
ppublish
Résumé
In recent years an increasing number of patients with cerebral metastasis (CM) have been referred to the neuro-oncology multidisciplinary team (NMDT). Our aim was to obtain a national picture of CM referrals to assess referral volume and quality and factors affecting NMDT decision making. A prospective multicenter cohort study including all adult patients referred to NMDT with 1 or more CM was conducted. Data were collected in neurosurgical units from November 2017 to February 2018. Demographics, primary disease, KPS, imaging, and treatment recommendation were entered into an online database. A total of 1048 patients were analyzed from 24 neurosurgical units. Median age was 65 years (range, 21-93 years) with a median number of 3 referrals (range, 1-17 referrals) per NMDT. The most common primary malignancies were lung (36.5%, n = 383), breast (18.4%, n = 193), and melanoma (12.0%, n = 126). A total of 51.6% (n = 541) of the referrals were for a solitary metastasis and resulted in specialist intervention being offered in 67.5% (n = 365) of cases. A total of 38.2% (n = 186) of patients being referred with multiple CMs were offered specialist treatment. NMDT decision making was associated with number of CMs, age, KPS, primary disease status, and extent of extracranial disease (univariate logistic regression, This study demonstrates a changing landscape of metastasis management in the United Kingdom and Ireland, including a trend away from adjuvant whole-brain radiotherapy and specialist intervention being offered to a significant proportion of patients with multiple CMs. Poor quality or incomplete referrals cause delay in NMDT decision making.
Sections du résumé
BACKGROUND
BACKGROUND
In recent years an increasing number of patients with cerebral metastasis (CM) have been referred to the neuro-oncology multidisciplinary team (NMDT). Our aim was to obtain a national picture of CM referrals to assess referral volume and quality and factors affecting NMDT decision making.
METHODS
METHODS
A prospective multicenter cohort study including all adult patients referred to NMDT with 1 or more CM was conducted. Data were collected in neurosurgical units from November 2017 to February 2018. Demographics, primary disease, KPS, imaging, and treatment recommendation were entered into an online database.
RESULTS
RESULTS
A total of 1048 patients were analyzed from 24 neurosurgical units. Median age was 65 years (range, 21-93 years) with a median number of 3 referrals (range, 1-17 referrals) per NMDT. The most common primary malignancies were lung (36.5%, n = 383), breast (18.4%, n = 193), and melanoma (12.0%, n = 126). A total of 51.6% (n = 541) of the referrals were for a solitary metastasis and resulted in specialist intervention being offered in 67.5% (n = 365) of cases. A total of 38.2% (n = 186) of patients being referred with multiple CMs were offered specialist treatment. NMDT decision making was associated with number of CMs, age, KPS, primary disease status, and extent of extracranial disease (univariate logistic regression,
CONCLUSIONS
CONCLUSIONS
This study demonstrates a changing landscape of metastasis management in the United Kingdom and Ireland, including a trend away from adjuvant whole-brain radiotherapy and specialist intervention being offered to a significant proportion of patients with multiple CMs. Poor quality or incomplete referrals cause delay in NMDT decision making.
Identifiants
pubmed: 32537183
doi: 10.1093/nop/npz063
pii: npz063
pmc: PMC7274191
doi:
Types de publication
Journal Article
Langues
eng
Pagination
344-355Subventions
Organisme : Medical Research Council
ID : MR/L017342/1
Pays : United Kingdom
Investigateurs
Shailendra Achawa
(S)
Rafid Al-Mahfoudh
(R)
Erminia Albanese
(E)
Michael Amoo
(M)
Reiko Ashida
(R)
Kirsty Benton
(K)
Harsh Bhatt
(H)
Ian Coulter
(I)
Pietro D'Urso
(P)
Andrew Dapaah
(A)
Kelly Dawson
(K)
Gareth Dobson
(G)
John Duddy
(J)
Edward W Dyson
(EW)
Ellie Edlmann
(E)
Laurence Glancz
(L)
Pablo Goetz
(P)
Athanasios Grivas
(A)
Paul Grundy
(P)
Cathal Hannan
(C)
Lianne Harrison
(L)
Syed Hassan
(S)
Damian Holliman
(D)
Aimun Jamjoom
(A)
Mohsen Javadpour
(M)
James Laban
(J)
Chris Lim
(C)
Donald MacArthur
(D)
Helen McCoubrey
(H)
Edward McKintosh
(E)
Mark Neilly
(M)
John Norris
(J)
Adam Nunn
(A)
Gerry O'Reilly
(G)
Konstantinos Petridis
(K)
Puneet Plaha
(P)
Jonathan Pollock
(J)
Chittoor Rajaraman
(C)
Fahid Tariq Rasul
(F)
William Sage
(W)
Rohit Sinha
(R)
Naomi Slator
(N)
Alexander Smedley
(A)
Lewis Thorne
(L)
Sebastian Trifoi
(S)
Micaela Uberti
(M)
Mohamed Ali Ugas
(M)
Ravi Vemaraju
(R)
James Walkden
(J)
Mueez Waqar
(M)
Stefan Yordanov
(S)
Informations de copyright
© The Author(s) 2019. Published by Oxford University Press on behalf of the Society for Neuro-Oncology and the European Association of Neuro-Oncology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
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