Evaluation and Treatment Allocation of Skull Base Tumor Patients in a Multidisciplinary Radiation Oncology and Neurosurgery Central Nervous System Community Hospital Clinic

2019 ◽  
Author(s):  
Shearwood Mcclelland ◽  
Timur Mitin ◽  
Jerry Jaboin ◽  
Jeremy Ciporen
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Skull Base ◽  
Radiation Oncology ◽  
Community Hospital ◽  
Skull Base Tumor ◽  
Tumor Patients ◽  
Treatment Allocation ◽  
Hospital Clinic

A Multidisciplinary Central Nervous System Clinic Model for Radiation Oncology and Neurosurgery (Radians): Three-Year Experience with Brain and Skull Base Lesions in a Community Hospital Setting

2020 ◽  
Author(s):  
Wencesley Paez ◽  
Rohi Gheewala ◽  
Shearwood McClelland III ◽  
Jerry J. Jaboin ◽  
Charles R. Thomas ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Skull Base ◽  
Radiation Oncology ◽  
Community Hospital ◽  
Hospital Setting ◽  
Skull Base Lesions

Geriatric patient outcomes in a multidisciplinary central nervous system community hospital clinic for radiation oncology and neurosurgery (RADIANS)

2021 ◽  
Author(s):  
Rohi Gheewala ◽  
Wencesley A. Paez ◽  
William Stadtlander ◽  
Brandon Lucke-Wold ◽  
Jerry J. Jaboin ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Patient Outcomes ◽  
Radiation Oncology ◽  
Geriatric Patient ◽  
Community Hospital ◽  
Hospital Clinic

Outcomes for geriatric patients evaluated in a same-day multidisciplinary central nervous system clinic for radiation oncology and neurosurgery in a community hospital setting.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e24034-e24034
Author(s):  
Wencesley A. Paez ◽  
Rohi Gheewala ◽  
Jerry J. Jaboin ◽  
Charles R. Thomas ◽  
Jeremy N. Ciporen ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Patient Satisfaction ◽  
Radiation Oncology ◽  
Patient Population ◽  
Geriatric Patients ◽  
Community Hospital ◽  
The United States ◽  
Cns Disease ◽  
Cns Malignancies

e24034 Background: The geriatric cancer population is rapidly increasing in the United States. Management of geriatric patients with central nervous system (CNS) disease requires a patient-centric, multidisciplinary approach together with meticulous assessment of their outcomes, as clinical studies guiding treatment recommendations are lacking in this patient population. We have previously reported the outcomes of our multidisciplinary community hospital-based CNS clinic, RADIANS, where both radiation oncology and neurosurgery specialists simultaneously evaluate patients in a same-day, single-setting clinic. We have sought to analyze the outcomes of the geriatric patient population of our RADIANS clinic. Methods: We identified patients 65 years and older in our IRB-approved RADIANS Prospective Patient Registry for CNS Disease. Descriptive statistics were used to report patient characteristics, diagnoses, treatments and outcomes, and patient satisfaction scores. Results: Between August 2016 and February 2020, 56 patients 65 years and older (mean age 74.6, range: 65-94; 32 women and 24 men) were evaluated in the RADIANS clinic. Mean distanced traveled by patients to clinic was 43.4 miles (med = 8.3; range = 0.6-341). Patient-reported Satisfaction Score was 4.81 (0-5 Scale, 5-very satisfied). The most common referral source was medical oncology. Forty-two patients had malignant CNS disease (brain mets-18; spine mets-12; both-4; primary brain-6; primary spine-2), 14 had benign CNS disease. Post-evaluation treatment: radiation therapy (RT) only (n = 20), neurosurgery (NS) only (n = 6), both RT and NS (n = 14), and no RT/NS intervention (n = 16). Fractionated stereotactic radiosurgery was most common RT delivered; craniotomy with tumor resection was most common NS performed. Treatment outcomes: local tumor control = 39/40 (97.5%); radiation necrosis/radiation-induced myelitis = 0/34 (0.0%). Conclusions: This is the first report of outcomes in geriatric patients with CNS malignancies treated in a community hospital-based multidisciplinary clinic. We show excellent outcomes comparable to younger patients with CNS malignancies, as well as patient satisfaction and ability to travel great distances to receive multidisciplinary care.

scholarly journals Telemedicine visits in an established multidisciplinary central nervous system clinic for radiation oncology and neurosurgery (RADIANS) in a community hospital setting

2021 ◽  
Vol 122 (09) ◽  
pp. 680-683
Author(s):  
S. C. Bowen, R. ◽  
B. Lucke-Wold ◽  
T. Mitin ◽  
J. N. Ciporen
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Radiation Oncology ◽  
Community Hospital ◽  
Hospital Setting

scholarly journals INNV-47. TREATMENT ALLOCATION AMONG PATIENTS EVALUATED IN A MULTIDISCIPLINARY RADIATION ONCOLOGY AND NEUROSURGERY CENTRAL NERVOUS SYSTEM CLINIC

2018 ◽  
Vol 20 (suppl_6) ◽  
pp. vi147-vi147 ◽  
Author(s):  
Shearwood McClelland ◽  
Timur Mitin ◽  
Jerry Jaboin ◽  
Jeremy Ciporen
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Radiation Oncology ◽  
Treatment Allocation

scholarly journals EPID-18. TRENDS IN INCIDENCE AND SURVIVAL OF MALIGNANT PEDIATRIC CENTRAL NERVOUS SYSTEM TUMORS IN THE NETHERLANDS

2020 ◽  
Vol 22 (Supplement_3) ◽  
pp. iii322-iii322
Author(s):  
Raoull Hoogendijk ◽  
Jasper van der Lugt ◽  
Dannis van Vuurden ◽  
Eelco Hoving ◽  
Leontien Kremer ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
The Netherlands ◽  
Malignant Gliomas ◽  
Survival Rates ◽  
Tumor Patients ◽  
Netherlands Cancer Registry ◽  
Malignant Astrocytomas ◽  
Brainstem Tumors ◽  
The Impact

Abstract BACKGROUND Variation in survival of pediatric central nervous system (CNS) tumors is large between countries. Within Europe, the Netherlands had one of the worst reported survival rates of malignant CNS (mCNS) tumors during 2000–2007. METHODS Using the Netherlands Cancer Registry, we evaluated trends in incidence and survival of pediatric mCNS tumors (behavior /3, 5th digit in the morphology code) diagnosed between 1990–2017. RESULTS 839 newly-diagnosed mCNS tumor patients <18 years were registered between 1990–2017. Incidence of mCNS tumors remained stable (average incidence rate, 21.6 per million person-years). However, an increased incidence of malignant gliomas, NOS was found (Estimated Annual Percentage Change (EAPC) 11.6% p<0.001). This appears to be related to a registration shift between 1990–1999 and 2000–2009 as brainstem tumors increased (+25%, n=79) for astrocytomas and other gliomas but decreased (-31%, n=32) for unspecified intracranial and intraspinal neoplasms. Overall, 5-year observed survival (5Y-OS) of mCNS tumors increased from 51% in 1990–1999 to 61% in 2010–2017 (P-for-trend<0.001). This increase was not constant over time, as 5Y-OS for the period 2000–2009 was 47%. The only significant decrease in survival was found for malignant astrocytomas and other gliomas with a 5Y-OS of 56% in 1990–1999 decreasing to 48% in 2010–2017 (P-for-trend<0.001). CONCLUSION Between 1990–2017 incidence of mCNS tumors in the Netherlands remained stable and survival increased. However, a decrease in survival was seen for malignant astrocytomas and other gliomas, which is partially explained by the registration shift of brainstem tumors. The impact of this shift on survival for all mCNS tumors is subject to further research.

Hypercoaulability state in central nervous system tumor patients

1997 ◽  
Vol 99 ◽  
pp. S251
Author(s):  
M.E. Kusak ◽  
J.M. Alonso ◽  
D. Santamarta ◽  
I. Recio ◽  
J.M. Borrás ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Central Nervous System Tumor ◽  
Tumor Patients ◽  
System Tumor

NCOG-42. SYMPTOM ONSET TO TIME OF DIAGNOSIS IN PRIMARY CENTRAL NERVOUS SYSTEM TUMOR PATIENTS: A REVIEW OF FINDINGS FROM THE NOB-NHS

2021 ◽  
Vol 23 (Supplement_6) ◽  
pp. vi161-vi161
Author(s):  
Matthew Lindsley ◽  
Elizabeth Vera ◽  
Alvina Acquaye ◽  
Nicole Briceno ◽  
Anna Choi ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Healthcare Providers ◽  
Healthcare Setting ◽  
Tumor Location ◽  
Low Grade ◽  
Central Nervous System Tumor ◽  
Tumor Patients ◽  
Patient Reported ◽  
Reported Data

Abstract Prior reports suggest the low prevalence of primary central nervous system (PCNS) tumors and the healthcare setting where patients seek care can contribute to diagnostic delays, potentially affecting prognosis. This descriptive report highlights findings from patient-reported data at presentation collected from a sample of 623 PCNS tumor patients. Participants were White (88%), males (56%), median age at diagnosis 41 (2-79) with high grade (HG) (66%) brain tumors (BT) (89%). Among BT patients, 30% reported ≥ 3 concurrent symptoms at presentation including headaches (40%), seizures (30%), and memory problems or difficulty with balance/walking (20% each). Over half (57%) had symptoms for < 6 months before diagnosis and 60% presented to the Emergency Room. Sixty-five percent of HG BT patients had symptoms for < 6 months prior to diagnosis compared to low grade (LG) tumors (40%) and had surgery in < 1 month from presentation (68% vs 51%, p < 0.01). More HG BT patients presented with weakness in the arms/legs than LG BT (14% vs 8%). Among spine tumor (ST) patients, 45% reported ≥ 3 concurrent symptoms at presentation including back pain (65%), sensory changes (45%), and weakness (40%). Almost half (46%) were symptomatic for > 1 year before diagnosis, presented in an outpatient clinic (64%) with 41% having surgery < 1 month from presentation. Younger (40% vs 16%) and HG ST patients (56% vs 21%) more often reported symptoms for < 6 months before diagnosis. HG ST patients more often presented to Emergency Rooms (67% vs 25%) and had surgery < 1 month from presentation (60% vs 36%). Further analysis of symptom presentation and clinical course is ongoing. Tumor location, grade, patient age and healthcare setting were associated with the time from clinical presentation to diagnosis. Development of aids providing guidance on diagnostic evaluation/treatment to front-line healthcare providers is warranted.

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