P16.13 * UNCERTAINTY AND VARIABILITY IN SURVEILLANCE IMAGING AFTER COMPLETION OF PRIMARY TREATMENT IN GLIOBLASTOMA MULTIFORME

Abstract

INTRODUCTION: Clear and evidence-based follow up imaging guideline after the completion of primary therapy in glioblastoma multiforme (GBM) is lacking. Here we provide the first report analysing international, national and local guidelines in GBM imaging surveillance. METHODS: First we performed a systematic review of GBM management guidelines indexed in PUBMED and EMBASE databases up until October 2013. We then searched for GBM guidelines on websites of the relevant international and national societies. Next, to ascertain local recommendations within the UK, we reviewed guideline documents produced by the local neuro-oncology multidisciplinary teams (MDTs; n = 28) in the UK accessed via the Care Quality Improvement Network (CQuIN) database. For all the relevant guidelines identified, we extracted imaging recommendations for the period following completion of primary therapy. RESULTS: Of identified guidelines produced by international and national societies, only 6 had follow up imaging guidelines with variability in imaging frequency ranging from 1-2 monthly (1 guideline), 2-4 monthly (1), 2-3 monthly (2), to 3-4 monthly (2). Twenty out of the 28 neuro-oncology MDTs had imaging guidelines. Of these, 18 had guidelines on imaging after completion of primary therapy, with also a wide variability in imaging frequency from 2 monthly (2 guidelines), 2-4 monthly (1), 3 monthly (6), 3-4 monthly (1), 3-6 monthly (2), 6 monthly (4), and yearly (2). Most guidelines did not include references to any evidence base to inform the recommendations. CONCLUSIONS: The guidelines and recommendations for follow up imaging after the completion of primary therapy in GBM are variable and uncertain. Future studies should assess effectiveness of these guidelines in detecting assymptomatic GBM recurrence.