QUANTIFYING THE NEED FOR A BEST SUPPORTIVE CARE CLINIC

Abstract

Abstract AIMS Patients newly diagnosed with high-grade primary brain tumour and poor performance status discussed in the Multidisciplinary team (MDT) may not be felt to benefit from active treatment and their uptake in clinic is poor. We aimed to explore the volume of patients not being treated in our region, their survival rates, and the reasons for the limited requests for clinical review. METHOD Data was obtained from medical records of identified patients from April 2021 to April 2022. This included demographics, presentation, diagnosis date, clinic visits, and date of death. RESULTS 78 patients were referred for suspected high-grade primary brain tumours and selected for best supportive care by the MDT. Only 73 (64% male) were diagnosed radiologically with a high-grade primary tumour and the rest were excluded. Median age was 79 years (range 74 – 84). The commonest presenting symptoms were confusion (53%), falls (29%), and dysphasia (25%). Median survival time after diagnostic scan was 67 days (range 34 – 107). Survival rates at 1, 3, 6, and 12 months were 82%, 33%, 8%, and 1%, respectively. 28 patients (38%) were seen in clinic. 13 had been provided with the option to attend by letter. The median duration from referral to clinic was 9 days (range 7 – 14). CONCLUSIONS Only a third of non-treatable patients with newly diagnosed high-grade primary brain tumours are being seen in the clinic. Communication between the MDT and the patient offering this service is poor. Longer term survivors suggest an incorrect diagnosis who may benefit from further review.