Marina Kastelan

Screening for Psychological Distress in Adult Primary Brain Tumor Patients and Caregivers: Considerations for Cancer Care Coordination.

Introduction This study aimed to assess psychological distress (PD) as scored by the Distress Thermometer (DT) in adult primary brain tumor patients and caregivers (CGs) in a clinic setting and ascertain if any high-risk subgroups for PD exist. Material and methods From May 2012 to August 2013, n = 96 patients and n = 32 CG underwent DT screening at diagnosis, and a differing cohort of n = 12 patients and n = 14 CGs at first recurrence. Groups were described by diagnosis (high grade, low grade, and benign) and English versus non English speaking. Those with DT score ≥4 met caseness criteria for referral to psycho-oncology services. One-way ANOVA tests were conducted to test for between-group differences where appropriate. Results At diagnosis and first recurrence, 37.5 and 75.0% (respectively) of patients had DT scores above the cutoff for distress. At diagnosis, 78.1% of CGs met caseness criteria for distress. All CGs at recurrence met distress criterion. Patients with high-grade glioma had significantly higher scores than those with a benign tumor. For patients at diagnosis, non English speaking participants did not report significantly higher DT scores than English speaking participants. Discussion Psychological distress is particularly elevated in CGs and in patients with high-grade glioma at diagnosis. Effective PD screening, triage, and referral by skilled care coordinators are vital to enable timely needs assessment, psychological support, and effective intervention.

Survival improvements with adjuvant therapy in patients with glioblastoma

Evaluate survival of patients diagnosed with glioblastoma multiforme (GBM) managed with adjuvant intensity modulated radiation therapy and temozolomide since the introduction of the European Organisation for Research and Treatment of Cancer and National Cancer Institute of Canada Clinical Trials Group (EORTC‐NCIC) protocol.

Australian Experience of Neuro-Oncology Care Coordination: A Conversation

BACKGROUND The role of care coordinator was introduced to support patients, caregivers, and healthcare professionals who work within a specialty, as well as to optimize and standardize care. Specifically, the role of neuro-oncology care coordinator is a developing one-and one that has encountered various barriers and difficulties. Patients diagnosed with neurologic cancer must endure a disease trajectory and multimodal treatment approach that present unique challenges to themselves and to the healthcare system. Consequently, the care coordinator role is needed. OBJECTIVES This article focuses on the role of the neuro-oncology care coordinator, including its challenges, the needs of patients with neurologic cancer, and the benefits this role can bring. METHODS Three neuro-oncology care coordinators from New South Wales, Australia, discussed their role in the healthcare system via structured meetings, conversations, and email correspondence. FINDINGS Making others aware of the issues faced by neuro-oncology care coordinators, as well as their patients, may help to solidify necessary supportive roles within the healthcare system.

O2.01RADIATION THERAPY DOSE PAINTING UTILIZING FET AND FDG PET IN THE MANAGEMENT OF HIGH GRADE GLIOMA

AIM: Assess the early outcome of patients with favourable subtype anaplastic glioma(AG) managed with an intensity modulated radiation therapy (ib-IMRT) integrated boost technique to minimise the normal brain volume irradiated. METHODS: Patients with AG were subgrouped into a favourable cohort based on presence of oligodendroglial features, 1p19q codeletion or presence of IDH1mutation. Those with favourable features were managed under a protocol utilizing an approach to minimising the volume of normal brain irradiated through the use of an ib-IMRT technique. Combined FET/FDG PET was used with 3T MRI to identify a high risk region, either FDG uptake, MRI gad enhanced region or T1 dense region. A lower risk region was identified by FET uptake or MRI T2 Flair. these regions were then incorporated into RT Plan and dose painted to 59.4Gy ( high risk) or 54 Gy (low risk) in 33 fractions over 6.5 weeks. RESULTS: 124 patients with AG managed with RT between 2008 and 2013 at the Northern Sydney Cancer were identified from a prospective database. 71 patients with favourable subtype received an ib-IMRT approach with 40 based on FET-FDG PET and 31 pts on MRI alone. Median follow-up for survivors was 32 months. 4yOS was 67% for the 124pts and 87% for the ib-IMRT subgroup. There were no infield relapses in the FET- FDG PET ib-IMRT group with the only treatment failure occurring at 12 months at a distant site. CONCLUSION: for patients with favourable AG, ib-IMRT at early followup provides an effective method to potentially minimise late RT morbidity.