Optimising outcomes for glioblastoma through subspecialisation in a regional cancer centre

Back, Michael, Jayamanne, Dasantha, Cove, Nicola, Wheeler, Helen, Khasraw, Mustafa, Guo, Linxin, Back, Jemimah and Wong, Matthew 2018, Optimising outcomes for glioblastoma through subspecialisation in a regional cancer centre, Brain sciences, vol. 8, no. 10, doi: 10.3390/brainsci8100186.

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Title Optimising outcomes for glioblastoma through subspecialisation in a regional cancer centre
Author(s) Back, Michael
Jayamanne, Dasantha
Cove, Nicola
Wheeler, Helen
Khasraw, MustafaORCID iD for Khasraw, Mustafa orcid.org/0000-0003-3249-9849
Guo, Linxin
Back, Jemimah
Wong, Matthew
Journal name Brain sciences
Volume number 8
Issue number 10
Total pages 10
Publisher MDPI
Place of publication Basel, Switzerland
Publication date 2018-10-15
ISSN 2076-3425
Summary © 2018 by the authors. Licensee MDPI, Basel, Switzerland. Delivery of highly sophisticated, and subspecialised, management protocols for glioblastoma in low volume rural and regional areas creates potential issues for equivalent quality of care. This study aims to demonstrate the impact on clinical quality indicators through the development of a novel model of care delivering an outsourced subspecialised neuro-oncology service in a regional centre compared with the large volume metropolitan centre. Three hundred and fifty-two patients with glioblastoma were managed under the European Organisation for Research and Treatment of Cancer and National Cancer Institute of Canada Clinical Trials Group (EORTC-NCIC) Protocol, and survival outcome was assessed in relation to potential prognostic factors and the geographical site of treatment, before and after opening of a regional cancer centre. The median overall survival was 17 months (95% CI: 15.5–18.5), with more favourable outcome with age less than 50 years (p < 0.001), near-total resection (p < 0.001), Eastern Cooperative Oncology Group (ECOG) Performance status 0, 1 (p < 0.001), and presence of O-6 methylguanine DNA methyltransferase (MGMT) methylation (p = 0.001). There was no difference in survival outcome for patients managed at the regional centre, compared with metropolitan centre (p = 0.35). Similarly, no difference was seen with clinical quality process indicators of clinical trial involvement, rates of repeat craniotomy, use of bevacizumab and re-irradiation. This model of neuro-oncology subspecialisation allowed equivalent outcomes to be achieved within a regional cancer centre compared to large volume metropolitan centre.
Language eng
DOI 10.3390/brainsci8100186
HERDC Research category C1 Refereed article in a scholarly journal
Copyright notice ©2018, The Authors
Persistent URL http://hdl.handle.net/10536/DRO/DU:30119845

Document type: Journal Article
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