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Optimising outcomes for glioblastoma through subspecialisation in a regional cancer centre

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Version 1 2019-03-14, 12:41
journal contribution
posted on 2024-06-13, 12:55 authored by M Back, D Jayamanne, N Cove, H Wheeler, M Khasraw, L Guo, J Back, M Wong
© 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.

History

Journal

Brain sciences

Volume

8

Location

Basel, Switzerland

Open access

  • Yes

eISSN

2076-3425

Language

eng

Publication classification

C1 Refereed article in a scholarly journal

Copyright notice

2018, The Authors

Issue

10

Publisher

MDPI

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