Adam Uppendahl1, Philip Chang1, Jessica Besbris1, Andrea Cocjin1, LJ Amaral1, Elissa Rosenberg1, Rebecca Naor1, Emily Downing-Mahli1, Desiree Williams-Trinidad1, Carrie Kohler1, Madison Stern1, Almar Guevarra1, Joanna Wilson1, Huda Alalami1, Rosario Pulido1, Samira Kadri2, Karina Suarez Perez1, Elaine Wittert3, Tomas Wagmister1, Sashana Macatangay1, Alisha Cabrera1, Jeremy Rudnick1, Scott Irwin1, Jethro Hu1
1Cedars-Sinai Medical Center, 2MD Anderson Cancer Center, 3Northern Centre for Cancer Care
Objective:
Expand multidisciplinary brain tumor clinics to include palliative care, rehabilitation medicine, and extensive supportive resources to improve quality of life (QoL) and function.
Background:
Multidisciplinary care clinics are a well-established approach to comprehensively provide complex care. However, most existing clinics focus on coordinating subspecialty consultations (eg, Neuro-oncology, Neurosurgery, Radiation Oncology) while neglecting broader needs.
Design/Methods:
Patients were evaluated by neuro-oncology, palliative care, PM&R, social work, dietetics, and spiritual care. Symptoms (Edmonton Symptom Severity Scale (ESAS)) and functional metrics (KPS, PROMIS Cancer Function Brief 3D Profile, grip strength) were evaluated. Patients also completed general satisfaction surveys.
Results:
58 unique patients completed 79 multidisciplinary clinic visits from October 2022 through September 2024. Median age 50 (range 20-82); 29 males. 8 patients had multiple multidisciplinary clinic visits (range 2-8). 36 patients had grade 4 glioma, 17 had non-grade 4 primary brain tumors, and 4 had CNS metastases. On initial visits, ESAS (n=33, median 26, range 4.5-66, SD 14.5), KPS (n=56, median 80, range 60-100), PROMIS score (Physical: median 27, range 6-30, SD 6.01; Social: median 11, range 3-15, SD 3.56; Fatigue: median 9, min 3, max 15, SD 3.28), and grip strength (median 27.24 kg, range 9.33 - 65.50, SD 11.46) were assessed. R2 correlation between KPS and PROMIS 3D Physical Function scores was low (0.15). Mean patient satisfaction score was 9.87 out of 10. 87% of patients preferred multidisciplinary clinic visits to traditional clinic visits.
Conclusions:
Our multidisciplinary clinic provides a comprehensive functional and psychosocial assessment of patient needs, with a high degree of patient satisfaction. Traditional KPS scores show low correlation to more in-depth functional assessments. Future steps include examining the relationship between intra-patient longitudinal trends and outcomes.
Disclaimer: Abstracts were not reviewed by Neurology® and do not reflect the views of Neurology® editors or staff.