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Beyond palliative radiotherapy: a pilot multidisciplinary brain metastases clinic

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Abstract

Purpose

The purpose of this study is to determine the feasibility of a multidisciplinary palliative radiotherapy clinic for patients with brain metastases.

Methods

We designed a 6-month pilot Rapid Access Palliative Radiotherapy Program (RAPRP) brain metastases clinic. The main goals of the clinic were: (1) to provide timely consultation and treatment, (2) to provide multidisciplinary assessment and care, (3) to facilitate accrual of patients to research studies, and (4) to be a positive experience for patients. Team members included a radiation oncologist, radiation therapist, nurse practitioner, social worker (SW), occupational therapist (OT), and registered dietitian (RD). Patients underwent multidimensional assessment with patient-reported questionnaires and completed a patient satisfaction survey. Data were collected in a prospective database and collated in a standardized fashion with descriptive statistics recorded as percentages, medians, and ranges.

Results

The pilot brain metastases clinic ran weekly from August 5, 2009 to January 27, 2010. In total, 33 patients were seen. The median time from referral date to clinic date was 6 days, with 76% of patients seen within 1 week. Most patients (94%) started their radiotherapy on clinic day. Fifteen patients (45%) required assessment by a SW, 36% by an OT, and 33% by a RD. Ninety-one percent of patients participated in a research study. Eighty-six percent of patients reported being very satisfied with the clinic experience, and 97% would recommend the clinic to a patient in a similar situation.

Conclusions

The pilot RAPRP Brain Metastases Clinic was successful in providing patients with timely and multidisciplinary care and will continue beyond the pilot phase.

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Acknowledgments

The authors wish to thank Dr. Matthew Parliament, Director of the Division of Radiation Oncology at the Cross Cancer Institute and Ms. Shannon Eberle, Process Coordinator for the Department of Radiation Therapy at the Cross Cancer Institute, for their support of the pilot brain metastases clinic. We also wish to thank the multidisciplinary team members who generously set aside time to participate in the clinic: Jo-Ann Borshneck and Linda Crockett (Social Work), Amy Driga and Leila Sidi (Occupational Therapy), and Patty Tachynski, Kathryn Houlihan, and Kim Johnson (Clinical Nutrition). This study had no sources of funding.

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Authors and Affiliations

  1. Department of Oncology, University of Alberta Division on Radiation Oncology, Cross Cancer Institute, 11560 University Avenue, Edmonton, AB, Canada, T6G 1Z2

    Brita Danielson & Alysa Fairchild

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  1. Brita Danielson
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Correspondence to Brita Danielson.

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Danielson, B., Fairchild, A. Beyond palliative radiotherapy: a pilot multidisciplinary brain metastases clinic. Support Care Cancer 20, 773–781 (2012). https://doi.org/10.1007/s00520-011-1149-1

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