P26 * A MANAGEMENT ALGORITHM FOR ELDERLY PATIENTS WITH HIGH GRADE GLIOMA

Abstract

INTRODUCTION: With the increased effectiveness of the neuro-oncology multidisciplinary meeting (MDM) more elderly patients are presenting with high grade glioma (HGG). The aim of this study is to identify the various pathways of care these patients took following discussion at the MDM. METHOD: All patients aged 70 and above who were referred to the MDM with appearances of HGG on their imaging between December 2012 and December 2013 were identified from the MDM records. Data regarding their management plan (resective surgery, biopsy, radiotherapy, palliative care) was collected along with their overall survival. An algorithm was then formulated to illustrate the various pathways of care received. RESULTS: A total of 32 patients of the above inclusion criteria were discussed at the MDM. 14 patients were offered surgery of which 8 underwent a debulking and 6 had biopsy. 6 of these undergoing debulking had radiotherapy with a mean overall survival (OS) of 6.6 months. Those undergoing a biopsy only with radiotherapy had a mean overall survival of 4.6 months. Those not offered surgery were referred back to their local acute oncologist, physician or palliative care service with close liaison with these teams. CONCLUSION: Decisions about this patient category should be individualised. Collaboration with local acute oncology/ medical/palliative services allows radical treatment offered to those who would benefit. This helps avoid unnecessary transportation of patients with poor performance status whilst maintaining support to patients and carers not undergoing surgery.