ESTRO 2025 - Abstract Book

S681

Clinical - CNS

ESTRO 2025

Purpose/Objective: Multidisciplinary tumor boards (MDTBs) play a pivotal role in ensuring high-quality cancer care, often leading to improved clinical and organisational outcomes for patients [1]; however, evidence in the literature is scarce regarding MDTBs in neuro-oncology, particularly from the perspective of radiation oncology [2,3]. We want to shed light on the critical role of MDTBs in optimizing decision-making in radiation oncology, which is of utmost importance since radiation oncologists often serve as referring physicians for patients with primary brain tumors. Material/Methods: In our institution a neuro-oncology MDTB is held weekly, attended by radiation oncologists, neurosurgeons, neuroradiologists, neuropathologists and, upon request, other specialists. Data from cases presented between 04/2022-03/2023 were prospectively recorded; missing data could be retrieved retrospectively. Information included patient demographics, clinical data, reasons for referral and board outcomes. Results: A total of 221 cases representing 167 patients were discussed in 34 meetings. The most frequent diagnoses were glioblastoma (32.6%), astrocytoma (9.9%), meningioma (7.7%), metastases (21.7%), unknown (14%) at the time of discussion. Of these, 130 (58.8%) requests for discussion came from radiation oncologists; patients’ status was post radiotherapy in 15 (11.5%), during chemotherapy in 32 (26%) and during follow-up in 59 (45%). Among the 77 (34.8%) cases presented by neurosurgeons, 23 (29.9%) were before and 19 (24.7%) right after surgery and 25 (32.5%) during follow-up. All cases required imaging display, but 31 cases (14%) were presented specifically for differential diagnosis and 65 (29.4%) for imaging review. Notably, among the latter some change in image interpretation occurred in 33 cases (50.8%) leading to a conservative (continuing chemotherapy or wait-and-see) approach in the majority of them (n=24, 72.7%). Agreement on a management plan was the reason for discussion in 135 cases (61%). Among the 94 cases with an explicit pre-meeting proposal by the treating physician, a change in patient management after discussion occurred in 23 (24.5%); compared to pre-MDTB plan, radiotherapy resulted to be part of the treatment plan in a higher number of cases following discussion (n=16 vs 22). Conclusion: Our findings underscore the critical role of MDTB in optimizing decision-making processes in neuro-oncology, where radiation oncologists are primarily involved. Collaborative approach ensures personalized care, leveraging diagnostic imaging to refine treatment strategies and possibily change treatment plans in a significant proportion of cases. As a perspective, development of a multifactorial workflow could help health-care providers identify patients that would derive the greatest benefit from MDTB discussion. References: [1] Bozzao A et al. European Cancer Organisation Essential Requirements for Quality Cancer Care: Adult glioma. J Cancer Policy. 2023 Dec;38:100438. doi: 10.1016/j.jcpo.2023.100438. Epub 2023 Aug 25. PMID: 37634617. [2] Khalafallah AM et al. Quantifying the utility of a multidisciplinary neuro-oncology tumor board. J Neurosurg. 2020 Sep 18;135(1):87-92. doi: 10.3171/2020.5.JNS201299. PMID: 32947258. [3] Gaudino S et al. Neuro-Oncology Multidisciplinary Tumor Board: The Point of View of the Neuroradiologist. J Pers Med. 2022 Jan 20;12(2):135. doi: 10.3390/jpm12020135. PMID: 35207625; PMCID: PMC8875699. Keywords: Neuro-oncology, multidisciplinary tumor board