Introduction: The distribution of radiation therapy (RT) for central nervous system disease has rarely been examined in a collaborative fashion. We describe our experience with a multidisciplinary clinic model featuring radiation oncology in tandem with neurosurgery in a community hospital setting, known as RADIANS (RADIation oncology And NeuroSurgery).
Methods: RADIANS patients receiving RT were assessed to determine fractionation patterns and anatomic location (brain versus spine). Patient satisfaction was assessed via survey questionnaire, where radiation oncology and neurosurgery attendings were blinded to both the administration of and patient responses in surveys.
Results: Thirty-nine patients have been seen since RADIANS inception, of which 24 (62%) received RT. Median age of RT patients was 66; the median patient distance from RADIANS was 37.2 miles (mean=54.8;range 0.7-252) with half of patients travelling more than 50 miles to receive care. Of the 24 patients receiving RT, 17 (71%) received stereotactic radiosurgery (SRS/SBRT) alone, 5 (21%) received conventional RT alone, and 2 (8%) received SRS/SBRT and conventional RT. 21/24 patients (87.5%) presented with metastatic disease. Lesions were equally distributed between the brain and spine (12 patients each). Two-thirds of survey responders felt comfortable receiving two separate bills rather than a single bill for their RADIANS visit, and all responders would recommend RADIANS for a friend/relative with a newly diagnosed spine or brain tumor. The average overall satisfaction on a 0 (not satisfied) to 5 (very satisfied) scale was 4.8.
Conclusions: The RADIANS clinic model has proved viable in a community setting, with nearly half of patients travelling a great distance to receive care. The vast majority of radiation therapy received has been SRS/SBRT rather than conventional fractionation, usually for metastatic disease. Thorough study will be needed to rigorously evaluate the long-term impact of RADIANS on patient education and quality of care.
Patient Care: To demonstrate the feasibility and success of a multidisciplinary clinic model featuring neurosurgery and radiation oncology, and the impact of this model on the distribution of radiation therapy.
Learning Objectives: 1. To describe early experience with a multidisciplinary radiation oncology and neurosurgery tandem clinic
2. To assess the distribution of radiation therapy administered in this multidisciplinary clinic setting
3. To determine patient perception of the RADIANS multidisciplinary clinic model