O1.01ESTIMATION OF THE INCIDENCE OF BRAIN METASTASES AND PATTERNS OF CARE IN THE NETHERLANDS

• Published in: Neuro-oncology (Charlottesville, Va.) Vol. 16; no. Suppl 2; p. ii1
• Main Authors: Kwakman, R.J.J.M., Jeene, P.M., Dieleman, E.M.T., Stalpers, L.J.A.
• Format: Journal Article
• Language: English
• Published: Oxford University Press 01.09.2014
• Subjects: ORAL PRESENTATIONS
• ISSN: 1522-8517; 1523-5866
• DOI: 10.1093/neuonc/nou174.1

PURPOSE: Brain metastases in The Netherlands: An estimation of the incidence and variation in treatment policy. METHODS: Radiation oncologists, neuro-oncologists and neurosurgeons, all members of the Dutch Association for of Neuro-Oncology (LWNO) were approached to complete a web-based questionnaire. The first part of the questionnaire contained questions about the incidence of brain metastases in 2012. The second part was aimed to investigate treatment practices using 13 different case descriptions, covering the different recommendations in the Dutch National Guideline for Brain Metastasis, particularly on the role of radiotherapy. RESULTS: Ten radiation-oncologists, eleven neuro-oncologists and five neurosurgeons from 15 hospitals completed the questionnaire, covering 41% of the addressed specialists. Five radiation-oncologists could provide incidence information from a patient data registration. Extrapolation to The Netherlands yields an estimate of 3500 newly diagnosed patients per year (21 per 105 citizens), of whom 21% with a single brain metastasis. Extrapolated to the USA, with a comparable sex and age-distribution, would yield almost 56,000 new cases per year. In only 3 of 13 case descriptions, there was more than 70% agreement in treatment policy; the National Guideline was, for each treatment choice, followed only by a minority of the specialists. For instance, there was no consensus on the role of radiotherapy for patients with a single brain metastasis. If radiotherapy was advised, there was no consensus which technique was considered most appropriate: Radiosurgery, local fractionated radiotherapy or whole brain radiotherapy. CONCLUSION: In The Netherlands, as in most cancer registries world-wide, the number of patients with brain metastases, their treatment and outcome are poorly registered. Hence it is not possible to give a reliable estimate of the incidence other than that the ‘number of patients with brain runs into many thousands per year’. There are major local differences in treatment policies, and the official national guideline is followed by only a minority of brain tumor specialists.