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Paediatric Neuro-Oncology 1 st April 2014 - 31 st March 2015 Kim - - PowerPoint PPT Presentation
Paediatric Neuro-Oncology 1 st April 2014 - 31 st March 2015 Kim - - PowerPoint PPT Presentation
Paediatric Neuro-Oncology 1 st April 2014 - 31 st March 2015 Kim Phipps Great Ormond Street Hospital for Children NHS Trust New Brain Tumours New Brain Tumours 2005 - March 2015 100 90 80 70 60 50 40 30 20 10 0 2005 2006 2007
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New Brain Tumours 2005 - March 2015
10 20 30 40 50 60 70 80 90 100 2005 2006 2007 2008 2009 2010 2011 2012 2013/14 2014/15
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New brain tumours Apr 2014-Mar 2015 Demographic details
Ethnic Group
43 (48%) Patients : White 46 (52% Patients : Non-White
- Nb. Excluding foreign private
patients from abroad (N=8) 42(52%) Patients : White 39(48%) Patients : Non-White
Sex
Female : 42 patients Male : 47 patients
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New brain tumours Apr 2014-Mar 2015 : Age Groups
10 20 30 40 50 60 Under 1yr 1yr - <3yrs 3yrs - <13 yrs 13ys-<16 yrs >16yrs
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New patients under 3yrs at diagnosis: Apr 2014-Mar 2015
5 10 15 20 25 30 2005 2006 2007 2008 2009 2010 2011 2012 2013/14 2014/15 1-3YRS UNDER 1YR
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New patients under 3yrs at diagnosis including 2nd referrals : Apr 2014-Mar 2015
5 10 15 20 25 30 35 2005 2006 2007 2008 2009 2010 2011 2012 2013/14 2014/15 1-3YRS UNDER 1YR
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New brain tumours by region 2009- March 2015
10 20 30 40 50 60 Abroad * Eastern London SouthEast Other 2009 2010 2011 2012 2013/14 2014/15
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New brain tumours Apr 2014-Mar 2015 : by diagnosis
5 10 15 20 25 30 MEDULLOBLASTOMA** ATRT EPENDYMOMA HIGH GRADE GLIOMA* BRAINSTEM GLIOMA OTHER GLIOMA CRANIOPHARYNGIOMA DNET/GLIONEURONAL GANGLIOGLIOMA CHOROID PLEXUS TUMOURS GERMINOMA/GCT/TERATOMA OTHER CNS TUMOURS under 1yr 1- 3yrs 3-12yrs >13yrs *Excludes brainstem ** Includes one Pineoblastoma
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New brain Glioma Apr 2014-Mar 2015 : site
2 4 6 8 10 12 14 HIGH GRADE* BRAINSTEM** OPTIC PATHWAY CEREBELLAR OTHER SITES > 13yrs 3-12yrs < 3yrs under 1yr
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New brain tumours Apr 2014-Mar 2015 : Treatment pathway
5 10 15 20 25 30 35
SURG ONLY SURG & CHEMO SURG CHEMO & RT SURG & PROTONS SURG & RT SURG GOS TF OTHER SURG & PALLIATIVE CARE RT ONLY RT & CHEMO CHEMO ONLY NONE(WAIT & SEE) UNDER 1yr 1yr-3yr 3yr-12yr 12yr-16yr >16yr
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New brain tumours Apr 2014-Mar 2015 : Treatment summary
10 20 30 40 50 60 70 80 SURGERY CHEMO RT PROTONS
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New brain tumours Apr 2014-Mar 2015:– method of diagnosis
Histological 81% Radiological & Clincal 19%
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2nd Referrals Brain tumours April 2014-March 2015
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2nd Referrals - Brain tumours April 2014-March 2015
2 4 6 8 10 12 14 16 2005 2006 2007 2008 2009 2010 2011 2012 2013/14 2014/15
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Tumour group - 2nd Referrals - Brain tumours April 2014-March 2015
1 2 3 Choroid plexus tumour ATRT Anaplastic astrocytoma/DPIG Low Grade Glioma
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Age group - 2nd Referrals - Brain tumours April 2014-March 2015
1 2 3 <1YR 1YR - 3YRS 3- 12 YRS >12 YRS
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Reason for 2nd Referral - Brain tumours April 2014-March 2015
1 2 3 Further managment of new tumour Management
- f
recurrent/prog tumour Moved to our catchment area
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2nd Referral - Brain tumours April 2014-March 2015 Treatment summary
1 2 3 4
SURGERY ONLY SURGERY & PALLIATIVE CARE CHEMO ONLY WATCH & WAIT
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Recurrent/progressive Brain Tumours
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Recurrent/progressive Brain Tumours April 2014 – March 2015
10 20 30 40 50 60 70 80 2005 2006 2007 2008 2009 2010 2012 2013/14 2014/15
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Brain tumour Recurrence/progression episode April 2014 – March 2015
5 10 15 20 25 30 35 40 45 1st 2nd 3rd 4th 5th 6th 7th
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Recurrent/progressive Brain Tumours April 2014-March 2015 : Tumour Type
5 10 15 20 25 30 PNET* ATRT EPENDYMOMA BRAINSTEM GLIOMA LGG CRANIOPHARYNGIOMA HIGH GRADE GLIOMA GCT OTHER
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Recurrent/progressive Brain Tumours
April 2014-March 2015 : Treatment Pathway
Note: 71 patients had 88 episodes of progression/ recurrence resulting in a Change in treatment pathway. These 17 changes are included above.
5 10 15 20 SURG ONLY SURG & CHEMO SURG & RT SURG CHEMO & RT SURG & CHEMO & PALLIATIVE CARE SURG & PALLIATIVE CARE SURG & INTRACYSTIC THERAPY PALLIATIVE CARE ONLY AWAITING PLAN RT & CHEMO RT & PALLIATIVE CARE CHEMO ONLY CHEMO & PALLIATIVE CARE PROTONS CONTINUE WITH CURRENT THERAPY TF / OR TREATMENT OTHER UNIT NONE(WAIT & SEE)
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Summary of Treatment Pathway: Brain tumour recurrence/progression Apr 2014 – Mar 2015
5 10 15 20 25 30 35 SURGERY CHEMOTHERAPY RADIOTHERAPY PROTONS PALLIATIVE CARE
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Spinal Tumours
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New Spinal Tumours : Apr 2014- Mar 2015
2 4 6 8 10 12 14 16 2005 2006 2007 2008 2009 2010 2011 2012 2013/14 2014/15
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New Spinal Tumours : April 2014-March 2015 :Tumour Type
1 2 3 Schwannoma grade 1 Neuroblastoma Pilocytic Astrocytoma Peripheral PNET Aneurysmal bone cyst Meningioma grade 2 Secreting GCT Osteosarcoma under 1yr 1- 3yrs 3-12yrs >13yrs
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New Spinal Tumours : April 2014- Mar 2015 Treatment pathway
1 2 3 4 5 6 7 8 NEUROSURGERY ONLY NEUROSURGERY & CHEMO NEUROSURGERY & TF GEN SURG CT GUIDED BIOPSY & CHEMO
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Deaths
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Deaths of patients April 2014-March 2015
5 10 15 20 25 30 35 2005 2006 2007 2008 2009 2010 2011 2012 2013/14 2014/15
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2nd Opinions
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2nd Opinions 1997 - 2015
20 40 60 80 100 120 140 160 1997 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013/14 2014/15
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2nd Opinions 2014/15
- 152 discussions on 116 patients
- 65 external patients (71 discussions)
- 51 Gosh patients - non neuro-oncology
(Oncology and other teams) - (81 discussions)
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Patient Discussions in MDT 2014/15
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Patient discussions in MDT 2014/15
246 51 65
Neuro-oncology patients Internal Opinions External Opinions
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Patient discussions in MDT 2014/15
1213 81 71
Neuro-oncology patients Internal Opinions External Opinions
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