UPDATE IN NEUROLOGY · NEUROLOGY UPDATE.2 SPRING trial Seizure PRophylaxis IN Glioma Use of diet in...
Transcript of UPDATE IN NEUROLOGY · NEUROLOGY UPDATE.2 SPRING trial Seizure PRophylaxis IN Glioma Use of diet in...
NEUROLOGY UPDATE
DR E. MOLINARI
QUEEN ELIZABETH UNIVERSITY HOSPITAL
GLASGOW
SANON 2018 National Meeting
TALK OVERVIEW QPI
Neurologists in context - changing needs - JLA - financial boost
What we do
What we would like to do
Howe we would like to do it
Coming up soon
NATIONAL CLINICAL AUDIT
PROGRAMME 2017-2018
QPIs
standard of care across all locations
quality performance indicators
Improving QPI 11
against a target of 95%
compared to 77.9%
84.1%
Are we important?
Are we dealing with similar conditions?
Can we learn from other neurological conditions?
Epilepsy
…there is a mass in the brain…
Transforming Care After Treatment (TCAT)
support people with the physical, emotional and
financial issues
NEURO-ONCOLOGY NEUROLOGISTS
Socio-economic impact of BTs survivorship
Halving the harm of BTs
JLA Neuro-Oncology Top 10
1. Do lifestyle factors (e.g. sleep, stress, diet) influence tumour
growth?
4. In second recurrence glioblastoma, what is the effect of
further treatment on survival and quality of life, compared with
best supportive care?
7.What are the long-term physical and cognitive effects of
surgery and/or radiotherapy?
9.What is the effect of additional strategies for managing fatigue,
compared with standard care?
10. What is the effect of extent of resection on survival in people
with a suspected glioma?
Neuro-Oncology Top 10
JLA
JLA Neuro-Oncology others priorities
• what is the effect of short-course steroid use, compared with
continuous steroid use, on managing symptoms?
• what is the effect of cognitive interventions (including memory
training) on improving memory after radiotherapy, compared
with standard care?
• what is the effect of management of depression on outcome,
compared with standard care?
• what is the effect of adopting a healthy diet on progression-
free survival?
FUNDING BOOST
• Department of Health & Social care £ 45 million
• National Institute for Health Research £ 20 million
• Cancer Research UK
• NIHR and DoH
£ 25 million £ 13 million/year
NEURO-ONCOLOGY NEUROLOGISTS 1
“when I go in the other room, they look at my
tumour”… “when I am here, you look after me”
Oncology
NEURO-ONCOLOGY NEUROLOGISTS 3
Secondary Epilepsy
Cognitive difficulties
Emotional difficulties
Physical difficulties
Neuropsychology
Psychiatry
Neuro-
rehabilitation
Health surveillance Integrate care
Neurosurgery
Clinical
Scope Diagnosis
Monitoring & Managing brain tumours in adults
Aims To improve diagnosis & standardize care
NICE GUIDELINES 2018
Several labs
NEURO-ONCOLOGY NEUROSCIENCE 1
Several teams
Inflammation
Regenerative
Medicine
Research
Imaging
Dementia &
Stroke
MS research
Demyelination
How lab skills in neuroscience could expand and
incorporate neuro-oncology
NEURO-ONCOLOGY NEUROSCIENCE 2
Mechanism of tumour-associated epilepsy
Mechanism of tumour-associated symptoms (HRQoL)
Mechanism of treatment-related symptoms
Basic science of Inflammation and immuno-therapy
Drugs combining seizure and tumour control
Biomarkers for risk-stratification on QoL
Inform on therapeutic strategies
Guide treatment decisions
Evaluate treatment global effects
NEURO-ONCOLOGY NEUROSCIENCE 3
Improve QoL
NEUROLOGY UPDATE
Plan for a position statement and future landscape
Research projects
Moving forward
Is it “normal brain" or not?
changes around tumour
changes far away from tumour
Clinical trials
Better assess symptom burden and QoL
Better incorporate PROs
Anti-epileptic medications
NEUROLOGY UPDATE.1
NEUROLOGY UPDATE.2
SPRING trial Seizure PRophylaxis IN Glioma
Use of diet in gliomas Cochrane Review
SCAN-LGG Symptoms Correlates And
Neuroimaging in Low Grade Gliomas:
addressing the quality of life
Incorporation of QoL
Neuro-Oncology Practice,npy032
Recent Incubator Day
RANO-PRO working plan