Abstract
INTRODUCTION: Radiation therapy for central nervous system disease commonly involves clinical collaboration between the disciplines of Radiation Oncology and Neurological Surgery. Unfortunately such collaboration has been rarely implemented in the outpatient clinic setting. We describe our experience with a multidisciplinary clinic model featuring radiation oncology in tandem with neurosurgery in a community hospital setting. METHODS: In August 2016, we initiated the novel RADIANS (RADIation oncology And NeuroSurgery) clinic model at a community hospital, with the fundamental idea being to establish a weekly time where patients could receive input from both disciplines during a single clinic visit. Disease and treatment demographics were collected and analyzed. Patient satisfaction was assessed via survey questionnaire, where both radiation oncology and neurosurgery attendings were blinded to both the administration of and patient responses in surveys. RESULTS: The majority of patients were seen for metastatic disease of the brain and/or spine. Of patients receiving radiation, most received stereotactic radiosurgery (SRS)/SBRT rather than conventional fractionation. Survey responses revealed that 86% found that having a consultation with two physicians at the same time in the same room “was a totally new experience”. All responders found that having two physicians at the same time was “a better way to be evaluated than simply having two separate appointments with these two physicians”, while describing the dynamics of the evaluation process as being shared equally between the radiation oncologist and neurosurgeon. CONCLUSIONS: The majority of radiation therapy provided through the RADIANS clinic model has been SRS/SBRT rather than conventional fractionation. The model is popular with patients, most of whom present with brain and/or spine metastatic disease. Continued meticulous collection and analysis of outcomes will be needed to rigorously evaluate the long-term impact of RADIANS.