Clinical impact following the establishment of a specialized brain metastases tumor board.

PURPOSE

To evaluate the impact of brain metastasis tumor board (BMTB) on treatment patterns and survival.

METHODS

365 patients with brain metastases (BM) were analyzed at the Hospital Clínic de Barcelona from October 2019 to October 2022. This included those treated in the department of neurosurgery and radiation oncology during the first 18 months following its establishment. Demographic, clinicopathological, and treatment data were recorded and compared between the groups with and without BTBM.

RESULTS

Of 365, 95 were in the BMTB group and 270 in the non-BMTB group. Patients discussed at the BMTB had higher rates of surgery (53.7% vs. 14.7%, p < 0.001) and stereotactic radiosurgery (63.1% vs. 21.6%, p < 0.001). The time between surgical treatment and adjuvant radiotherapy was shorter in the BMTB group (37 days, 95% CI 4 vs. 48 days, 95% CI 18, p = 0.018). No differences were observed in local progression (26.0% vs. 20.8%, p = 0.9) but there were differences in cerebral progression (43.2% vs. 27.4%, p = 0.004). Rescue treatment was more common in the BMTB group (26.3% vs 10.0%, p < 0.001). Median survival after BM was significantly longer in the BMTB group (28.2 ± 2.7 vs. 12.7 ± 1.04 months, p < 0.001).

CONCLUSION

Multidisciplinary discussions for patients with BM are crucial as they improve overall survival through integrated therapies. Additional trials are needed to optimize treatment integration in this complication.