title: Neuro-oncology practices in Australia: a Cooperative Group for Neuro-Oncology patterns of care study.
abstract: OBJECTIVE
  To provide data on the patterns of care in neuro-oncology practices at Australian cancer centres over the previous 12-month period.
  
  
  METHODS
  A 5-page questionnaire was sent to Cooperative Trials Group for Neuro-Oncology members at 28 Australia cancer centres. The questions included access to neuro-oncology services; treatment protocols and patterns of supportive care.
  
  
  RESULTS
  Provision of neuro-oncology services was consistent in metropolitan cancer centres. Treatment protocols are virtually identical for patients with an initial diagnosis of glioblastoma multiforme (GBM), with the main variation being for older or less fit patients. Most patients (70%) received chemotherapy at recurrence, most commonly modified schedule temozolomide, with half of the cancer centers offering bevacizumab. For anaplastic astrocytoma (AA), most clinicians offer radiotherapy alone but 30% would use radiotherapy with concurrent and adjuvant temozolomide. Half of clinicians continued to use prophylactic anticonvulsants; 25% do not prescribe prophylactic antibiotics during chemoradiotherapy and half would continue anti-coagulation therapy indefinitely for thromboembolism.
  
  
  CONCLUSIONS
  This is the first Australia-wide patterns of study of care in the management of gliomas. There is general consensus on the use of radiotherapy with concurrent and adjuvant temozolomide and the use of chemotherapy for recurrent GBM. The choice of chemotherapy at recurrence is not standard and the provision of bevacizumab is inconsistent. This survey highlights variation in the treatment of the elderly GBM and patients with AA as well as in areas of supportive care, in particular, the ongoing use of prophylactic anticonvulsants despite guidelines.
authors.affiliation: National Health and Medical Research Council Clinical Trials Centre, University of Sydney.
authors.forename: James Y
authors.initials: JY
authors.lastname: Chen
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Hovey
authors.forename: Mark
authors.initials: M
authors.lastname: Rosenthal
authors.forename: Ann
authors.initials: A
authors.lastname: Livingstone
authors.forename: John
authors.initials: J
authors.lastname: Simes
mesh_terms: D001315:Australia; D001932:Brain Neoplasms / Q000175:diagnosis* / Q000628:therapy*; D003625:Data Collection; D005909:Glioblastoma / Q000175:diagnosis* / Q000628:therapy*; D006801:Humans; D008495:Medical Oncology / Q000379:methods* / Q000706:statistics & numerical data*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires
keywords: Group 1: major specialty; Group 2: tumor type; central nervous system cancer; epidemiology; public health