In Brain News, Brain Tumour Data, Research News

Introduction

For patients battling brain metastases or benign brain tumours like meningiomas, Stereotactic Radiosurgery (SRS) offers a highly targeted radiotherapy treatment option. While SRS is a promising treatment, its effects on brain function are not fully understood. A new pilot study seeks to shed light on these effects, aiming to identify specific brain regions that, when exposed to radiation, contribute to cognitive decline. This understanding could help future patients by refining treatment plans to minimize side effects, thereby improving their quality of life.

 

Why Does This Study Matter?

CoDe B-Rad is a study exploring Cognitive Decline after Brain Radiosurgery. Brain metastases patients typically have a life expectancy of 6 months to 1 year, while meningioma patients can live for 10 years or more. Given these different prognoses, understanding the short- and long-term cognitive effects of SRS is crucial. If certain areas of the brain are found to be particularly sensitive to radiation, future treatments can be adjusted to protect these areas, potentially preserving brain function.

 

Research Objectives and Study Design

The primary goal of this study is to identify which regions of the brain are linked to cognitive decline following SRS. Stereotactic Radiosurgery, or SRS, is a highly precise form of radiation therapy used to treat brain tumours. Despite its name, it is not a surgical procedure. Instead, it uses focused beams of radiation to target and treat specific areas in the brain.

The study uses tools like the Montreal Cognitive Assessment (MoCA) and specific quality-of-life questionnaires, researchers aim to correlate cognitive function with radiation doses received in different brain areas.

This single-centre observational study will involve both prospective and retrospective data collection. Participants are divided into two groups:

  • Group 1: Patients will undergo MoCA and quality-of-life assessments before treatment and every three months for a year.
  • Group 2: Patients will complete these assessments once.

Data from these assessments, along with MRI scans and SRS treatment plans, will be analysed to pinpoint brain regions where radiation doses may lead to cognitive issues.

Identifying brain areas sensitive to radiation will help develop guidelines to limit doses to these regions in future SRS treatments. This could significantly reduce cognitive side effects, enhancing the overall quality of life for patients undergoing SRS. Additionally, with detailed knowledge of potential side effects, healthcare providers can offer better-informed guidance to patients and help them to make more educated decisions about their treatment options.

 

Current Status

Anna Bangiri is a radiotherapy physicist who is working on the project and brainstrust has closely worked with Anna to provide patient input and feedback through PRIME. She recently provided some information regarding the status of the project:

“The Measuring and Mapping Cognitive Decline after Brain Radiosurgery (CoDe B-Rad) is ready to recruit its first patient. All ethical approvals have been granted by the London Stanmore Research Ethics Committee and the Health Research Authority and Health and Care Research Wales (IRAS project ID:340408, REC reference 24/PR/0426). Nottingham University Hospitals NHS Trust is the final piece of the puzzle, whose approval we are expecting imminently. The research team will send more updates when the first patient has been successfully recruited. We are also in the process of writing a paper to document the patient and public involvement that we carried out during the protocol development, as well as how that involvement shaped the protocol itself. We are currently looking for a contributor to help us write the plain English summary for the paper. If you are interested, please contact me at anna.bangiri1@nottingham.ac.uk”  

 

Conclusion

This pilot study represents a significant step toward optimizing SRS treatment for brain tumour patients. By focusing on preserving cognitive function, the study aims to improve the quality of life for patients with brain metastases and non-malignant brain tumours. As SRS continues to be a vital tool in the fight against brain tumours, such research is essential in refining its use to benefit patients the most.

To read more scientific information, click here.

 

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If you or someone you love is living with a brain tumour and have any questions around this latest news, or want to access support, give us a call on 01983 292 405 or email hello@brainstrust.org.uk. You can also visit our little brainstrust website which features support for children affected by brain tumour.

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Introduction

The Brain Tumour Data Dashboard lets you explore up -to-date, population level data about the brain tumours diagnosed in England between 2013 and 2015. Using the drop down menus on the left you can select different groups of patients to view in the charts below. In these charts the number of patients for every 100 diagnoses is displayed as images of people. Patients have been grouped by date of diagnosis, type of tumour, age, gender, and region in England.

For each group of patients you can explore the different routes to diagnosis, the proportion of those who received chemotherapy or radiotherapy, as well as the survival of the patients within each group. For more information about what these metrics mean please see the glossary.

How to use

  1. Select the year of diagnosis using the drop down menu.
  2. Select your patient group of interest from the four drop down menus in the following order:
    1. Tumour group
    2. Age at diagnosis
    3. Region of England
    4. Gender of patient
  3. To view a second chart to compare different groups of patients, click the ‘compare’ button.The second chart will appear below the first chart.

*Note that the tool is best used on a laptop or tablet rather than a mobile phone*

Unavailable data

Some of the data in these charts is not available.There are two main reasons for this:

  1. How the data has been grouped

If you cannot select a patient group from the drop down menus, the data is unavailable because of how the data has been organised.

Public Health England has grouped the data like a branching tree. The bottom of the tree contains all the patients with brain tumours, and then each branch divides the data by a certain characteristics, like age, or location of tumour. But the data is divided in an order, starting with location of the tumour (endocrine or brain), then by age, region, and gender. Age is at the start because it makes a bigger difference to survival rates and treatment rates than gender or region. Sometimes, after the data has been split by type of tumour and age, there is not enough data to be split again. This is because to protect patient confidentiality groups cannot contain less than 100 patients. Because some groups cannot be split further, you cannot create ‘totals’ for everyone by region or gender. For example, you cannot see results for all ages by region, or all brain tumours by gender. If these totals were calculated and released, it might be possible to identify patients, which is why Public Health England cannot release this data.

  1. Statistical reasons and data availability

If you can select a patient group from the chart menus, but the chart does not display, the data is unavailable for one of several reasons:

  1. Data is not yet available for the selected year from Public Health England.
  2. Data is not available because the data quality is too poor to release this statistic.
  3. Data is not available as the statistic is not appropriate for this group.
  4. Data is not available because the standard error of the estimate was greater than 20% and so the estimate has been supressed.

Up to date brain tumour data

Brain tumour data may influence the decisions you make about your care. Data also helps you understand the bigger picture, or landscape, in which you find yourself.

Brain tumour data and statistics influence the focus, and work of organisations like brainstrust. The information helps us to understand the scale and impact of the problems we are setting out to solve.

This tool helps you understand the landscape in which you find yourself having been diagnosed with a brain tumour. This landscape can be particularly tricky to navigate as there are many different types of brain tumour, all of which have a different impact.

The information you see represents the most up-to-date, official, population level brain tumour data available for England. Over time we will be adding to the brain tumour data available and publishing reports, with recommendations, as a result of what we learn from this data.

The data behind this content has come from Public Health England’s National Cancer Registration and Analysis Service (NCRAS) and is a direct result of the ‘Get Data Out’ project.

This project provides anonymised population level brain tumour data for public use in the form of standard output tables, accessible here: http://cancerdata.nhs.uk/standardoutput

Incidence

The number or rate (per head of population) of new cases of a disease diagnosed in a given population during a specified time period (usually a calendar year). The crude rate is the total number of cases divided by the mid-year population, usually expressed per 100,000 population.

Malignant

Malignant tumours which grow by invasion into surrounding tissues and have the ability to metastasise to distant sites

Mortality

The number or rate (per head of population) of deaths in a given population during a specified time period (usually a calendar year). The crude rate is the total number of deaths divided by the mid-year population, usually expressed per 100,000 population.

Non-malignant

Not cancerous. Non-malignant tumours may grow larger but do not spread to other parts of the body.

Survival

The length of time from the date of diagnosis for a disease, such as cancer, that patients diagnosed with the disease are still alive. In a clinical trial, measuring the survival is one way to see how well a new treatment works. Also called ‘overall survival’ or ‘OS’.

Routes to Diagnosis

Under the ‘Routes to Diagnosis’ tab in the Brain Tumour Data Dashboard, you can explore the ways patients have been diagnosed with brain tumours. There are many ways, or routes, for cancers to be diagnosed in the NHS. A ‘route to diagnosis’ is the series of events between a patient and the healthcare system that leads to a diagnosis of cancer. The routes include:

  1. Two Week Wait

Patients are urgently referred by their GP for suspected cancer via the Two Week Wait system and are seen by a specialist within 2 weeks where they are diagnosed.

  1. GP referral

Diagnosis via a GP referral includes routine and urgent referrals where the patient was not referred under the Two Week Wait system.

  1. Emergency Presentation

Cancers can be diagnosed via emergency situations such as via A&E, emergency GP referral, emergency transfer or emergency admission.

  1. Outpatient

Outpatient cancer diagnoses include diagnoses via an elective route which started with an outpatient appointment that is either a self-referral or consultant to consultant referral. (It does not include those under the Two Week Wait referral system).

  1. Inpatient elective

Diagnosis via an inpatient elective route is where diagnosis occurs after the patient has been admitted into secondary care from a waiting list, or where the admission is booked or planned.

  1. Death Certificate Only

Diagnoses made by Death Certificate Only are made where there is no more information about the cancer diagnosis other than the cancer related death notifications. The date of diagnosis is the same as that of the date of death.

  1. Unknown

For some patients with a cancer diagnosis, there is no relevant data available to understand the route to diagnosis.

 

More information

If any of the statistical terms in this section of the brainstrust website are hard to understand, we recommend looking them up here:

Cancer Research UK’s Cancer Statistics Explained

http://www.cancerresearchuk.org/health-professional/cancer-statistics/cancer-stats-explained/statistics-terminology-explained#heading-Seven

If you are looking for help understanding terms relating specifically to brain tumours, and treatment, then the brainstrust glossary is available here:

https://www.brainstrust.org.uk/advice-glossary.php