NICE guidance on the use of carmustine wafers in high grade gliomas: a national study on variation in practice

Background. Multidisciplinary team (MDT) working in oncology aims to improve outcomes for patients with cancer. One role is to ensure the implementation of best practice and National Institute for Health and Clinical Excellence (NICE) guidance. In this study, we have assessed the role of MDT in impl...

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Main Authors:	Price, Stephen J., Whittle, Ian R., Ashkan, Keyoumars, Grundy, Paul, Cruickshank, Garth
Format:	Online
Language:	English
Published:	Informa Healthcare 2012
Online Access:	https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3432583/

id	pubmed-3432583
recordtype	oai_dc
spelling	pubmed-34325832012-09-05 NICE guidance on the use of carmustine wafers in high grade gliomas: a national study on variation in practice Price, Stephen J. Whittle, Ian R. Ashkan, Keyoumars Grundy, Paul Cruickshank, Garth Original Article Background. Multidisciplinary team (MDT) working in oncology aims to improve outcomes for patients with cancer. One role is to ensure the implementation of best practice and National Institute for Health and Clinical Excellence (NICE) guidance. In this study, we have assessed the role of MDT in implementing the TA121 appraisal of the use of carmustine wafers in high grade gliomas. Methods. 296 patients with high-grade glioma suitable for maximal resection were recruited from 17 Neurosurgical Centres. The number of patients treated with carmustine wafers and reasons for not using this were recorded. Complications at 48 hours post-operatively and at 6 weeks post-radiotherapy were recorded. Results. 94/296 (32%) of suitable patients received carmustine wafers. In 55% of cases carmustine was not used due to either surgeon preference or a lack of an MDT decision. There was no increased complication rate with carmustine use at either 48 hours post-surgery or at 6 weeks post radiotherapy. Use of carmustine wafers did not decrease access to and use of chemoradiotherapy. Conclusions. One third of patients suitable for carmustine wafers received them. Their use was neither associated with more frequent complications, nor decreased use of chemoradiotherapy. Implementation of NICE TA121 Guidance is extremely variable in different MDTs across the United Kingdom. Informa Healthcare 2012-06 2012-05-28 /pmc/articles/PMC3432583/ /pubmed/22482926 http://dx.doi.org/10.3109/02688697.2012.673651 Text en © 2012 The Neurosurgical Foundation http://creativecommons.org/licenses/by/2.0/ This is an open access article distributed under the Supplemental Terms and Conditions for iOpenAccess articles published in Informa Healthcare journals (http://www.informaworld.com/mpp/uploads/iopenaccess_tcs.pdf) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
repository_type	Open Access Journal
institution_category	Foreign Institution
institution	US National Center for Biotechnology Information
building	NCBI PubMed
collection	Online Access
language	English
format	Online
author	Price, Stephen J. Whittle, Ian R. Ashkan, Keyoumars Grundy, Paul Cruickshank, Garth
spellingShingle	Price, Stephen J. Whittle, Ian R. Ashkan, Keyoumars Grundy, Paul Cruickshank, Garth NICE guidance on the use of carmustine wafers in high grade gliomas: a national study on variation in practice
author_facet	Price, Stephen J. Whittle, Ian R. Ashkan, Keyoumars Grundy, Paul Cruickshank, Garth
author_sort	Price, Stephen J.
title	NICE guidance on the use of carmustine wafers in high grade gliomas: a national study on variation in practice
title_short	NICE guidance on the use of carmustine wafers in high grade gliomas: a national study on variation in practice
title_full	NICE guidance on the use of carmustine wafers in high grade gliomas: a national study on variation in practice
title_fullStr	NICE guidance on the use of carmustine wafers in high grade gliomas: a national study on variation in practice
title_full_unstemmed	NICE guidance on the use of carmustine wafers in high grade gliomas: a national study on variation in practice
title_sort	nice guidance on the use of carmustine wafers in high grade gliomas: a national study on variation in practice
description	Background. Multidisciplinary team (MDT) working in oncology aims to improve outcomes for patients with cancer. One role is to ensure the implementation of best practice and National Institute for Health and Clinical Excellence (NICE) guidance. In this study, we have assessed the role of MDT in implementing the TA121 appraisal of the use of carmustine wafers in high grade gliomas. Methods. 296 patients with high-grade glioma suitable for maximal resection were recruited from 17 Neurosurgical Centres. The number of patients treated with carmustine wafers and reasons for not using this were recorded. Complications at 48 hours post-operatively and at 6 weeks post-radiotherapy were recorded. Results. 94/296 (32%) of suitable patients received carmustine wafers. In 55% of cases carmustine was not used due to either surgeon preference or a lack of an MDT decision. There was no increased complication rate with carmustine use at either 48 hours post-surgery or at 6 weeks post radiotherapy. Use of carmustine wafers did not decrease access to and use of chemoradiotherapy. Conclusions. One third of patients suitable for carmustine wafers received them. Their use was neither associated with more frequent complications, nor decreased use of chemoradiotherapy. Implementation of NICE TA121 Guidance is extremely variable in different MDTs across the United Kingdom.
publisher	Informa Healthcare
publishDate	2012
url	https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3432583/
_version_	1611553822963924992

NICE guidance on the use of carmustine wafers in high grade gliomas: a national study on variation in practice

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