84 A Clinical Audit of Glioblastoma Services at Weston Park Hospital

Abstract Introduction The glioblastoma services at Weston Park Hospital (WPH) are audited on a rolling basis to evaluate patient follow-up, treatment interventions and outcomes. NICE recommendations on the management of primary brain tumours are regularly reviewed, and were last updated in 2021. This audit aimed to assess current clinical practice in line with updated national standards, and ensure continued monitoring of outcomes to allow the trust to review data trends. Methods A retrospective audit was performed on a sample of 91 patients diagnosed with Glioblastoma, IDH wild-type, WHO stage IV, who had a biopsy or resection from Oct 2020-Dec 2024 at WPH. Data was collected from electronic patient notes and clinic letters. The type of surgery, post-operative imaging, choice of chemotherapy, and palliative care referrals were evaluated in accordance with NICE guidance. Results 97% of patients who had a resection had a post-operative MRI within 72 hours. 26 sampled patients survived over 24 months post-operation. Of these, only 37.5% had follow-up MRIs at the advised 6 month interval. 100% of patients deemed suitable for chemotherapy received first-line Temozolomide. All patients with progression were considered for alternative second-line chemotherapies. Only 69.2% of patients had palliative care referrals arranged, with 8.8% having no clear documentation of this. Conclusions Most standards analysed have been met. However, management needs to be optimised to ensure patients undergo monitoring MRI scans at the recommended intervals. Extra consideration needs to be given to apt timing and clear documentation of palliative care referrals. As WPH moves to an all-electronic system, there is a chance to introduce new flagging methods to ensure that these standards are met.