132 Evaluating the role of neuro-oncology CNSs in managing patients with brain metastases treated with SRS/FRST within a specialist cancer centre

Abstract Introduction Patients with brain metastases undergoing stereotactic radiosurgery (SRS) or fractionated stereotactic radiotherapy (FRST) often present with neurological, oncological and psychosocial needs. The delivery of safe, effective specialist nursing input, requires advanced clinical knowledge and coordinated care. Neuro-oncology CNSs are central to ensuring a streamlined, holistic approach to care. Methods A retrospective service evaluation was undertaken of 71 patients, over a 6 month period, receiving SRS/FRST for brain metastases. Electronic patient records were reviewed to identify the timing, frequency and nature of CNS contacts, including pre and post treatment reviews, nature of involvement and discharge planning. An overall evaluation of CNS activity was included to greater understand the impact on workload. Results During the 6-month period, the Neuro-Oncology CNS team supported 411 patients and recorded 2,532 total interventions. Of these, 71 patients underwent SRS/FRST for brain metastases, accounting for 355 contacts (14% of total activity). Pre-treatment CNS contact occurred in 38/71 patients (53.5%), increasing to 70/71 (98.6%) during or after treatment. Contacts ranged from two to fourteen per patient. Post-treatment follow-up was predominantly telephone-based (68/71; 95.8%), while 36/71 (50.7%) received face-to-face review, all following FRST. Clinical assessment was undertaken in 98.6%, clinical advice provided in 97.2%, and medication advice in 93.0%, with independent prescribing in 12.7%. CNS-led discharge occurred in 77.5%. Only 21.1% required medical review post-treatment. Conclusion Specialist nursing input encompasses advanced assessment, symptom management, prescribing, psychosocial support and coordination of care, with the majority of patients managed without requirement for additional medical review. These findings highlight the importance of protected specialist neuro-oncology nursing provision to ensure safe monitoring, continuity of care and holistic management within this complex group of patients.