BACKGROUND Delay in cancer care may adversely affect emotional distress, treatment outcome and survival. Optimal timings in multidisciplinary glioblastoma care are a matter of debate and clear national guidelines only exist for time to neurosurgery. We evaluated the between-hospital variation in timings to neurosurgery and adjuvant radiotherapy and chemotherapy in newly diagnosed glioblastoma patients in the Netherlands. MATERIAL AND METHODS Data were obtained from the nation-wide Dutch Brain Tumor Registry between 2014 and 2018. All adult patients with glioblastoma were included, covering all 18 neurosurgical hospitals, 28 radiotherapy hospitals, and 33 oncology hospitals. Long time-to-surgery (TTS) was defined as >3 weeks from the date of first brain tumor diagnosis to surgery, long time-to-radiotherapy (TTR) as either >4 or >6 weeks after surgery, and long time-to-chemotherapy (TTC) as either >4 or >6 weeks after completion of radiotherapy. Between-hospital variation in standardized rate of long timings was analyzed in funnel plots after case-mix correction. RESULTS A total of 4203 patients were included. Median TTS was 20 days and 52.4% of patients underwent surgery within 3 weeks. Median TTR was 20 days and 24.6% of patients started radiotherapy within 4 weeks and 84.2% within 6 weeks after surgery. Median TTC was 28 days and 62.6% of patients received chemotherapy within 4 weeks and 91.8% within 6 weeks after radiotherapy. After case-mix correction, three (16.7%) neurosurgical hospitals had significantly more patients with longer than expected TTS. Three (10.7%) and one (3.6%) radiotherapy hospitals had significantly more patients with longer than expected TTR for >4 and >6 weeks, respectively. In seven (21.2%) chemotherapy hospitals, significantly less patients with TTC >4 weeks were observed than expected. In four (12.1%) chemotherapy hospitals, significantly more patients with TTC >4 weeks were observed than expected. CONCLUSION Between-hospital variation in timings to multidisciplinary treatment was observed in glioblastoma care in the Netherlands. A substantial percentage of patients experienced timings longer than anticipated.

中文翻译：

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P14.31 荷兰脑肿瘤登记处多学科胶质母细胞瘤护理时间的医院差异

背景癌症治疗的延迟可能会对情绪困扰、治疗结果和生存产生不利影响。多学科胶质母细胞瘤护理的最佳时机是一个有争议的问题，明确的国家指南只存在于神经外科手术的时间。我们评估了荷兰新诊断的胶质母细胞瘤患者的神经外科和辅助放疗和化疗时间的医院间差异。材料与方法 数据来自荷兰全国脑肿瘤登记处 2014 年至 2018 年。纳入所有成年胶质母细胞瘤患者，覆盖所有 18 家神经外科医院、28 家放疗医院和 33 家肿瘤医院。手术时间长 (TTS) 定义为从第一次脑肿瘤诊断到手术之日起 > 3 周，放射治疗时间长 (TTR) 定义为 > 4 或 & 手术后 > 6 周，以及放疗完成后 > 4 或 > 6 周的长化疗时间 (TTC)。在病例组合校正后，在漏斗图中分析了长时间标准化率的医院间差异。结果共纳入4203例患者。中位 TTS 为 20 天，52.4% 的患者在 3 周内接受了手术。中位 TTR 为 20 天，24.6% 的患者在术后 4 周内开始放疗，84.2% 的患者在术后 6 周内开始放疗。中位 TTC 为 28 天，62.6% 的患者在 4 周内接受了化疗，91.8% 的患者在放疗后 6 周内接受了化疗。在病例组合校正后，三家 (16.7%) 神经外科医院的 TTS 长于预期的患者明显更多。三 (10.7%) 和一 (3. 6%) 放射治疗医院有明显更多的患者，其 TTR 比预期的长，分别为＞4 周和＞6 周。在七家 (21.2%) 化疗医院中，观察到的 TTC > 4 周患者明显少于预期。在四家 (12.1%) 化疗医院中，观察到的 TTC > 4 周患者明显多于预期。结论 在荷兰的胶质母细胞瘤护理中观察到医院间多学科治疗时间的差异。相当大比例的患者经历的时间比预期的要长。观察到的TTC＞4周的患者明显多于预期。结论 在荷兰的胶质母细胞瘤护理中观察到医院间多学科治疗时间的差异。相当大比例的患者经历的时间比预期的要长。观察到的TTC＞4周的患者明显多于预期。结论 在荷兰的胶质母细胞瘤护理中观察到医院间多学科治疗时间的差异。相当大比例的患者经历的时间比预期的要长。