Neuro-oncology Top 10

  1. Do lifestyle factors (e.g. sleep, stress, diet) influence tumour growth in people with a brain or spinal cord tumour?
  2. What is the effect on prognosis of interval scanning to detect tumour recurrence, compared with scanning on symptomatic recurrence, in people with a brain tumour?
  3. Does earlier diagnosis improve outcomes, compared to standard diagnosis times, in people with a brain or spinal cord tumour?
  4. In second recurrence glioblastoma, what is the effect of further treatment on survival and quality of life, compared with best supportive care?
  5. Does earlier referral to specialist palliative care services at diagnosis improve quality of life and survival in people with a brain or spinal cord tumours?
  6. Do molecular subtyping techniques improve treatment selection, prediction and prognostication in people with a brain or spinal cord tumour?
  7. What are the long-term physical and cognitive effects of surgery and/or radiotherapy when treating people with a brain or spinal cord tumour?
  8. What is the effect of interventions to help carers cope with changes that occur in people with a brain or spinal cord tumour, compared with standard care?
  9. What is the effect of additional strategies for managing fatigue, compared with standard care, in people with a brain or spinal cord tumour?
  10. What is the effect of extent of resection on survival in people with a suspected glioma of the brain or spinal cord?

The remaining questions discussed at the workshop were (in no order of priority):

  • In brain tumour patients, what is the effect of short-course steroid use, compared with continuous steroid use, on managing symptoms?
  • In patients with a brain tumour, what is the effect of early surgical intervention on prognosis, compared with standard guidelines for surgery?
  • For people with low grade gliomas (LGG) at risk of malignant transformation to high grade gliomas (HGG), what is the optimal MRI monitoring protocol?
  • In brain tumour patients, what is the effect of cognitive interventions (including memory training) on improving memory after radiotherapy, compared with standard care?
  • In patients with a low grade or a high grade glioma, what is the effect of extent of resection on neuropsychological function, compared with no resection/biopsy?
  • Does chromosomal analysis of low grade gliomas improve prediction of transformation to a higher grade?
  • In malignant brain tumour patients, how effective are complementary and alternative medicines, which include supplements and herbal remedies, compared to standard treatment alone, for extending and improving quality of life? 
  • In patients with low grade glioma, can the use of circulatory biomarkers predict an early malignant transformation process?
  • In patients with brain and spinal cord tumours, what is the effect of psychological interventions on coping with living with a brain tumour, compared with standard care?
  • In elderly patients with a high grade glioma, what is the most effective treatment?  For example, 30Gy dose in 6 fractions for 2 weeks with concurrent Temozolomide vs Temozolomide vs Radiotherapy alone?
  • In imaging-diagnosed Glioblastoma Multiforme patients, where the benefits of biopsy are uncertain, does biopsy improve survival, compared to no biopsy?
  • In patients with a brain or spinal cord tumour, how effective is additional clinical nurse specialist support, compared to standard care, in improving quality of life?
  • In patients with brain or spinal cord tumour, how effective are interventions that provide structured emotional support during diagnosis and primary treatment in reducing psychological distress, compared to care as usual?
  • In brain or spinal cord tumour patients, what is the effect of management of depression on outcome, compared with standard care?
  • In patients with brain tumours, what is the effect of adopting a healthy diet on progression-free survival?