Organizational Guidance for the Care of Patients with Central Nervous System Tumours in Ontario: Consensus Recommendations

Guideline Objective

To provide guidance for the organization and delivery of healthcare services for adult patients with primary central nervous system (CNS) tumours in Ontario.

The goal is to ensure that all patients in Ontario have access to comprehensive CNS tumour services, regardless of their place of residence. Specifically, to ensure appropriate coordination of concurrent services (surgery, chemotherapy, radiotherapy, and supportive care) within a province-wide CNS tumour program, including:

• Appropriate clinician/health professional skill set, experience, and qualifications
• Case review at multidisciplinary case conferences (MCCs)
• Access to expert multidisciplinary resources (including allied health/psychosocial oncology)
• Care as close to home as possible
• Access to clinical trials

Patient Population

This guideline focuses on adult patients with primary CNS tumours (glioma and other primary parenchymal neoplasms, sellar lesions, and skull-base lesions and meningioma) and their caregivers. This guideline does not apply to patients with brain or spinal metastases, sarcomatous tumours of the CNS, or pediatric patients with CNS tumour, as care considerations for these patients have been addressed by previous or parallel guideline efforts. For organizational guidance on brain metastases, please see the related Ontario Health (Cancer Care Ontario) (OH (CCO)) organizational care guideline for stereotactic radiosurgery treatment of brain metastasis.

Intended Guideline Users

Stakeholders include all Ontario Regional Cancer Programs and affiliated centres that deliver CNS tumour care (primary brain tumours), as well as programs that plan to provide CNS tumour care in the future. Specifically, this document is intended for administrators responsible for developing, implementing, and maintaining CNS tumour programs and for the oncology health care professionals who interact with and care for patients with CNS tumours.

Research Questions

1. What are the centre requirements for the organization and delivery of care for adult patients with CNS primary tumours?
2. What are the recommended staff requirements and expertise required by medical/surgical, nursing, and allied healthcare professionals to provide optimal care for patients with CNS primary tumours?