Abstract AIMS Glioma patients have a high symptom burden and limited life expectancy with WHO Grade 4 glioma patients living an average of 12-18 months (WHO). NICE 2018 Clinical guidelines recommend specialist neurological re- habilitation at diagnosis and throughout follow At Guy’s Cancer Centre, a Multi-disciplinary team (MDT) comprising Physiotherapy (PT), Occupational Therapy (OT) and Speech and Language Therapy (SLT) is embed- ded in the Neuro-Oncology clinic, following the Dietz Rehabilitation model to optimise function, enhance treat- ment tolerance and improve quality of life. METHODS A 75-year-old male with a right parietal astrocytoma (WHO Grade 4, unmethylated), underwent biopsy on 31/10/24, followed by a course of radiotherapy (40Gy/15#). Symptoms were managed with Dexamethasone and Keppra. History included hypertension and smoking, with primary social support from his daughter. Clinical assessment revealed fatigue, global weakness, cognitive decline, and left facial nerve palsy (FNP) all impacting activities of daily living (ADL). He transitioned to end-of-life care on 31/12/24. RESULTS Comprehensive specialist assessment and rehabilitation was provided pre, during and post oncology treatment. OT identified cognitive decline and reduced ADL independence, recommending home safety strategies, includ- ing medication management and with PT, fatigue management PN1 techniques. PT and OT focused on safe, independent transfers, and a tailored PT home exercise program was introduced alongside home equipment. SLT identified oropharyngeal dysphagia due to FNP, implementing strategies to reduce aspiration risk and im- prove oral intake. Facial massage and speech strategies were recommended, with a referral to a specialist FNP clinic. Patient and family education on treatment effects, disease stage, fatigue, cognition, and inactivity were provided. Anticipatory referrals to Community rehabilitation services minimized wait-times. CONCLUSION Embedding an MDT in a neuro-oncology clinic enables integrated rehabilitation, improving function, treatment tolerance, and symptom management. This coordinated model within a single clinic facilitates timely, syner- gistic interventions targeting complex symptom burden for patients with high-grade gliomas.
Clark et al. (Mon,) studied this question.
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