Patient-Based Council

Brain Tumors & Neuro-Oncology Council

In brain tumors every decision must be weighed against neurological function. Our council brings together neurosurgery, radiation oncology and neuro-oncology.

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About the disease

Brain tumors fall into two groups: primary tumors (such as glioma and meningioma) and brain metastases spreading from other organs. Because of neurological function, tumor location can directly constrain the treatment decision.

In current classification, molecular markers (IDH mutation, 1p/19q co-deletion, MGMT methylation) are an inseparable part of the diagnosis; they determine both treatment and the course of disease.

The extent of surgical resection, the radiotherapy technique (stereotactic radiosurgery or fractionated treatment) and the systemic treatment sequence are planned by evaluating tumor type, location and the patient’s neurological status together.

Which specialties evaluate it?

In this council your case is reviewed jointly by the disciplines below.

Neurosurgery
Radiation Oncology
Medical Oncology
Neurology
Neuroradiology
Pathology / Neuropathology
Nuclear Medicine
Rehabilitation

Files requested from the patient

Pathology report and molecular markers (IDH, 1p/19q, MGMT)
Cranial MRI images (preoperative and postoperative) and reports
Perfusion / spectroscopy or functional MRI findings (if available)
Operative note and extent-of-resection details
Neurological examination findings and performance status
Discharge summary and a summary of radiotherapy and chemotherapy received

Clinical questions answered

Is my tumor suitable for surgery, and how much can be safely removed?
How do my molecular results change the diagnosis and my treatment?
Is radiosurgery or fractionated radiotherapy more appropriate?
How will my neurological functions be protected?
What options come into play if the tumor recurs?
Is there a suitable clinical trial option?

Scope of the council report

Written opinion confirming the case was reviewed by a multidisciplinary council
Council confirmation of the diagnosis, stage and risk group
Recommended treatment options and the reasoning behind them
Alignment with current guidelines (ESMO / NCCN) and a level-of-evidence note
Comparison of alternative options and their expected side-effect profiles
Recommendations for any additional tests or consultations
Potentially suitable clinical trial options

Scope of the second opinion

Independent review of the current diagnosis and staging
Re-evaluation of pathology and imaging findings
Confirmation that the ongoing or planned treatment is appropriate
Comparative presentation of alternative treatment approaches
Clarification of unanswered clinical questions
Assessment of how well the decision fits the patient’s priorities and quality-of-life goals