Abstracts ii31 NEURO-ONCOLOGY • September 2021 the frequency (median 4.5, IQR 2.5) and burden (median 4.0, IQR 3.00) dimension and 21% of the patients were willing to undergo treatment for fatigue. Overall 35% of the patients were willing to undergo treatment for at least one symptom. Frequency and burden of symptoms correlated well (median Kendall’s Tau of 0.84 with a range of correlations of 0.73–0.95). Frequency and willingness to undergo treatment correlated less (median Kendall’s Tau of 0.35, range 0.24–0.57), as well as burden and willingness to undergo treatment (median Kendall’s Tau, range 0.28–0.61). CONCLU- SION: The top five symptoms most often reported by patients with diffuse glioma during stable disease were: fatigue, memory problems, reduced phys- ical fitness, concentration problems and drowsiness. These symptoms may serve as a roadmap for future research on treatment strategies to alleviate these symptoms. SUPPORT/DISCLOSURE: This project is funded by The Anita Veldman Foundation (CCA-2019-2-21). P12.03 A DELPHI SURVEY TO INFORM CORE ‘RED FLAG’ SYMPTOMS FOR AN ELECTRONIC PATIENT REPORTED OUTCOME SYSTEM IN GLIOBLASTOMA FOLLOW UP A. Luis 1,2 , F. Boele 3,4 , T. Booth 2,5 1 National Hospital of Neurology and Neurosurgery, London, United Kingdom, 2 King’s College London, London, United Kingdom, 3 Leeds Institute of Medical Research, Leeds, United Kingdom, 4 Leeds Institute of Health Sciences, Leeds, United Kingdom, 5 King’s College Hospital NHS Foundation Trust, London, United Kingdom. BACKGROUND: Glioblastoma is a common and aggressive primary ma- lignant brain tumour in adults associated with a poor prognosis and consid- erable symptom burden. Clinical review and serial neuroimaging remain the primary monitoring tools to assess for disease status. However, the evidence base for the existing surveillance imaging schedule is yet to be established. New models of follow up care are needed to demonstrate better patient outcomes in this patient cohort. There are indications that patient-reported outcome measures (PROMs) can contribute to improved survival and maintaining an optimal quality of life in other oncology populations. MA- TERIALS AND METHODS: There are no standardised PROMs for the pri- ority symptoms in glioblastoma patients, which can be used for evaluation in clinical care as a surrogate marker for disease progression. A broad set of symptoms were therefore initially identified in a targeted literature search and were further refined via Delphi methodology, with the aim to obtain consensus amongst a small expert panel involved in the care of glioblastoma patients. A three round Delphi email survey was conducted. Consensus was defined as 70% agreement. RESULTS: Symptom and function constructs were assessed for relevance, relationship to disease and treatment, sensitivity to change, psychometric properties and patient acceptability. Consensus was reached on the red flag symptoms and symptom clusters to monitor, as well as the minimum severity thresholds needed to trigger an alert on an electronic symptom reporting system, which has been developed to allow patient self-reporting of symptoms during treatment. CONCLUSION: The red flag symptoms to monitor, along with the symptom severity thresholds, informed an app-based symptom reporting system, which is currently being piloted in a feasibility study exploring triggered imaging using ePROMs. This has the potential to inform future clinical practice through development of patient reported biomarkers. P12.04 BODY MASS INDEX: A POSSIBLE PICC-RELATED COMPLICATIONS RISK FACTOR IN NEURO ONCOLOGICAL PATIENTS G. Simonetti, P. Gaviani, A. Botturi, V. Redaelli, E. Anghileri, A. Silvani Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy. BACKGROUND: The use of central venous catheter with peripheral in- sertion (PICC) has increased rapidly in recent years particularly in cancer pa- tients because they represent a stable and safe vascular access to administer irritants or vesicants therapies. However, the benefit provided may occa- sionally be affected by severe complications. An observational study con- ducted at our Institute, showed a significant increase of thromboembolic risk in neuro-oncological patients compared to general cancer population (16.3% vs 6.7% respectively). For this reason, it is essential to identify in- dependent risk factors in order to avoid preventable harm. MATERIAL AND METHODS: Neuro-oncological patients with PICC that developed a thromboembolic event were retrospectively analyzed. We evaluated clinical data, BMI, KPS, steroid therapies and anticoagulants at the time of posi- tioning of the PICC and at the onset of the thrombotic event. RESULTS: A total of 90 neuro-oncological patients have been analyzed. The most common histology was represented by glioblastoma, followed by anaplastic astrocytoma, primary central nervous system lymphoma, grade II glioma. 17.6% of patients were at first diagnoses, 41.6% were at the first recur- rence, and the remaining patients were at the second or third recurrence. The median KPS was 90 (range 80–100), and the median ECOG was 0 (range 0–2). Overall, 14% patients developed thromboembolic events within a me- dian time of 34.5 days (range 5–146) after PICC implantation. Among these, 64% of patients was considered overweight. No patients were on anticoagu- lant therapy but all were treated with a median dose of 5.5 mg of steroids (range 3,5-12), stable between PICC insertion and onset of adverse event. CONCLUSION: 64% of patients who developed a thromboembolic event had BMI >28 at the time of PICC insertion, suggesting a possible trend to- wards a risk of developing PICC related thrombosis in overweight/obese patients. Other independent risk factors for PICC associated complications seems to be amount of previous chemotherapies administered: 82% of pa- tients who developed thrombotic complications had already undergone at least one line of chemotherapy before PICC placement, suggesting this con- dition as a possible risk factor for the onset of the event. Also failed posi- tioning attempts could damage vascular endothelium, contributing to the onset of thrombotic complications. An accurate anamnesis and a physical evaluation with particular attention to the presence of malnutrition could help in the in the early identification of independent risk factors that could farther negatively influence the outcome of neuro-oncological patients. P12.05 PULMONARY EMBOLISM IN NEURONCOLOGICAL PATIENTS: MONOISTITUTIONAL EXPERIENCE P. Gaviani, G. Simonetti, V. Redaelli, A. Botturi, E. Corsini, A. Silvani Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy. BACKGROUND: Venous thromboembolism (VTE) is a frequent and po- tentially fatal event in cancer patients. Patients with brain tumors in particular have one of the highest risk of developing VTE among cancer patients (25– 39%), contributing significantly to mortality and morbidity. VTE is particu- larly high in the postoperative period, with almost half of the events occurring at that time, but it also persists in the first 12 months, with a risk ranging between 7–28%. Despite the high incidence of VTE in patients with brain tu- mors, to date there are no sufficient data to predict teh real risk or to lead to a standardized approach in the management of these patients. We conducted a retrospective analysis to assess the prevalence of pulmonary embolism com- plication in patients with brain tumors treated by our Institution in the last 3 years. MATERIAL AND METHODS: Clinical data, treatment modalities, and patients outcome were analyzed and described. In particular, In particular, the dosages of D-dimer performed in the clinical suspicion of thromboembolic complication were reviewed, and the data of patients with pulmonary em- bolism confirmed by chest CT scan were recorded.RESULTS: Overall 372 patients were treated at our Institute in the last 3 years for brain tumors. 14 patients (3.7%) 9 males and 5 females, with a median age of 62 years and a median KPS of 80, affected by glioblastoma (69%), cerebral lymphoma (23%) and low-grade gliomas (8%) had pulmonary embolism during the course of treatment. None of the 14 patients was on prophylactic anticoagu- lant treatment. One patient developed the embolic event during radio and chemotherapy concomitant treatment, 5 patients during chemotherapy only (2 with PCV scheme and 3 with fotemustine scheme), 2 patients with pri- mary nervous system lymphoma during methotrexate infusion. Six patients were not receiving any chemotehrapy treatment at the onset of pulmonary em- bolism. At the time of pulmonary embolism diagnosis, more than half of the patients had clinical signs suggestive of deep venous thrombosis, confirmed by echocolor Doppler, 10/14 patients were treated with high-dose enoxaparin, the others with fondaparinux and calcium nadroparin. CONCLUSION: Des- pite the high incidence of VTE in patients with brain tumors, there is currently no gold standard in the prevention and treatment of this complication. In fact, many questions are still open, for example the efficacy of low molecular weight heparins vs oral anticoagulants as a prophylactic treatment, the timing of onset and the real risk of bleeding. Future prospective studies should be de- signed to identify parameters for optimize stratification of thrombotic / haem- orrhagic risk in this group of patients. This could allow patients at high risk to undergo more aggressive prophylactic therapy or closer clinical-instrumental surveillance, without incurring the opposite risk of bleeding. P12.06 UNMET NEEDS AND WISH FOR SUPPORT OF INFORMAL CAREGIVERS OF PRIMARY BRAIN TUMOUR PATIENTS L. Pointon 1 , R. Grant 2 , S. Peoples 2 , S. Erridge 2 , P. Sherwood 3 , M. Klein 4 , F. Boele 1 1 University of Leeds, Leeds, United Kingdom, 2 Edinburgh Centre for Neuro-Oncology, Edinburgh, United Kingdom, 3 University of Pittsburgh, Pittsburgh, PA, United States, 4 Amsterdam University Medical Centers, Amsterdam, Netherlands. BACKGROUND: Most primary brain tumour patients rely on informal caregivers (i.e. family members or friends) for practical and emotional sup- port. While caregiving can be rewarding, it also commonly leads to signifi- cant burden. In developing support for caregivers, it is vital to distinguish between caregivers’ unmet needs, and their actual wish for support to resolve unmet needs. We aimed to 1) identify the presence and magnitude of unmet needs; 2) examine associations between unmet needs and desire for support; 3) evaluate perceived usefulness of caregiver needs screening in clinical prac- tice. MATERIAL AND METHODS: Family caregivers of patients with pri- mary brain tumours were recruited and asked to complete an adapted version of the Caregiver Needs Screen (CNS). This covered the level of distress re- sulting from 33 common issues in neuro-oncology caregiving (scale 0–10), and wish for information or support for any issue (yes/no). In addition, par- Downloaded from https://academic.oup.com/neuro-oncology/article/23/Supplement_2/ii31/6366666 by guest on 10 January 2024