St George's Hospital, London, UK, National Hospital for Neurology and Neurosurgery, London, UK and Whipps Cross Hospital, London, UK.
Whipps Cross Hospital, London, UK.
Clin Med (Lond). 2021 Nov;21(6):e648-e655. doi: 10.7861/clinmed.CM-2021-0223.
The UK uses the 2-week-wait (2WW) pathway for rapid access to cancer services. It is unclear whether this is effective for brain cancer.
We retrospectively analysed all 2WW referrals for brain cancer between 2009 and 2016 in a district general neurology department. We compared clinical presentations to national guidelines and diagnoses of brain cancer.
Of the 153 cases analysed, four brain cancers were identified: two glioblastomas and two metastases. Headaches were the most common referral. The end diagnosis was mostly migraine. The highest positive predictive value was for behavioural/personality change (5.3%) and sub-acute neurological deficit (3.2%). There was no significant association between any symptom(s) and brain cancer.
The 2WW pathway is not effective in the diagnosis of brain cancer. Resources are better directed towards clinical research and treatment trials. Headache remains the most common reason for referral although it is not yet a reliable indicator of brain cancer.
英国采用 2 周等待（2WW）途径来快速获得癌症服务。目前尚不清楚这种方法是否对脑癌有效。
我们回顾性分析了 2009 年至 2016 年间，一个地区综合神经病学系中所有 2WW 转介的脑癌病例。我们将临床表现与国家脑癌指南和诊断进行了比较。
在分析的 153 例病例中，发现了 4 例脑癌：2 例胶质母细胞瘤和 2 例转移瘤。头痛是最常见的转介症状。最终诊断大多为偏头痛。行为/人格改变（5.3%）和亚急性神经功能缺损（3.2%）的阳性预测值最高。没有任何症状与脑癌之间存在显著关联。
2WW 途径在脑癌诊断中无效。资源最好用于临床研究和治疗试验。头痛仍然是最常见的转介原因，尽管它还不是脑癌的可靠指标。
