10228-NQPC-8 Current Status and Challenges of Multidisciplinary Approaches to Social Reintegration of Brain Tumor Patients

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Abstract Introduction Since 2019, our hospital has implemented a multidisciplinary vocational rehabilitation program for over 300 patients unable to return to work immediately after acute treatment for brain diseases. Through this program, specific challenges faced by brain tumor (BT) patients have emerged. In this study, we examined 26 BT patients (15 glioma, 4 meningioma, and 7 others) and compared their outcomes to 125 stroke (St.) patients to identify challenges and potential solutions. Methods After the attending physician explained the program, a medical social worker coordinated with employers, and health-related quality of life (HRQOL) was assessed using QLQ-C30 and BN-20. Therapists, nurses, and pharmacists provided individualized rehabilitation and support tailored to each patient’s work environment. Results At admission, patients’ Karnofsky Performance Status (KPS) scores were 50 (3 patients), 60 (14), 70 (14), and 80 (3). At discharge, 33% (1/3) of initial KPS 50 and 78.6% (11/14) of KPS 60 improved to KPS ≧70. Return-to-work (RTW) rates were 54% in the BT group (program completion: 61%) versus 78% in the St. group (completion: 82%). Higher KPS was associated with higher RTW rates (KPS ≧70: ≧82%), a trend also observed in St. patients with mRS ≧3. BT patients with KPS 60 achieved an RTW rate of only 30%, whereas St. patients with mRS 4 achieved a rate of 72%. All glioblastoma cases received temozolomide and continued Optune® therapy in the hospital. In the BT group, 89% of non-RTW cases were due to disease progression or tumor-related death, significantly higher than 43% in the St. group. BT patients showed reduced physical, role, and social functioning with significant financial and future-related concerns. These HRQOL domains showed less improvement over time, especially in malignant cases. Conclusion Effective RTW support for BT patients must prioritize mental health support and flexible planning for ongoing treatment and disease progression.

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