Table 3.

Suggested Adult Brain Tumor Survivorship Guideline

Complication	Brain Tumor Treatment	Suggested Screening Recommendations	Frequency
Eye	Cranial radiation close to optic nerve or known ocular pathology related to tumor or treatment	Neuro-ophthalmology evaluation	Annually
	All brain tumor	Comprehensive eye examination	Every 1-2 years
Hearing	All brain tumor	Hearing screen question: Do you have any difficulty with hearing?	Annually
	Patients with cisplatin >200 mg/m2 or carboplatin >1500 mg/m2	Audiology testing	Post treatment, 2 years after, then every 5 years
	Patient with Cranial RT	Post treatment baseline with audiogram. If detected hearing loss, annual audiogram. If normal, proceed with survey screening annually as below.	Annually
	Radiosurgery near CN VIII	Audiology testing	Annually
Cognition	Any	MoCA	Every 6 -12 months
Hormones/Endocrine	All brain tumor	Annual survey for symptoms	Every 6 -12 months
	Brain Radiation	TSH, free T4, AM cortisol Men – Testosterone Women of child-bearing age – clinic screening with question of experiencing irregular menses	Annually
	Immunotherapy	Per NCCN guidelines	Per NCCN guidelines
	Chemotherapy	Men: Testosterone Women of child-bearing age – clinic screening with question of experiencing irregular menses	Men: Test once post treatment Women: Annually
Mood	Any	PHQ9 and GAD	Every 6 months
Sleep	Any	Insomnia single question: Do you have problems falling sleep or staying asleep for three or more nights per week?	Annually
		STOP BANG	Every 5 years
		RLS single question: “When you try to relax in the evening or sleep at night, do you ever have unpleasant, restless feelings in your legs that can be relieved by walking or movement?”	Annually
Balance/ Coordination	Any	Survey questions and exam: Have you had any difficulty taking care of yourself, walking, balancing, or falling? Have you had any difficulty taking your own medications?	Annually
		Tandem stance (5-10 seconds), Romberg, Single leg stance	Annually
Cerebrovascular	Brain Radiation	Brain Vessel Imaging (CTA vs MRI)	1 year from XRT, then 3 years. If no vasculopathy every 5 years. If cardiovascular risk factors every 3 years.
		MRI brain with T2* imaging	Every 5 years
Employment	Any	If you are currently in work or school:  Are you having difficulty preforming tasks at work or school?  How often are you missing work?  Have you received negative feedback on job/school performance?  Is it taking you longer to complete tasks?  Are you behind at work or putting in extra hours to keep up?  Do you have concerns your employment or enrollment are in jeopardy?	Every 6 months
Financial	Any	Over the last 6 months:  Are you feeling more financially stressed?  Are you struggling to meet monthly expenses?	Every 6 months
Support/Caregivers	Any	Subjective Assessment/Survey Clinical Screening:  Caregiver Needs Screen in Neuro-Oncology Family Caregivers (CNS)  Distress Thermometer  Kingston Caregiver Stress Scale (KCSS)	Every 6 months
Secondary Malignancy	Chemotherapy or XRT	Physical exam	Annually