150 - Development and Implementation of the SOaR² Spine Oncology Program: Expanding Access to Complex Multidisciplinary Care

08:10am - 08:20am ET

Room 107

Presenter(s)

Alyssa Adelizzi, MSN - University of Pennsylvania Health System, Philadelphia, PA

A. B. Adelizzi¹, I. Messing¹, N. R. Malhotra², J. M. Schuster², H. Knollman³, A. Hassankhani⁴, C. Freeman⁴, H. Hoplock⁵, G. W. Peters¹, and A. A. Butala⁶; ¹Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA, ²Department of Neurosurgery, University of Pennsylvania, Philadelphia, PA, ³Department of Medicine, Division of Hematology/Oncology, University of Pennsylvania, Philadelphia, PA, ⁴Department of Radiology, University of Pennsylvania, Philadelphia, PA, ⁵University of Pennsylvania, Philadelphia, PA, ⁶Department of Radiation Oncology, University of Pennsylvania, Philadelp, IL

Purpose/Objective(s):

The management of spinal metastases requires coordinated expertise across multiple specialties to optimize survival, function, and quality of life. We hypothesized that establishing a dedicated multidisciplinary program integrating neurosurgery (NSG), radiation oncology (RO), neuroradiology, and medical oncology would improve access to specialized diagnostic and therapeutic interventions for patients with spinal malignancies. In this context, the SOaR² (Surgical Spinal Oncology, Medical Oncology, and Radiation Oncology/Radiology) program was established within a large academic medical center. Here, we describe its framework and impact since inception.

Materials/Methods:

A multidisciplinary infrastructure was developed to streamline access and coordination of care. Two rapid-access full spine MRI slots were reserved each weekday for patients with new or progressive neurologic deficits, enabling near-immediate evaluation and reducing emergency department utilization. A standardized neuroradiology spine oncology macro report (SOIS) was implemented and automatically distributed to the spine team to expedite review and intervention. A weekly multidisciplinary spine tumor board evaluated 12–20 patients to support integrated treatment planning. A co-located clinic was launched to provide same-day NSG and RO consultations with same-day CT/MRI simulation when indicated. Institution-wide credentialing and quality assurance processes standardized spine SRS delivery. A dedicated spine SRS planning team was created, enabling two-business-day plan generation from simulation.

Results:

From 2022–2025, rapid outpatient spine MRI utilization for symptomatic patients increased 340% (70 to 238 studies), while SOIS report generation rose 165% (676 to 1,112). Access to spine SRS expanded substantially, with patient volumes increasing 173% from FY24 to FY25, 124% from FY25 to FY26, and 215% overall between FY24 and FY26 (103 to 221 projected). The program’s reach broadened across the enterprise, with referrals from over 100 unique providers across disciplines.

Conclusion:

The SOaR² Spine Oncology program integrated multidisciplinary processes that enhanced timely diagnosis, evaluation, and treatment for patients with spinal metastases. Implementation of rapid MRI access, standardized reporting, and a co-located clinic with a dedicated SRS planning team improved efficiency and coordination of care. Ongoing collaborations, including development of a rapid spinal metastasis outpatient triage and evaluation pathway at the cancer center urgent care, aim to further expand access to high-value patient-centered care.