Leo Francesco, Venissac Nicolas, Poudenx Michel, Otto Josiane, Mouroux Jérôme
Thoracic Surgery Department, University Hospital of Nice, France.
J Thorac Oncol. 2007 Jan;2(1):69-72. doi: 10.1097/JTO.0b013e31802bff56.
The multidisciplinary management of lung cancer has been universally accepted. In France, the multidisciplinary approach for cancer patients is established by law. However, the efficacy of this approach remains theoretical, given that no evaluation criteria have been made available and no previous reports have been published on the prospective follow-up of these patients. The Groupe d' Oncologie Thoracique Azuréen carried out a 1-year prospective study on patients discussed during its multidisciplinary weekly meetings, to analyze the concordance between the proposed and administered treatment, the delay of treatment, and the 1-year actuarial survival. Of the 344 patients discussed during the period considered, the therapeutic decision was chemotherapy in 183 patients, surgery in 93, radiochemotherapy in 42, radiotherapy in 14, and supportive care 12. Therapeutic discordance between the planned and the administered treatment was recorded in 15 cases (4.4%), mainly for patient's refusal (seven cases) or poor performance status (five cases). The median delay of treatment was 20 days, shorter for chemotherapy (16 days), and longer for radiotherapy (27 days). The overall 1-year survival rate was 51.4%: 80.4% for stage I, 50.3% for stage II, 37.5% for stage III, and 27.2% for stage IV. For patients for whom discordance of treatment was recorded, a lower survival rate was recorded, without reaching statistical significance (0.07). In conclusion, the efficacy of the Groupe d' Oncologie Thoracique Azuréen multidisciplinary management was confirmed, as we believe that a discordant rate of less than 5% and a delay of treatment of 4 weeks can be considered acceptable. Furthermore, a periodic survival evaluation of the population as a whole could provide additional useful information for multidisciplinary groups.
肺癌的多学科管理已被广泛接受。在法国，癌症患者的多学科治疗方法是由法律确立的。然而，鉴于尚无可用的评估标准，且此前也没有关于这些患者前瞻性随访的报道，这种方法的疗效仍停留在理论层面。蔚蓝海岸胸科肿瘤学组对其多学科周会讨论的患者进行了为期1年的前瞻性研究，以分析拟实施治疗与实际给予治疗之间的一致性、治疗延迟情况以及1年精算生存率。在所考虑期间讨论的344例患者中，治疗决策为化疗的有183例，手术的有93例，放化疗的有42例，放疗的有14例，支持治疗的有12例。计划治疗与实际给予治疗之间的治疗不一致情况记录在15例（4.4%）中，主要原因是患者拒绝（7例）或身体状况不佳（5例）。治疗的中位延迟时间为20天，化疗较短（16天），放疗较长（27天）。总体1年生存率为51.4%：I期为80.4%，II期为50.3%，III期为37.5%，IV期为27.2%。对于记录有治疗不一致情况的患者，生存率较低，但未达到统计学意义（0.07）。总之，蔚蓝海岸胸科肿瘤学组多学科管理的疗效得到了证实，因为我们认为不一致率低于5%且治疗延迟4周可被视为可接受。此外，对整个人群进行定期生存评估可为多学科团队提供更多有用信息。
