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多学科胸恶性肿瘤会议对肺癌患者治疗的影响。

The effect of a multidisciplinary thoracic malignancy conference on the treatment of patients with lung cancer.

机构信息

Department of Thoracic and Cardiovascular Surgery, St Vincent Hospital, Indianapolis, IN, USA.

出版信息

Eur J Cardiothorac Surg. 2010 Jul;38(1):1-5. doi: 10.1016/j.ejcts.2010.01.051. Epub 2010 Mar 4.

Abstract

INTRODUCTION

There is a paucity of data evaluating whether a multidisciplinary conference coordinating surgery, chemotherapy and radiation therapy translates into better patient care. This article compares the experiences of patients with lung cancer before and after the formation of a prospective, multidisciplinary thoracic malignancy care conference (TMC).

METHODS

The records of patients with a non-small-cell lung cancer at a tertiary care hospital were reviewed for completeness of staging, multidisciplinary evaluation prior to the initiation of therapy, time from pathologic diagnosis to treatment, multimodality therapy and adherence to national treatment guidelines. The summary data of patients treated before and after the TMC were initiated, and then compared.

RESULTS

Between 2001 and 2007, 535 patients were treated prior to the initiation of the TMC and 687 patients within the TMC. The number of patients receiving a complete staging evaluation (79%/93%: p<0.0001), multidisciplinary evaluation prior to therapy (62%/96%: p<0.0001) and adherence to the National Comprehensive Cancer Network (NCCN) treatment guidelines (81%/97%: p<0.0001) all increased significantly while mean days from diagnosis to treatment significantly decreased (29/17: p<0.0001) following the initiation of a TMC.

CONCLUSION

A multidisciplinary thoracic malignancy conference increased the percentage of patients receiving complete staging, a multidisciplinary evaluation and adherence to nationally accepted care guidelines while decreasing the interval from diagnosis to treatment significantly. While the ultimate goal of treatment is to improve patient survival, the surrogate variables examined in this review indicate that patients with non-small-cell lung cancer benefit from being evaluated in a prospective, multidisciplinary care conference.

摘要

简介

目前评估多学科会议协调手术、化疗和放疗是否能改善患者护理的相关数据较少。本文比较了在建立前瞻性多学科胸恶性肿瘤治疗会议(TMC)前后,肺癌患者的治疗经历。

方法

回顾了一家三级护理医院的非小细胞肺癌患者的记录,以评估分期的完整性、治疗前的多学科评估、从病理诊断到治疗的时间、多模式治疗以及对国家治疗指南的遵守情况。总结了 TMC 启动前后治疗的患者数据,并进行了比较。

结果

在 2001 年至 2007 年期间,535 例患者在 TMC 启动前接受了治疗,687 例患者在 TMC 启动后接受了治疗。接受完整分期评估的患者比例(79%/93%:p<0.0001)、治疗前多学科评估的患者比例(62%/96%:p<0.0001)和对国家综合癌症网络(NCCN)治疗指南的遵守率(81%/97%:p<0.0001)均显著增加,而从诊断到治疗的平均时间显著缩短(29/17:p<0.0001)。

结论

多学科胸恶性肿瘤会议的建立增加了接受完整分期、多学科评估和遵守国家认可的护理指南的患者比例,同时显著缩短了从诊断到治疗的时间间隔。虽然治疗的最终目标是提高患者的生存率,但本研究中检查的替代变量表明,非小细胞肺癌患者从前瞻性多学科治疗会议的评估中受益。

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