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多学科头颈部肿瘤委员会的临床影响的前瞻性研究。

A prospective study of the clinical impact of a multidisciplinary head and neck tumor board.

机构信息

Department of Otolaryngology–Head & Neck Surgery, University of North Carolina Hospitals, Chapel Hill, NC, USA.

出版信息

Otolaryngol Head Neck Surg. 2010 Nov;143(5):650-4. doi: 10.1016/j.otohns.2010.07.020.

Abstract

OBJECTIVE

There have been no studies undertaken on the effect of the multidisciplinary head and neck tumor board on treatment planning. The objective of this study was to determine the efficacy of the multidisciplinary tumor board in altering diagnosis, stage, and treatment plan in patients with head and neck tumors.

STUDY DESIGN

Case series with planned data collection.

SETTING

Comprehensive cancer center and tertiary academic hospital.

SUBJECTS AND METHODS

A prospective study of the discussions concerning 120 consecutive patients presented at a multidisciplinary head and neck tumor board was performed. As each patient was presented, a record was made of the "pre-conference" diagnosis, stage, and treatment plan. After case discussion, the "post-conference" diagnosis, stage, and treatment plan were recorded. Results are compared between malignant and benign tumor cohorts.

RESULTS

The study population comprised 120 patients with new presentations of head and neck tumors: 84 malignancies and 36 benign tumors. Approximately 27 percent of patients had some change in tumor diagnosis, stage, or treatment plan. Change in treatment was significantly more common in cases of malignancy, occurring in 24 percent of patients versus six percent of benign tumors (P = 0.0199). Changes in treatment were also noted to be largely escalations in management (P = 0.0084), adding multi-modality care.

CONCLUSION

A multidisciplinary tumor board affects diagnostic and treatment decisions in a significant number of patients with newly diagnosed head and neck tumors. The multidisciplinary approach to patient care may be particularly effective in managing malignant tumors, in which treatment plans are most frequently altered.

摘要

目的

目前尚无研究探讨多学科头颈部肿瘤委员会对治疗计划的影响。本研究旨在确定多学科肿瘤委员会在改变头颈部肿瘤患者的诊断、分期和治疗计划方面的效果。

研究设计

病例系列研究,计划收集数据。

地点

综合性癌症中心和三级学术医院。

受试者和方法

对 120 例连续在多学科头颈部肿瘤委员会就诊的患者进行了前瞻性研究。每次患者就诊时,都会记录“会前”诊断、分期和治疗计划。病例讨论后,记录“会后”诊断、分期和治疗计划。将恶性和良性肿瘤组的结果进行比较。

结果

研究人群包括 120 例新诊断的头颈部肿瘤患者:84 例恶性肿瘤和 36 例良性肿瘤。约 27%的患者的肿瘤诊断、分期或治疗计划有所改变。恶性肿瘤患者的治疗方案改变更为常见,发生率为 24%,而良性肿瘤患者为 6%(P=0.0199)。治疗方案的改变也主要是治疗管理的升级(P=0.0084),增加了多模式治疗。

结论

多学科肿瘤委员会会显著影响新诊断的头颈部肿瘤患者的诊断和治疗决策。多学科方法对患者的护理可能特别有效,特别是在恶性肿瘤中,治疗方案最常被改变。

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