Collaboration for Cancer Outcome, Research and Evaluation, Liverpool Hospital, Liverpool, New South Wales, Australia.
Cancer. 2011 Nov 15;117(22):5112-20. doi: 10.1002/cncr.26149. Epub 2011 Apr 26.
There is limited evidence regarding the effectiveness of multidisciplinary team (MDT) meetings in lung cancer. The objective of this study was to compare the patterns of care for patients with newly diagnosed lung cancer who were presented at a lung cancer MDT meeting with the patterns of care for patients who were not presented.
All patients who had lung cancer newly diagnosed in South West Sydney (SWS) between December 1, 2005, and December 31, 2008, were identified from the local Clinical Cancer Registry. Patient and tumor characteristics and treatment receipt were compared between patients who were and were not presented at MDT meetings. A logistic regression model was constructed to determine predictors for receiving treatment and survival.
In total, there were 988 patients, including 504 patients who were presented at MDT meetings and 484 who were not presented at MDT meetings. The median patient age was 69 years and 73 years in the MDT group and the non-MDT group, respectively (P < .01). There was no pathologic diagnosis for 13% of non-MDT patients compared with 4% of MDT patients (P < .01). Treatment receipt for MDT patients versus non-MDT patients was 12% versus 13%, respectively, for surgery (P value nonsignificant); 66% versus 33%, respectively, for radiotherapy (P < .001); 46% versus 29%, respectively, for chemotherapy (P < .001); and 66% versus 53%, respectively, for palliative care (P < .001). In patients with good performance status, the MDT group had significantly better receipt of radiotherapy among patients with stage I through IV nonsmall cell lung cancer (NSCLC) and had significantly better receipt of chemotherapy among patients with stage IV NSCLC. MDT discussion was an independent predictor of receiving radiotherapy, chemotherapy, and referral to palliative care but did not influence survival.
MDT discussion was associated with better treatment receipt, which potentially may improve quality of life for patients with lung cancer. However, it did not improve survival.
关于多学科团队（MDT）会议在肺癌中的有效性，证据有限。本研究的目的是比较在肺癌 MDT 会议上提出的新诊断肺癌患者的治疗模式与未提出的患者的治疗模式。
从当地临床癌症登记处确定 2005 年 12 月 1 日至 2008 年 12 月 31 日期间在新南威尔士州西南悉尼（SWS）新诊断出患有肺癌的所有患者。比较 MDT 会议上提出的患者和未提出的患者的患者和肿瘤特征以及治疗接受情况。构建逻辑回归模型以确定接受治疗和生存的预测因素。
共纳入 988 例患者，其中 504 例在 MDT 会议上提出，484 例未在 MDT 会议上提出。MDT 组和非 MDT 组患者的中位年龄分别为 69 岁和 73 岁（P<.01）。非 MDT 患者中有 13%未进行病理诊断，而 MDT 患者中有 4%（P<.01）。MDT 患者与非 MDT 患者的治疗接受率分别为手术 12%与 13%（P 值无统计学意义）；放疗 66%与 33%（P<.001）；化疗 46%与 29%（P<.001）；姑息治疗 66%与 53%（P<.001）。在功能状态良好的患者中，MDT 组 I 期至 IV 期非小细胞肺癌（NSCLC）患者的放疗接受率显著提高，IV 期 NSCLC 患者的化疗接受率显著提高。MDT 讨论是接受放疗、化疗和转介姑息治疗的独立预测因素，但不影响生存。
MDT 讨论与更好的治疗接受率相关，这可能为肺癌患者的生活质量带来潜在改善。然而，它并未改善生存。
