Cancer Control and Screening Research Group, University of Otago, Wellington.
Cancer Control and Screening Research Group, University of Otago, Wellington
Ann Oncol. 2015 Jul;26(7):1325-32. doi: 10.1093/annonc/mdv025. Epub 2015 Jan 20.
Comorbidity is very common among patients with cancer. Multidisciplinary team meetings (MDTs) are increasingly the context within which cancer treatment decisions are made internationally. Little is known about how comorbidity is considered, or impacts decisions, in MDTs.
A systematic literature review was conducted to evaluate previous evidence on consideration, and impact, of comorbidity in cancer MDT treatment decision making. Twenty-one original studies were included.
Lack of information on comorbidity in MDTs impedes the ability of MDT members to make treatment recommendations, and for those recommendations to be implemented among patients with comorbidity. Where treatment is different from that recommended due to comorbidity, it is more conservative, despite evidence that such treatment may be tolerated and effective. MDT members are likely to be unaware of the extent to which issues such as comorbidity are ignored.
MDTs should systematically consider treatment of patients with comorbidity. Further research is needed to assist clinicians to undertake MDT decision making that appropriately addresses comorbidity. If this were to occur, it would likely contribute to improved outcomes for cancer patients with comorbidities.
癌症患者常伴有合并症。多学科团队会议（MDTs）日益成为国际上制定癌症治疗决策的场所。对于合并症在 MDT 中的考虑方式或对决策的影响，目前知之甚少。
系统地进行了文献回顾，以评估既往关于 MDT 治疗决策中合并症的考虑和影响的证据。共纳入 21 项原始研究。
MDTs 中缺乏合并症信息，阻碍了 MDT 成员制定治疗建议的能力，也阻碍了合并症患者实施这些建议的能力。由于合并症的原因而采用不同的治疗方案时，治疗方案更保守，尽管有证据表明这种治疗方案是可以耐受和有效的。MDT 成员可能不知道忽略合并症等问题的程度。
MDTs 应系统地考虑合并症患者的治疗。需要进一步研究以帮助临床医生进行适当考虑合并症的 MDT 决策。如果这一点能够实现，很可能会改善合并症癌症患者的治疗效果。
