Zhang Panpan, Shen Lin
Department of Gastroenterological Oncology, Key Laboratory of Carcinogenesis and Translational Research(Ministry of Education), Peking University Cancer Hospital and Institute, Beijing 100142, China.
Zhonghua Wei Chang Wai Ke Za Zhi. 2016 Nov 25;19(11):1205-1210.
Multidisciplinary team(MDT) has been considered as the best practice in the treatment planning and care for patients with cancer around the world. With the increased range and number of specialists involved, multidisciplinary coordination and communication have been enhanced, and the efficiency and quality of diagnosis and treatment of cancer have been improved. Neuroendocrine neoplasm (NEN) is a heterogeneous group of tumors originating from neuroendocrine cells located throughout the body, most of which is gastroenteropancreatic neuroendocrine neoplasm (GEP-NEN). Due to the low incidence of GEP-NEN, the knowledge of such rare disease went through a long way of exploration, and a large number of unresolved issues still plagued the clinicians. An effective diagnosis of GEP-NEN requires a multimodal approach that combines evaluation of clinical symptoms and hormone levels, radiological and nuclear imaging, and histological confirmation. The treatment is complex, including surgery, oncology, radiotherapy,peptide receptor radionuclide treatment (PRRT) and interventional therapy, so MDT model should play an important role in the diagnosis and treatment of GEP-NEN to maximize the integration of multidisciplinary resources and improve the life quality as well as survival. A NEN-MDT was organized in 2013 by the Beijing Cancer Hospital, including oncology, surgery, pathology, nuclear medicine and radiology. This paper investigates the significance and management in the implementation of MDT model in the diagnosis and treatment of GEP-NEN, based on the experience of MDT operation in our center.
多学科团队（MDT）被认为是全球癌症患者治疗规划与护理的最佳实践模式。随着参与的专家范围扩大和数量增加，多学科协调与沟通得到加强，癌症诊断与治疗的效率和质量得以提高。神经内分泌肿瘤（NEN）是一组起源于全身神经内分泌细胞的异质性肿瘤，其中大部分是胃肠胰神经内分泌肿瘤（GEP-NEN）。由于GEP-NEN发病率低，对这种罕见疾病的认知经历了漫长的探索过程，大量未解决的问题仍困扰着临床医生。GEP-NEN的有效诊断需要一种多模式方法，将临床症状评估、激素水平检测、放射学和核医学成像以及组织学确认相结合。其治疗复杂，包括手术、肿瘤学、放疗、肽受体放射性核素治疗（PRRT）和介入治疗，因此MDT模式在GEP-NEN的诊断和治疗中应发挥重要作用，以最大限度地整合多学科资源，提高生活质量和生存率。北京肿瘤医院于2013年组建了NEN-MDT团队，成员包括肿瘤学、外科、病理学、核医学和放射学专家。本文基于我们中心MDT运作的经验，探讨MDT模式在GEP-NEN诊断和治疗中的实施意义及管理。
