Department of Medicine, Queen's University, Kingston, ON, Canada.
School of Medicine, Queen's University, Kingston, ON, Canada.
Clin Lung Cancer. 2018 Jul;19(4):323-330.e3. doi: 10.1016/j.cllc.2018.02.001. Epub 2018 Feb 21.
Multidisciplinary cancer clinics (MDCCs) are recognized in cancer care as an alternate model of care for lung cancer patients. However, the precise MDCC characteristics that could potentially improve the quality of care in lung cancer care have not been clearly defined. We performed a systematic review of the data regarding MDCCs in the treatment of patients with lung cancer to summarize and evaluate the available evidence and to determine valuable clinic characteristics and projected outcomes. We searched Embase, Cochrane, Medline, PubMed, and Web of Science through April 2017 for studies that included ≥ 2 physician specialties in a MDCC for lung cancer. A total of 2374 unique articles were identified, of which 13 met the inclusion criteria. All the studies were either retrospective or qualitative, with many having small sample sizes. The most commonly reported quantitative outcome for MDCCs was a decreased time from diagnosis to treatment; however, this was only statistically significant in 2 studies. Evidence was conflicting regarding improved patient survival. Several studies of MDCCs reported improved qualitative outcomes, including increased patient satisfaction, increased collaboration, and cohesive communication among care providers, although the sample sizes were small. The few studies of MDCCs that included a care coordinator, in addition to physicians from multiple specialties, reported improvements in patient satisfaction. Overall, our review of the reported data revealed a paucity of evidence regarding the value of MDCCs for lung cancer patients, highlighting the need for further studies to understand the optimal medical model to deliver care.
多学科癌症诊疗中心（MDCC）在癌症治疗中被认为是一种治疗肺癌患者的替代护理模式。然而，能够提高肺癌护理质量的 MDCC 具体特征尚未明确界定。我们对治疗肺癌患者的 MDCC 相关数据进行了系统评价，以总结和评估现有证据，并确定有价值的临床特征和预期结果。我们通过 Embase、Cochrane、Medline、PubMed 和 Web of Science 搜索了截至 2017 年 4 月的研究，这些研究包括 MDCC 中至少 2 个医师专业治疗肺癌的患者。共确定了 2374 篇独特的文章，其中 13 篇符合纳入标准。所有研究均为回顾性或定性研究，许多研究的样本量较小。MDCC 最常报告的定量结果是从诊断到治疗的时间缩短；然而，仅有 2 项研究具有统计学意义。关于改善患者生存的证据存在矛盾。几项 MDCC 研究报告了改善的定性结果，包括增加患者满意度、增加协作以及护理提供者之间的协调沟通，尽管样本量较小。少数包括多个专业医生和护理协调员的 MDCC 研究报告患者满意度有所提高。总体而言，我们对报告数据的审查显示，MDCC 对肺癌患者的价值的证据不足，突出了需要进一步研究以了解提供护理的最佳医疗模式。
