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德国肉瘤治疗现状:对医生进行的在线调查结果。

Current State of Sarcoma Care in Germany: Results of an Online Survey of Physicians.

机构信息

Department of Internal Medicine I, University Hospital Carl Gustav Carus, Dresden, Germany,

Department of Internal Medicine I, University Hospital Carl Gustav Carus, Dresden, Germany.

出版信息

Oncol Res Treat. 2019;42(11):589-598. doi: 10.1159/000502758. Epub 2019 Sep 11.

Abstract

BACKGROUND

Sarcoma treatment is a complex and multidisciplinary process. Little is known about the actual status of sarcoma care in Germany.

OBJECTIVES

We evaluated: (1) on an institutional level, which physician diagnosed and treated sarcomas; (2) whether guidelines and tumor board recommendations were routinely implemented; and (c) access to which diagnosis and treatment options was regarded as problematic. We also examined factors that were associated with access problems.

METHODS

A cross-sectional online survey was employed among German sarcoma physicians between June 2017 and February 2018 with convenience sampling.

RESULTS

Two hundred fourteen physicians participated; 46% were oncologists and 27% surgeons, 38% worked in hospitals of maximum care, 34% were office based and 27% worked in other hospitals, 68% of all of the physicians consulted established guidelines, and 93% presented their patients in multidisciplinary tumor boards. The most common access problems were: isolated limb perfusion (39%), deep-wave hyperthermia (33%), and FDG-PET (27%), and 42% reported no access problems at all. Those physicians who treat more than 100 patients per year reported "no access problems" more frequently compared to centers with lower patient numbers (vs. 0-10 patients, OR 0.14; 95% CI 0.03-0.61; vs. 11-100 patients, OR 0.21; 95% CI 0.06-0.73).

CONCLUSIONS

Access to multidisciplinary tumor boards seems to be largely guaranteed in the participants of our survey. The use of guidelines could be further implemented and expanded. The number of treated patients appears to be a significant factor to avoid access problems to treatment options.

摘要

背景

肉瘤的治疗是一个复杂且多学科的过程。对于德国肉瘤治疗的实际情况,我们知之甚少。

目的

我们评估了:(1)在机构层面上,哪些医生诊断和治疗肉瘤;(2)是否常规实施指南和肿瘤委员会的建议;(c)肉瘤治疗方案的可及性存在哪些问题。我们还研究了与治疗方案可及性问题相关的因素。

方法

我们采用便利抽样法,于 2017 年 6 月至 2018 年 2 月期间对德国肉瘤医生进行了横断面在线调查。

结果

共有 214 名医生参与了调查,其中 46%为肿瘤学家,27%为外科医生;38%在最高级别护理医院工作,34%在诊所工作,27%在其他医院工作;68%的医生会咨询既定指南,93%的医生会在多学科肿瘤委员会中呈现他们的患者。最常见的治疗方案可及性问题是:孤立肢体灌注(39%)、深层波高热疗法(33%)和 FDG-PET(27%),有 42%的医生报告没有任何治疗方案可及性问题。与治疗患者数量较少的中心相比,每年治疗超过 100 名患者的医生报告“没有治疗方案可及性问题”的频率更高(与 0-10 名患者相比,OR=0.14,95%CI:0.03-0.61;与 11-100 名患者相比,OR=0.21,95%CI:0.06-0.73)。

结论

在我们的调查参与者中,多学科肿瘤委员会的使用似乎得到了广泛的保障。指南的使用可以进一步实施和扩大。治疗患者的数量似乎是避免治疗方案可及性问题的一个重要因素。

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