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在非小细胞肺癌的诊断和治疗决策中导航:多学科团队方法的专家评论。

Navigating Diagnostic and Treatment Decisions in Non-Small Cell Lung Cancer: Expert Commentary on the Multidisciplinary Team Approach.

机构信息

Lung Unit, Royal Marsden Hospital, London, United Kingdom.

The Institute of Cancer Research, University of London, London, United Kingdom.

出版信息

Oncologist. 2021 Feb;26(2):e306-e315. doi: 10.1002/onco.13586. Epub 2020 Nov 21.

Abstract

Non-small cell lung cancer (NSCLC) accounts for approximately one in five cancer-related deaths, and management requires increasingly complex decision making by health care professionals. Many centers have therefore adopted a multidisciplinary approach to patient care, using the expertise of various specialists to provide the best evidence-based, personalized treatment. However, increasingly complex disease staging, as well as expanded biomarker testing and multimodality management algorithms with novel therapeutics, have driven the need for multifaceted, collaborative decision making to optimally guide the overall treatment process. To keep up with the rapidly evolving treatment landscape, national-level guidelines have been introduced to standardize patient pathways and ensure prompt diagnosis and treatment. Such strategies depend on efficient and effective communication between relevant multidisciplinary team members and have both improved adherence to treatment guidelines and extended patient survival. This article highlights the value of a multidisciplinary approach to diagnosis and staging, treatment decision making, and adverse event management in NSCLC. IMPLICATIONS FOR PRACTICE: This review highlights the value of a multidisciplinary approach to the diagnosis and staging of non-small cell lung cancer (NSCLC) and makes practical suggestions as to how multidisciplinary teams (MDTs) can be best deployed at individual stages of the disease to improve patient outcomes and effectively manage common adverse events. The authors discuss how a collaborative approach, appropriately leveraging the diverse expertise of NSCLC MDT members (including specialist radiation and medical oncologists, chest physicians, pathologists, pulmonologists, surgeons, and nursing staff) can continue to ensure optimal per-patient decision making as treatment options become ever more specialized in the era of biomarker-driven therapeutic strategies.

摘要

非小细胞肺癌(NSCLC)约占癌症相关死亡人数的五分之一,其管理需要医疗保健专业人员做出越来越复杂的决策。因此,许多中心采用多学科方法来为患者提供护理,利用各种专家的专业知识提供最佳的循证、个性化治疗。然而,疾病分期越来越复杂,生物标志物检测和新型治疗方法的多模式管理算法不断扩展,这就需要进行多方面的协作决策,以最佳地指导整体治疗过程。为了跟上不断发展的治疗领域,已经引入了国家级指南来规范患者的治疗途径,以确保及时诊断和治疗。这些策略取决于相关多学科团队成员之间的高效和有效的沟通,这不仅提高了对治疗指南的依从性,还延长了患者的生存时间。本文强调了多学科方法在 NSCLC 诊断和分期、治疗决策制定以及不良事件管理方面的价值。

对实践的影响

本文强调了多学科方法在非小细胞肺癌(NSCLC)诊断和分期以及治疗决策制定和不良事件管理方面的价值,并就多学科团队(MDT)如何在疾病的各个阶段最佳部署以改善患者预后和有效管理常见不良事件提出了实用建议。作者讨论了协作方法如何通过适当利用 NSCLC MDT 成员(包括放射和医学肿瘤学家、胸部内科医生、病理学家、肺病学家、外科医生和护理人员)的多样化专业知识,继续确保在治疗选择因生物标志物驱动的治疗策略而变得更加专业化的时代,为每位患者做出最佳决策。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8796/7873339/c6f235a2435e/ONCO-26-e306-g001.jpg

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