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虚拟多学科肿瘤委员会:以肺癌为重点的叙述性综述

Virtual Multidisciplinary Tumor Boards: A Narrative Review Focused on Lung Cancer.

作者信息

Gebbia Vittorio, Guarini Aurelia, Piazza Dario, Bertani Alessandro, Spada Massimiliano, Verderame Francesco, Sergi Concetta, Potenza Enrico, Fazio Ivan, Blasi Livio, La Sala Alba, Mortillaro Gianluca, Roz Elena, Marchese Roberto, Chiarenza Maurizio, Soto-Parra Hector, Valerio Maria Rosaria, Agneta Giuseppe, Amato Carmela, Lipari Helga, Baldari Sergio, Ferraù Francesco, Di Grazia Alfio, Mancuso Gianfranco, Rizzo Sergio, Firenze Alberto

机构信息

Medical Oncology Unit, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, La Maddalena Clinic for Cancer, University of Palermo, Via San Lorenzo Colli n. 312D, 90100, Palermo, Italy.

GSTU Foundation, Palermo, Italy.

出版信息

Pulm Ther. 2021 Dec;7(2):295-308. doi: 10.1007/s41030-021-00163-8. Epub 2021 Jun 4.

Abstract

To date, the virtual multidisciplinary tumor boards (vMTBs) are increasingly used to achieve high-quality treatment recommendations across health-care regions, which expands and develops the local MTB team to a regional or national expert network. This review describes the process of lung cancer-specific MTBs and the transition process from face-to-face tumor boards to virtual ones. The review also focuses on the project organization's description, advantages, and disadvantages. Semi-structured interviews identified five major themes for MTBs: current practice, attitudes, enablers, barriers, and benefits for the MTB. MTB teams exhibited positive responses to modeled data feedback. Virtualization reduces time spent for travel, allowing easier and timely patient discussions. This process requires a secure web platform to assure the respect of patients' privacy and presents the same unanswered problems. The implementation of vMTB also permits the implementation of networks especially in areas with geographical barriers facilitating interaction between large referral cancer centers and tertiary or community hospitals as well as easier access to clinical trial opportunities. Studies aimed to improve preparations, structure, and conduct of MTBs, research methods to monitor their performance, teamwork, and outcomes are also outlined in this article. Analysis of literature shows that MTB participants discuss 5-8 cases per meeting and that the use of a vMTB for lung cancer and in particular stage III NSCLC and complex stage IV cases is widely accepted by most health professionals. Despite still-existing gaps, overall vMTB represents a unique opportunity to optimize patient management in a patient-centered approach.

摘要

迄今为止,虚拟多学科肿瘤委员会(vMTB)越来越多地被用于在各医疗区域实现高质量的治疗建议,这将本地的MTB团队扩展并发展成为一个区域或国家级专家网络。本综述描述了肺癌特异性MTB的流程以及从面对面肿瘤委员会向虚拟肿瘤委员会的转变过程。该综述还聚焦于项目组织的描述、优势和劣势。半结构化访谈确定了MTB的五个主要主题:当前实践、态度、促成因素、障碍以及MTB的益处。MTB团队对模拟数据反馈表现出积极回应。虚拟化减少了出行时间,使患者讨论更加便捷和及时。这一过程需要一个安全的网络平台来确保患者隐私得到尊重,同时也存在一些尚未解决的问题。vMTB的实施还允许建立网络,特别是在存在地理障碍的地区,促进大型转诊癌症中心与三级或社区医院之间的互动,并使患者更容易获得临床试验机会。本文还概述了旨在改善MTB的准备工作、结构和开展情况、监测其绩效的研究方法、团队合作及结果的研究。文献分析表明,MTB参与者每次会议讨论5 - 8个病例,并且vMTB在肺癌治疗中的应用,特别是在III期非小细胞肺癌和复杂IV期病例中的应用,得到了大多数医疗专业人员的广泛认可。尽管仍存在差距,但总体而言,vMTB代表了一个以患者为中心优化患者管理的独特机会。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f772/8589912/8612f73cf1e4/41030_2021_163_Fig1_HTML.jpg

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