Ahmed Hiba Z, Nittala Mary R, Kosalram Nivedha, Crosswhite Betsy, Lee Alice P, Frazier Tracy C, Milner Carter P, Vijayakumar Srinivasan
Radiation Oncology, University of Mississippi Medical Center, Jackson, USA.
Hematology and Medical Oncology, University of Mississippi Medical Center, Jackson, USA.
Cureus. 2023 Feb 6;15(2):e34693. doi: 10.7759/cureus.34693. eCollection 2023 Feb.
Incorporation of patients' preferences often leads to improved outcomes when included in the multidisciplinary tumor conference/board (MTC). However, patients' wishes are not included or considered in the MTC decision-making. We need better strategies and approaches for patient-inclusive, shared decision-making. When finding ourselves at a crossroads regarding the next step in a patient's treatment, we saw a unique opportunity for an MTC with the patient and her husband in attendance. The results of a full literature review regarding the role of consolidative radiation therapy (RT) in a patient with primary (thymic) B-cell lymphoma after completion of chemotherapy and fluorodeoxyglucose positron emission tomography-computed tomography (FDG-PET/CT) scan with a Deauville score of 4 were presented in a creative, engaging debate-style forum with visual aids. The patient and her husband were able to follow the discussion and, in the end, a consensus recommendation, heavily focused on the patient's preferences, was offered and adopted, which ultimately resulted in the avoidance of excess treatment and likely improved her long-term quality of life outcome. These collaborative and innovative interactions benefit not only our patients but enrich our lives too as healthcare providers and strengthen us as a cancer care team in terms of understanding diversity in decision-making processes.
在多学科肿瘤会议(MTC)中纳入患者偏好通常会带来更好的治疗结果。然而,患者的意愿在MTC决策中并未得到纳入或考虑。我们需要更好的策略和方法来实现以患者为中心的共同决策。当我们在患者治疗的下一步面临抉择时,我们看到了一个让患者及其丈夫参加MTC的独特机会。在一个配有视觉辅助工具的、富有创意且引人入胜的辩论式论坛上,展示了关于巩固性放射治疗(RT)在化疗及氟脱氧葡萄糖正电子发射断层扫描-计算机断层扫描(FDG-PET/CT)检查后Deauville评分为4的原发性(胸腺)B细胞淋巴瘤患者中的作用的全面文献综述结果。患者及其丈夫能够跟上讨论,最终,一项高度关注患者偏好的共识性建议被提出并采纳,这最终避免了过度治疗,并可能改善了她的长期生活质量。这些协作性和创新性的互动不仅使我们的患者受益,也丰富了我们作为医疗服务提供者的生活,并在理解决策过程中的多样性方面增强了我们作为癌症护理团队的实力。