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鼻咽癌多学科团队核心会议提高了患者的护理质量和生存率。

Multidisciplinary Team Meeting in the Core of Nasopharyngeal Cancer Management Improved Quality of Care and Survival of Patients.

作者信息

Taroeno-Hariadi Kartika W, Herdini Camelia, Briliant Aulia S, Husodoputro Henry K, Dhamiyati Wigati, Indrasari Sagung Rai, Lestari Setiyani P, Widyastuti Yulestrina, Puspitaningtyas Herindita, Rahmasari Risa, Rachmawati Innayah Nur, Purwanto Ibnu, Setyawan Nurhuda H, Ekaputra Ericko, Hutajulu Susanna H, Dwidanarti Sri R, Kurniawan Torana, Meidania Lidya, Yanuarta Seize E, Hardianti Mardiah S, Kurnianda Johan

机构信息

Division of Hematology and Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito Hospital, Yogyakarta, Indonesia.

Department of Ear, Nose and Throat, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito Hospital, Yogyakarta, Indonesia.

出版信息

Health Serv Insights. 2023 Oct 16;16:11786329231204757. doi: 10.1177/11786329231204757. eCollection 2023.

Abstract

Nasopharyngeal cancer (NPC) cases are often diagnosed in advanced stages. The complexity of clinical management for advanced-stage NPC requires thorough communication and shared decisions between medical professionals and allied teams. Incorporating a multidisciplinary team meeting (MDTM) for newly diagnosed NPC patients was chosen to facilitate collaboration and communication between physicians. This retrospective study aimed to compare the quality of care, clinical responses and survival between NPC patients treated with and without MDTM. Data on clinical responses, assessment visits, date of progression and death with progression-free survival (PFS), overall survival (OS), and hazard ratio (HR) were collected and analyzed with 95% confidence interval (CI) and significance set as  < .05. There were 87 of 178 NPC patients treated with MDTM. Revisions of diagnosis and stage occurred in 5.7% and 52.9% of cases during the MDTM. More clinical responses were achieved by patients treated with MDTM (69.0%vs 32.0%,  < .00). NPC patients who received MDTM treatment recommendation had a lower risk for progression (median PFS 59.89 months vs 12.68 months; HR 0.267, 95% CI: 0.17-0.40,  < .00) and mortality (median OS was not reached vs 13.44 months; HR 0.134, 95% CI: 0.08-0.24,  < .00) compared to patients without MDTM. Incorporating the MDTM approach into NPC management improves patients' clinical responses and survival.

摘要

鼻咽癌(NPC)病例往往在晚期才被诊断出来。晚期NPC临床管理的复杂性要求医疗专业人员和相关团队之间进行充分沟通并共同做出决策。选择为新诊断的NPC患者组织多学科团队会议(MDTM),以促进医生之间的协作与沟通。这项回顾性研究旨在比较接受和未接受MDTM治疗的NPC患者的护理质量、临床反应和生存率。收集并分析了有关临床反应、评估访视、疾病进展日期和因无进展生存期(PFS)、总生存期(OS)及风险比(HR)导致的死亡的数据,95%置信区间(CI),显著性设定为<0.05。178例NPC患者中有87例接受了MDTM治疗。在MDTM期间,5.7%的病例发生了诊断修订,52.9%的病例发生了分期修订。接受MDTM治疗的患者获得了更多的临床反应(69.0%对32.0%,<0.00)。接受MDTM治疗建议的NPC患者与未接受MDTM治疗的患者相比,疾病进展风险更低(中位PFS 59.89个月对12.68个月;HR 0.267,95%CI:0.17 - 0.40,<0.00),死亡率也更低(中位OS未达到对13.44个月;HR 0.134,95%CI:0.08 - 0.24,<0.00)。将MDTM方法纳入NPC管理可改善患者的临床反应和生存率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/56cd/10578065/2c24392571de/10.1177_11786329231204757-fig1.jpg

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