Sebastian M. Christ , Minsu Breitenstein , Philip Heesen , Brandon Turner , Urs J. Muehlematter , Kaspar Pohl , Jonas Willmann , Alexander Maurer , Sukhdeep K. Nagpal , Maiwand Ahmadsei , Eugenia Badra Vlaskou , Esmée L. Looman , Astrid E. Heusel , Michael Mayinger , Panagiotis Balermpas , Andreas Wicki , Nicolaus Andratschke , Tracy Balboni , Mai Anh Huynh , Martin Huellner , Matthias Guckenberger
{"title":"寡转移性癌症的临床管理：在实践中应用多学科肿瘤委员会的建议","authors":"Sebastian M. Christ , Minsu Breitenstein , Philip Heesen , Brandon Turner , Urs J. Muehlematter , Kaspar Pohl , Jonas Willmann , Alexander Maurer , Sukhdeep K. Nagpal , Maiwand Ahmadsei , Eugenia Badra Vlaskou , Esmée L. Looman , Astrid E. Heusel , Michael Mayinger , Panagiotis Balermpas , Andreas Wicki , Nicolaus Andratschke , Tracy Balboni , Mai Anh Huynh , Martin Huellner , Matthias Guckenberger","doi":"10.1016/j.ctro.2024.100838","DOIUrl":null,"url":null,"abstract":"<div><h3>Aims</h3><p>Multidisciplinary tumor boards (MDTs) are an integral part of ensuring high-quality, evidence-based and personalized cancer care. In this study, we aimed to evaluate the adherence to and implementation of MDT recommendations in patients with oligometastatic disease (OMD).</p></div><div><h3>Methods</h3><p>We screened all oncologic positron emission tomography (PET) scans conducted at a single comprehensive cancer center in 2020. Patients were included if they had evidence of imaging-based OMD from a solid organ malignancy on the index scans, had their OMD case discussed at an MDT, and were treated and followed up at the same center. A switch away from the MDT-recommended treatment modalities was classified as a <em>major deviation</em>; non-MDT-mandated adjustments to a recommended treatment modality were coded as <em>minor deviation</em>. Clinical data was obtained via chart review; statistical calculations were computed using the R software.</p></div><div><h3>Results</h3><p>After review of PET and/or concurrent brain scans, 787 cases of OMD were identified. Thereof, 347 (44.1 %) cases were discussed at MDT, of which 331 (42.1 %) were therapeutically managed and subsequently followed. The three most commonly recommended therapies were systemic therapy (35.6 %), multimodality treatment including definitive local therapy (17.8 %), and radiotherapy (13.9 %). A major deviation was recorded in 16.3 % of cases (most commonly: none of the MDT-recommended treatment modalities were performed: 19 (35.2 %); not all MDT-planned treatment modalities were performed: 12 (22.2 %); and additional treatment modality was performed: 11 (20.3 %). A minor deviation was found in 1.5 % of cases. On multivariable regression, number of distant metastases (n > 1) was associated with a major deviation (OR: 1.85; 95 % CI, 1.0–3.52). Major deviations were associated with a significantly worse OS (p = 0.0034).</p></div><div><h3>Conclusions</h3><p>Adherence to and implementation of MDT recommendations in OMD patients was generally high (83.7%). Major deviations might be further reduced by more careful and elaborate discussions of OMD patient characteristics s and patient preferences.</p></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"48 ","pages":"Article 100838"},"PeriodicalIF":2.7000,"publicationDate":"2024-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405630824001150/pdfft?md5=9a42b209182c7b0d262673433f04cfeb&pid=1-s2.0-S2405630824001150-main.pdf","citationCount":"0","resultStr":"{\"title\":\"Clinical management of oligometastatic cancer: Applying multidisciplinary tumor board recommendations in practice\",\"authors\":\"Sebastian M. Christ , Minsu Breitenstein , Philip Heesen , Brandon Turner , Urs J. Muehlematter , Kaspar Pohl , Jonas Willmann , Alexander Maurer , Sukhdeep K. Nagpal , Maiwand Ahmadsei , Eugenia Badra Vlaskou , Esmée L. Looman , Astrid E. Heusel , Michael Mayinger , Panagiotis Balermpas , Andreas Wicki , Nicolaus Andratschke , Tracy Balboni , Mai Anh Huynh , Martin Huellner , Matthias Guckenberger\",\"doi\":\"10.1016/j.ctro.2024.100838\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Aims</h3><p>Multidisciplinary tumor boards (MDTs) are an integral part of ensuring high-quality, evidence-based and personalized cancer care. In this study, we aimed to evaluate the adherence to and implementation of MDT recommendations in patients with oligometastatic disease (OMD).</p></div><div><h3>Methods</h3><p>We screened all oncologic positron emission tomography (PET) scans conducted at a single comprehensive cancer center in 2020. Patients were included if they had evidence of imaging-based OMD from a solid organ malignancy on the index scans, had their OMD case discussed at an MDT, and were treated and followed up at the same center. A switch away from the MDT-recommended treatment modalities was classified as a <em>major deviation</em>; non-MDT-mandated adjustments to a recommended treatment modality were coded as <em>minor deviation</em>. Clinical data was obtained via chart review; statistical calculations were computed using the R software.</p></div><div><h3>Results</h3><p>After review of PET and/or concurrent brain scans, 787 cases of OMD were identified. Thereof, 347 (44.1 %) cases were discussed at MDT, of which 331 (42.1 %) were therapeutically managed and subsequently followed. The three most commonly recommended therapies were systemic therapy (35.6 %), multimodality treatment including definitive local therapy (17.8 %), and radiotherapy (13.9 %). A major deviation was recorded in 16.3 % of cases (most commonly: none of the MDT-recommended treatment modalities were performed: 19 (35.2 %); not all MDT-planned treatment modalities were performed: 12 (22.2 %); and additional treatment modality was performed: 11 (20.3 %). A minor deviation was found in 1.5 % of cases. On multivariable regression, number of distant metastases (n > 1) was associated with a major deviation (OR: 1.85; 95 % CI, 1.0–3.52). Major deviations were associated with a significantly worse OS (p = 0.0034).</p></div><div><h3>Conclusions</h3><p>Adherence to and implementation of MDT recommendations in OMD patients was generally high (83.7%). Major deviations might be further reduced by more careful and elaborate discussions of OMD patient characteristics s and patient preferences.</p></div>\",\"PeriodicalId\":10342,\"journal\":{\"name\":\"Clinical and Translational Radiation Oncology\",\"volume\":\"48 \",\"pages\":\"Article 100838\"},\"PeriodicalIF\":2.7000,\"publicationDate\":\"2024-08-10\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.sciencedirect.com/science/article/pii/S2405630824001150/pdfft?md5=9a42b209182c7b0d262673433f04cfeb&pid=1-s2.0-S2405630824001150-main.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Clinical and Translational Radiation Oncology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2405630824001150\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"ONCOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical and Translational Radiation Oncology","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2405630824001150","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ONCOLOGY","Score":null,"Total":0}
Clinical management of oligometastatic cancer: Applying multidisciplinary tumor board recommendations in practice
Aims
Multidisciplinary tumor boards (MDTs) are an integral part of ensuring high-quality, evidence-based and personalized cancer care. In this study, we aimed to evaluate the adherence to and implementation of MDT recommendations in patients with oligometastatic disease (OMD).
Methods
We screened all oncologic positron emission tomography (PET) scans conducted at a single comprehensive cancer center in 2020. Patients were included if they had evidence of imaging-based OMD from a solid organ malignancy on the index scans, had their OMD case discussed at an MDT, and were treated and followed up at the same center. A switch away from the MDT-recommended treatment modalities was classified as a major deviation; non-MDT-mandated adjustments to a recommended treatment modality were coded as minor deviation. Clinical data was obtained via chart review; statistical calculations were computed using the R software.
Results
After review of PET and/or concurrent brain scans, 787 cases of OMD were identified. Thereof, 347 (44.1 %) cases were discussed at MDT, of which 331 (42.1 %) were therapeutically managed and subsequently followed. The three most commonly recommended therapies were systemic therapy (35.6 %), multimodality treatment including definitive local therapy (17.8 %), and radiotherapy (13.9 %). A major deviation was recorded in 16.3 % of cases (most commonly: none of the MDT-recommended treatment modalities were performed: 19 (35.2 %); not all MDT-planned treatment modalities were performed: 12 (22.2 %); and additional treatment modality was performed: 11 (20.3 %). A minor deviation was found in 1.5 % of cases. On multivariable regression, number of distant metastases (n > 1) was associated with a major deviation (OR: 1.85; 95 % CI, 1.0–3.52). Major deviations were associated with a significantly worse OS (p = 0.0034).
Conclusions
Adherence to and implementation of MDT recommendations in OMD patients was generally high (83.7%). Major deviations might be further reduced by more careful and elaborate discussions of OMD patient characteristics s and patient preferences.
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