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Factors influencing multi-disciplinary tumor board recommendations in stage III non-small cell lung cancer.
Ronden, Merle I; Bahce, Idris; Hashemi, Sayed M S; Dickhoff, Chris; de Haan, Patricia F; Becker, Annemarie; Spoelstra, Femke O B; Dahele, Max R; Ali, Rania; Tiemessen, Marian A; Tarasevych, Svitlana; Maassen van den Brink, Karen; Haasbeek, Cornelis J A; Daniels, Johannes M A; van Laren, Marjolein; Verbakel, Wilko F A R; Senan, Suresh.
Afiliação
  • Ronden MI; Department of Radiation Oncology, Amsterdam UMC, VUmc location, Amsterdam, the Netherlands. Electronic address: m.ronden@amsterdamumc.nl.
  • Bahce I; Department of Pulmonology, Amsterdam UMC, VUmc location, Amsterdam, the Netherlands.
  • Hashemi SMS; Department of Pulmonology, Amsterdam UMC, VUmc location, Amsterdam, the Netherlands.
  • Dickhoff C; Department of Surgery, Amsterdam UMC, VUmc location, Amsterdam, the Netherlands.
  • de Haan PF; Department of Radiation Oncology, Amsterdam UMC, VUmc location, Amsterdam, the Netherlands.
  • Becker A; Department of Pulmonology, Amsterdam UMC, VUmc location, Amsterdam, the Netherlands.
  • Spoelstra FOB; Department of Radiation Oncology, Amsterdam UMC, VUmc location, Amsterdam, the Netherlands.
  • Dahele MR; Department of Radiation Oncology, Amsterdam UMC, VUmc location, Amsterdam, the Netherlands.
  • Ali R; Department of Radiation Oncology, Amsterdam UMC, VUmc location, Amsterdam, the Netherlands.
  • Tiemessen MA; Department of Pulmonology, Dijklander Ziekenhuis, Hoorn & Purmerend, the Netherlands.
  • Tarasevych S; Department of Pulmonology, Zaans Medisch Centrum, Zaandam, the Netherlands.
  • Maassen van den Brink K; Department of Pulmonology, Dijklander Ziekenhuis, Hoorn & Purmerend, the Netherlands.
  • Haasbeek CJA; Department of Radiation Oncology, Amsterdam UMC, VUmc location, Amsterdam, the Netherlands.
  • Daniels JMA; Department of Pulmonology, Amsterdam UMC, VUmc location, Amsterdam, the Netherlands.
  • van Laren M; Department of Pulmonology, Dijklander Ziekenhuis, Hoorn & Purmerend, the Netherlands.
  • Verbakel WFAR; Department of Radiation Oncology, Amsterdam UMC, VUmc location, Amsterdam, the Netherlands.
  • Senan S; Department of Radiation Oncology, Amsterdam UMC, VUmc location, Amsterdam, the Netherlands.
Lung Cancer ; 152: 149-156, 2021 02.
Article em En | MEDLINE | ID: mdl-33418430
OBJECTIVES: Treatment patterns in patients with stage III non-small cell lung cancer (NSCLC) vary considerably between countries, for reasons that are not well understood. We studied factors influencing treatment decision-making at thoracic multidisciplinary tumor boards (MDT's) and outcome for patients treated between 2015-2017, at a regional network comprising 5 hospitals. MATERIALS AND METHODS: Details of all patients, including comorbidities, with stage III NSCLC were collected in an ethics-approved database. Weekly MDT's were conducted. The preferred radical intent treatments (RIT) for suitable patients were assumed to be concurrent chemoradiotherapy and/or surgery and other therapies were non-radical intent treatments (n-RIT). RESULTS: Of 197 patients identified, 95 % were discussed at an MDT. RIT were recommended in 61 % of patients, but only 48 % finally received RIT. The estimated median OS was significantly better for patients undergoing RIT (28.3 months, CI-95 % 17.3-39.3), versus those who did not (11.2 months, CI-95 % 8.0-14.3). Patient age ≥70 years and a WHO-PS ≥2 were the most important predictors of not recommending RIT. Deaths due to progressive lung cancer within 2 years were observed in 36, 26 and 29 % of patients who received RIT, sequential chemoradiotherapy or radical radiotherapy. Corresponding comorbidity related deaths within 2 years were 3, 12 and 38 %. CONCLUSION: A large number of patients who underwent MDT review were considered too old or not fit for RIT. More effective and better tolerated systemic treatments are required for patients presenting with stage III NSCLC.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Carcinoma Pulmonar de Células não Pequenas / Neoplasias Pulmonares Tipo de estudo: Prognostic_studies Aspecto: Ethics Limite: Aged / Humans Idioma: En Revista: Lung Cancer Assunto da revista: NEOPLASIAS Ano de publicação: 2021 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Carcinoma Pulmonar de Células não Pequenas / Neoplasias Pulmonares Tipo de estudo: Prognostic_studies Aspecto: Ethics Limite: Aged / Humans Idioma: En Revista: Lung Cancer Assunto da revista: NEOPLASIAS Ano de publicação: 2021 Tipo de documento: Article
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