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Clinical management of oligometastatic cancer: Applying multidisciplinary tumor board recommendations in practice.
Christ, Sebastian M; Breitenstein, Minsu; Heesen, Philip; Turner, Brandon; Muehlematter, Urs J; Pohl, Kaspar; Willmann, Jonas; Maurer, Alexander; Nagpal, Sukhdeep K; Ahmadsei, Maiwand; Badra Vlaskou, Eugenia; Looman, Esmée L; Heusel, Astrid E; Mayinger, Michael; Balermpas, Panagiotis; Wicki, Andreas; Andratschke, Nicolaus; Balboni, Tracy; Anh Huynh, Mai; Huellner, Martin; Guckenberger, Matthias.
Afiliación
  • Christ SM; Dept. of Radiation Oncology, University Hospital & University of Zurich, Zurich, CH, Switzerland.
  • Breitenstein M; Faculty of Medicine, University of Zurich, Zurich, CH, Switzerland.
  • Heesen P; Faculty of Medicine, University of Zurich, Zurich, CH, Switzerland.
  • Turner B; Dept. of Radiation Oncology, Brigham and Women's Hospital, Dana Farber Cancer Institute, Boston, MA, USA.
  • Muehlematter UJ; Dept. of Nuclear Medicine, University Hospital & University of Zurich, Zurich, CH, Switzerland.
  • Pohl K; Faculty of Medicine, University of Zurich, Zurich, CH, Switzerland.
  • Willmann J; Dept. of Radiation Oncology, University Hospital & University of Zurich, Zurich, CH, Switzerland.
  • Maurer A; Dept. of Nuclear Medicine, University Hospital & University of Zurich, Zurich, CH, Switzerland.
  • Nagpal SK; Radiotherapy Dept., The Royal Marsden NHS Foundation Trust, London, UK.
  • Ahmadsei M; Dept. of Radiation Oncology, University Hospital & University of Zurich, Zurich, CH, Switzerland.
  • Badra Vlaskou E; Dept. of Radiation Oncology, University Hospital & University of Zurich, Zurich, CH, Switzerland.
  • Looman EL; Dept. of Radiation Oncology, University Hospital & University of Zurich, Zurich, CH, Switzerland.
  • Heusel AE; Dept. of Radiation Oncology, University Hospital & University of Zurich, Zurich, CH, Switzerland.
  • Mayinger M; Dept. of Radiation Oncology, University Hospital & University of Zurich, Zurich, CH, Switzerland.
  • Balermpas P; Dept. of Radiation Oncology, University Hospital & University of Zurich, Zurich, CH, Switzerland.
  • Wicki A; Dept. of Medical Oncology & Hematology, University Hospital & University of Zurich, Zurich, CH, Switzerland.
  • Andratschke N; Dept. of Radiation Oncology, University Hospital & University of Zurich, Zurich, CH, Switzerland.
  • Balboni T; Dept. of Radiation Oncology, Brigham and Women's Hospital, Dana Farber Cancer Institute, Boston, MA, USA.
  • Anh Huynh M; Dept. of Radiation Oncology, Brigham and Women's Hospital, Dana Farber Cancer Institute, Boston, MA, USA.
  • Huellner M; Dept. of Nuclear Medicine, University Hospital & University of Zurich, Zurich, CH, Switzerland.
  • Guckenberger M; Dept. of Radiation Oncology, University Hospital & University of Zurich, Zurich, CH, Switzerland.
Clin Transl Radiat Oncol ; 48: 100838, 2024 Sep.
Article en En | MEDLINE | ID: mdl-39224662
ABSTRACT

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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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Clin Transl Radiat Oncol Año: 2024 Tipo del documento: Article País de afiliación: Suiza Pais de publicación: Irlanda
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Clin Transl Radiat Oncol Año: 2024 Tipo del documento: Article País de afiliación: Suiza Pais de publicación: Irlanda