对III-N2NON-N2NON-SMALL-CELL肺癌患者的管理实践的前瞻性分析（观察IIIA-B GFPC 04-2020研究）
A prospective analysis of the management practices for patients with Stage-III-N2Non-Small-Cell lung cancer (OBSERVE IIIA-B GFPC 04-2020Study)
影响因子:4.40000
分区:医学2区 / 肿瘤学3区 呼吸系统3区
发表日期:2024 Aug
作者:
Mathilde Jacob, Pierre Fournel, Claire Tissot, Jacques Cadranel, Olivier Bylicki, Isabelle Monnet, Grégoire Justeau, Charles Ricordel, Pascal Thomas, Lionel Falchero, Chrystel Locher, Marie Wislez, Alain Vergnenegre, Samir Abdiche, Floran Guisier, Acya Bizieux, Regine Lamy, Geraldine François, Gonzagues De Chabot, Thomas Pierret, Marie Sabatini, Marion Abeillera, Sabine Vieillot, Stephanie Martinez, Hugues Morel, Hélène Doubre, Anne Madroszyk, Margaux Geier, Jean LucLabourey, Christos Chouaïd, Laurent Greillier
摘要
基于多模式策略（手术或与全身药物的放射治疗）基于IIII-N2期非小细胞肺癌（NSCLC）的管理仍然有争议。用治疗意图治疗患者，并且可用的数据表明完整切除后的生存期。但是，“肿瘤可察”的定义不存在。这项研究旨在分析法国法国肿瘤委员会会议（TBM） - III-N2 NSCLC。这项多中心，前瞻性观察性研究的主要目标是评估每种情况TBMPanel决策的一致性。次要端点确定了可能影响决策的人口或技术因素。来自大学医院，癌症中心，普通医院和私人医院的二十七个TBM。他们对六例案件的决策都不是一致的。对于三个案例，这些决定是同质的（分别为78％，85％和88％的TBMS选择了医疗治疗），而对其他三个案例的决定则是矛盾的（医疗与外科手术策略受到44％/56％/56％，46％/54％/54％/58％/42％/42％/42％/42％/42％的比例。有趣的是，有关化学放疗和围手术期化学疗法的决策，分别是医学和外科手术策略的决定。医院类型，专家参与TBM和活动量与治疗决定没有显着相关性。这项研究的结果突出了French TBMS在III-II-N2阶段N2 NSCLC治疗管理方面的实质性差异。这些决定与当地条件无关。
Abstract
Management of stage-III-N2 non-small-cell lung cancer (NSCLC) based on a multimodal strategy (surgery or radiotherapycombined with systemic drugs) remains controversial. Patients are treated with a curative intent, and available data suggestprolonged survival after complete resection. However, no consensual definition of "tumor resectability" exists. This study aimed to analyze the concordanceamong French tumor board meeting (TBM)-emittedtherapeutic decisions forstage-III-N2 NSCLC.Six patients with stage-III-N2 NSCLC discussed at Saint-Etienne University Hospital'sthoracic TBMs were selected, anonymouslyreported, and submitted to the participating TBMs. The primary goal of this multicenter, prospective, observational study was to assess the consistency of TBMpanel decisions for each case. The secondary endpointwas identifying the demographic or technical factors that potentiallyaffected decision-making.Twenty-seven TBMs from university hospitals, a cancer center, general hospitals, and a private hospitalparticipated in this study. None of their decisions for the six cases were unanimous.The decisions were homogenous for three cases (78%, 85%, and 88% TBMs opted for medical treatment, respectively),andmore ambivalent for the other three (medical versus surgical strategies were favored by 44%/56%, 46%/54%, and 58%/42% TBMs, respectively). Interestingly, decisions regarding chemoradiationand perioperative chemotherapyinthe medical and surgical strategies, respectively, were also discordant. Hospital type, specialist participation in TBMs, and activity volumes were not significantly associated with therapeutic decisions.The results of this study highlight substantial disparities amongFrench TBMs regarding therapeutic management of stage-III-N2 NSCLC. The decisions were not associated with local conditions.