基于多模式策略（手术或放疗联合全身药物）治疗 III-N2 期非小细胞肺癌（NSCLC）仍存在争议。患者接受治疗的目的是治愈，现有数据表明完全切除后生存期延长。然而，对于“肿瘤可切除性”尚无一致的定义。本研究旨在分析法国肿瘤委员会会议（TBM）制定的 III-N2 期 NSCLC 治疗决策的一致性。选择了在圣艾蒂安大学医院胸腔 TBM 讨论的 6 名 III-N2 期 NSCLC 患者，匿名报告并提交至参与的 TBM。这项多中心、前瞻性、观察性研究的主要目标是评估 TBMpanel 对每个病例​​决策的一致性。次要终点是确定可能影响决策的人口或技术因素。来自大学医院、癌症中心、综合医院和私立医院的 27 名 TBM 参与了这项研究。他们对这 6 个案例的决定都不一致。其中 3 个案例的决定是一致的（分别为 78%、85% 和 88% 的 TBM 选择药物治疗），而其他 3 个案例则更加矛盾（倾向于药物治疗还是手术治疗）分别为 44%/56%、46%/54% 和 58%/42% TBM）。有趣的是，内科和手术策略中关于放化疗和围手术期化疗的决定也不一致。医院类型、TBM 专家参与度以及活动量与治疗决策没有显着相关。这项研究的结果凸显了法国 TBM 之间在 III-N2 期 NSCLC 治疗管理方面存在巨大差异。这些决定与当地情况无关。版权所有 © 2024 作者。由 Elsevier B.V. 出版。保留所有权利。

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.Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.