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R. Damhuis
Author of
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P3.01 - Advanced NSCLC (ID 621)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Advanced NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 10/18/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
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P3.01-088g - Variation in Treatment Recommendations for NSCLC Patients by Multidisciplinary Tumor Board Meetings Across the Netherlands (ID 9522)
09:30 - 09:30 | Author(s): R. Damhuis
- Abstract
Background:
The treatment choice for lung cancer patients is dependent on the expertise of the treating physician and the tumor board meetings (TBM) in which a treatment plan is discussed multidisciplinary. However, despite availability of a national guideline, the treatment selection criteria for NSCLC patients are not very explicit. Consequently, this may result in a variation of treatment recommendations across TBM. In this study, we investigated the variation in treatment recommendations by TBM within the Netherlands for 3 patients. Furthermore, patient characteristics associated with the treatment choice were explored.
Method:
A qualitative study was performed across 9 TBM at general hospitals in the Netherlands of which three hospitals had a radiotherapy(RT) department. Three existing patient cases were selected. The full medical history including imaging examinations was provided. Patient 1: 92years, cT3-4N0-1M0 (stage III). Patient 2: 73years, cT3NxM1b oligometastatic disease with a single adrenal metastasis (stage IV). Patient 3: 66years, cT2b-3N2M0 (stage III). All patients had a good performance score (WHO 0-1). The discussions and treatment plans during TBM were audiotaped. Analysis of the tapes was performed using open and axial coding techniques.
Result:
For patient 1 the recommended treatment was radical RT (45%), palliative RT (33%), surgery + RT (11%) and restaging before any treatment recommendation (11%). For patient 2 the recommended treatment was concurrent chemoradiotherapy (CRT) (45%), concurrent CRT + adrenal resection (33%), palliative RT (11%) and sequential CRT (11%). For patient 3 the recommended treatment was concurrent CRT (89%) and sequential CRT (11%). The patient characteristic ‘age’ was quoted in 96% of the treatment discussions, followed by ‘performance score’(89%) and ‘medical history’(85%). Figure 1
Conclusion:
In this qualitative study, a large variation in recommended treatment across the Netherlands was observed. The most extreme variation was seen in the treatment recommendation for the elder patient (92years), with treatment plans ranging from palliative RT to radical surgery.
