Publication date: Available online 21 November 2015
Source:Revue des Maladies Respiratoires
Author(s): J.-P. Sculier, N. Leclercq, A.-P. Meert, M. Paesmans, T. Berghmans
IntroductionOn manque d'études sur la mise en pratique des recommandations de pratique clinique (RPC) en oncologie thoracique.MéthodesLes dossiers des 354 patients avec cancer bronchique non encore traité entre janvier 2009 et décembre 2012 ont été revus. Tout nouveau traitement devrait être proposé en consultation multidisciplinaire (CMD) sur base d'un programme de soins oncologiques (PSO) fondé sur nos RPC.RésultatsOn a 636 CMD (332, 176, 81 et 47 en 1re, 2e, 3e et suivantes lignes). Le taux de CMD en 1re ligne a été de 94 % avec 88 % et 75 % en conformité avec le PSO et les RPC. En 2e et 3e lignes, les taux sont de 93 et 92 % (CMD), 90 et 89 % (PSO), 56 et 63 % (RPC). En 1re ligne, les principales causes de non-application ont été, pour le PSO, le refus du patient ou un autre choix par le médecin et pour les RPC le manque de recommandations adéquates pour des situations spécifiques ou l'apparition de nouveaux traitements.ConclusionLa plupart des patients fait l'objet d'une CMD avec bonne application du PSO. Les RPC doivent être rapidement mises à jour pour incorporer les nouveaux traitements.IntroductionA working group has highlighted guidelines in thoracic oncology in Europe without study of their implementation, due to a lack of data.MethodsThe records of 354 untreated lung cancer patients seen between January 2009 and December 2012 were reviewed. Any new treatment should have been proposed by a multidisciplinary consultation (MDC) in accordance with an oncology care program (OCP) based on the European Lung Cancer Working Party guidelines.ResultsFor the 354 patients, there were 636 MDC (332, 176, 81 and 47 in 1st, 2nd, 3rd and subsequent lines). For the first line, the MDC rate was 88%, in accordance with the OCP, and 75% of treatments were in agreement with the guidelines. For the 2nd and 3rd lines, the rates were 93% and 92% respectively (MDC), 90 and 89% (OCP), 55 and 63% (guidelines). In the first line, the main causes of non-compliance with the OCP were patient's refusal or doctor's choice and with guidelines a lack of adequate recommendations for specific situations such as comorbidities or the appearance of new treatments.ConclusionThe vast majority of patients are the subject of a MDC with a high rate of application of OCP. Guidelines should be updated regularly to incorporate new treatments.
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Implémentation d’un programme de soins oncologiques en consultation multidisciplinaire
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