多学科团队诊疗模式下纵隔肿瘤的临床治疗策略分析  

Analysis of clinical treatment strategies of mediastinal tumors under multidisciplinary team diagnosis and treatment model

作　　者：王帅 高健 蒋家好 陈岗 徐蓓 董继宏 杜世锁[5] 刘骏帧 赖颢[7] 葛圣金 承璐雅 谭黎杰 范越 丁建勇 WANG Shuai;GAO Jian;JIANG Jiahao;CHEN Gang;XU Bei;DONG Jihong;DU Shisuo;LIU Junzhen;LAI Hao;GE Shengjin;CHEN Luya;TAN Lijie;FAN Yue;DING Jianyong(Department of Thoracic surgery,Zhongshan Hospital Fudan University,Shanghai 230032,China;Department of Pathology,Zhongshan Hospital Fudan University,Shanghai 230032,China;Department of Oncology,Zhongshan Hospital Fudan University,Shanghai,230032,China;Department of Neurology,Zhongshan Hospital Fudan University,Shanghai 230032,China;Department of Radiotherapy,Zhongshan Hospital Fudan University,Shanghai 230032,China;Department of Radiology,Zhongshan Hospital Fudan University,Shanghai 230032,China;Department of Cardiac Surgery,Zhongshan Hospital Fudan University,Shanghai 230032,China;Department of Anesthesiology,Zhongshan Hospital Fudan University,Shanghai 230032,China;Department of Hematology,Zhongshan Hospital Fudan University,Shanghai 230032,China;Department of Integrative Medicine,Zhongshan Hospital Fudan University,Shanghai 230032,China)

机构地区：[1]复旦大学附属中山医院胸外科,上海230032 [2]复旦大学附属中山医院病理科,上海230032 [3]复旦大学附属中山医院肿瘤内科,上海230032 [4]复旦大学附属中山医院神经内科,上海230032 [5]复旦大学附属中山医院放射治疗科,上海230032 [6]复旦大学附属中山医院放射诊断科,上海230032 [7]复旦大学附属中山医院心脏外科,上海230032 [8]复旦大学附属中山医院麻醉科,上海230032 [9]复旦大学附属中山医院血液科,上海230032 [10]复旦大学附属中山医院中西医结合科,上海230032

出　　处：《肿瘤》2022年第12期813-819,共7页Tumor

基　　金：国家自然科学基金(81972168);复旦大学附属中山医院优秀青年基金(2021ZSYQ28)

摘　　要：目的:探索多学科团队(multidisciplinary team,MDT)诊疗模式对纵隔疾病的治疗策略。方法:回顾性分析在2020年1—12月复旦大学附属中山医院接受纵隔MDT讨论的纵隔疾病患者的临床资料,并与2019年未进行MDT讨论的胸腺肿瘤患者的临床资料进行对比。结果:共为166例患者进行185次MDT讨论,涉及的病种包括112例胸腺上皮肿瘤、12例淋巴瘤、21例生殖源性肿瘤、6例后纵隔神经源性肿瘤,、12例其他肿瘤、3例非肿瘤性疾病。35例首选手术治疗,35例在放化疗后进行手术治疗。与既往未接受纵隔MDT讨论的胸腺肿瘤患者的临床资料进行比较,接受纵隔MDT讨论的胸腺肿瘤患者的中位诊断治疗间隔时间缩短(13 vs 7 d),接受手术治疗的比例提高(35.8%vs 45.7%),手术完全切除的比例提高(76.5%vs 79.1%),术后平均住院时间缩短(9 vs 7 d)。结论:MDT讨论对于复杂纵隔疾病的治疗具有潜在优势,能够为患者制定安全合理的治疗策略。Objective:To explore the therapeutic strategy of multidisciplinary team(MDT)model on the treatment of mediastinal diseases.Methods:The clinical data of patients with mediastinal diseases who were discussed in mediastinal MDT in Zhongshan Hospital Fudan University from January 2020 to December 2020 were analyzed retrospectively and compared with those without MDT discussion in 2019.Results:A total of 185 MDT discussions were conducted for 166 patients,including 112 cases of thymic epithelial tumor,12 cases of lymphoma,21 cases of germ cell tumor,6 cases of posterior mediastinal neurogenic tumor,12 cases of other tumor and 3 cases of non-neoplastic disease.A total of 35 patients underwent surgery,and 35 patients underwent surgery after radiotherapy and chemotherapy.Compared with clinical data of thymoma patients who did not receive MDT discussion,the median diagnosis and treatment interval of thymoma patients who received MDT discussion was shortened(13 vs 7 days),the proportion of patients who received surgical treatment was increased(35.8%vs 45.7%),the proportion of patients who underwent complete surgical removal was increased(76.5%vs 79.1%),and the average postoperative hospital stay was shortened(9 vs 7 days).Conclusion:MDT model has potential advantages in the treatment of complex mediastinal diseases with individual treatment.MDT discussion provides a safe and reasonable treatment strategy for mediastinal diseases.

关 键 词：多学科团队诊疗 纵隔疾病 胸腺瘤 手术 重症肌无力 

分 类 号：R734.5[医药卫生—肿瘤]