中低收入国家和新兴经济体早期肺癌的多学科团队护理：当前立场和行动呼吁
Multidisciplinary Team Care for Early-Stage Lung Cancer in Low- and Middle-Income Countries and Emerging Economies: Current Position and Call for Action.
作者
作者单位
- Department of Medical Oncology, Instituto Nacional de Câncer, Rio de Janeiro, Brazil.
- Lung Cancer Unit, National Thorax Institute, Santiago, Chile.
- Department of Cardiothoracic Surgery, Gleneagles Hospital Johor, Iskandar Puteri, Malaysia.
- Center of Expertise in Thoracic Oncology Oncotórax, Fundación Neumológica Colombiana, Luis Carlos Sarmiento Angulo Cancer Treatment and Research Center, Bogotá, Colombia.
- Department of Clinical Oncology, Alexandria University, Alexandria, Egypt.
- Medical Oncology Department, Instituto Nacional de Enfermedades Respiratorias (INER), Mexico City, Mexico.
- Department of Pulmonary Medicine, Pamukkale University, Denizli, Türkiye.
- Thoracic Oncology Center, British Hospital, Buenos Aires, Argentina.
- Department of Thoracic Surgery, Peking University People's Hospital, Beijing, China.
- Faculty of Medicine, Nguyen Tat Thanh University, Ho Chi Minh City, Vietnam.
- Department of Radiation Oncology, BLK MAX Hospital, New Delhi, India.
- Medical Affairs, AstraZeneca, Baar, Switzerland.
摘要
中文
肺癌（LC）是一种预后不良的复杂癌症。中低收入国家（LMICs）和新兴经济体近年来由于症状意识低、烟草使用增加、空气污染和肺部感染，肺癌负担不断增长。最佳管理LC需要多学科团队（MDT）方法，以支持准确的诊断、分期和治疗。MDT陈述与早期肺癌（ESLC）的及时诊断和分期、接受手术和生存获益相关。然而，在LMICs和新兴经济体中，通过MDT方法提供高质量的ESLC护理仍然具有挑战性。组织结构薄弱、融资和卫生系统碎片化、肿瘤劳动力短缺以及不了解MDT的潜在影响阻碍了最佳护理。系统识别、分析和报告ESLC护理障碍对于提高护理质量和为有效的纠正干预提供信息至关重要。本文旨在探讨LMICs和新兴经济体中ESLC患者护理所特有的MDT实施障碍，并制定了加强MDT护理路径的循证建议。这些建议解决的关键重点领域包括ESLC管理MDT小组的组成、标准化MDT流程和指南、定义用于数据收集和内部MDT审查的标准化数据集、数据共享实践，以及简化决策过程。本指导文件还为改进ESLC中标准化MDT护理提供了一个合理的框架（RISE-LC），以指导在资源受限环境中实施和优化MDT护理，旨在改善及时诊断、治疗协调和患者结局。
English
Lung cancer (LC) is a complex cancer marked by poor prognosis. Low- and middle-income countries (LMICs) and emerging economies have witnessed a growing burden of LC in recent years due to low symptom awareness, rising tobacco use, air pollution, and pulmonary infections. Managing LC optimally requires a multidisciplinary team (MDT) approach to support accurate diagnosis, staging, and treatment. MDT presentation has been linked to timely diagnosis and staging, receipt of surgery, and survival benefits in early-stage LC (ESLC). However, delivering high-quality ESLC care through an MDT approach remains challenging in LMICs and emerging economies. Weak organizational structure, fragmentation of the financing and health system, oncology workforce deficits, and unawareness of the potential impact of MDTs hinder optimal care. Systematic identification, analysis, and reporting of barriers to ESLC care are critical for improving care quality and informing effective corrective interventions. This article aimed to explore barriers to MDT implementation that are unique to the care of patients with ESLC in LMICs and emerging economies and developed evidence-informed recommendations for strengthening MDT care pathways. Key focus areas addressed by these recommendations include the composition of the MDT panel for ESLC management, standardizing MDT processes and guidelines, defining standardized datasets for data collection and internal MDT review, data sharing practices, and streamlining decision-making processes. This guidance document also provides a rational framework for improved standardized MDT care in ESLC (RISE-LC) to guide the implementation and optimization of MDT care in resource-constrained settings, aiming to improve timely diagnosis, treatment coordination, and patient outcomes.
分类与指标
- 研究类型
- 综述Meta
- 病种
- 肺癌
- JCR 分区
- Q2
- 影响因子
- 2.6
- 新锐分区
- 4区