Multidisziplinäre Tumorboards: Fakten und Zufriedenheitsanalyse eines unverzichtbaren Instruments von Tumorzentren

Zusammenfassung

Hintergrund und Fragestellung Ein etablierter Weg, die optimale Behandlung von Tumorpatienten zu gewährleisten, stellen interdisziplinäre Tumorboards (TBs) dar, die im „Nationalen Krebsplan“ und „Leitlinien der Fachgesellschaften“ als zeitgemäßer Standard der onkologischen Versorgung eingefordert werden. Diese Arbeit untersuchte die Fragen an das Multiple Myelom (MM)-TB, den Befolgungs- und Evidenzgrad, Frequenz der Studieneinschlüsse, Überleben und die Zufriedenheit der TB-Teilnehmer, -Zuweiser und -Patienten.

Patienten und Methodik 498 TB-Empfehlungen wurden hinsichtlich der TB-Fragestellungen, Vorstellungsfrequenz, Befolgungs-, Evidenzgrad und Studieneinschlüssen retrospektiv analysiert und eine Zufriedenheitsanalyse anhand zuvor an gesunden Probanden intensiv getesteter Fragebögen prospektiv durchgeführt.

Ergebnisse Nach Einführung des MM-TBs konnte die Vorstellungsfallzahl kontinuierlich gesteigert werden; Fragestellungen umfassten symptomatische MM-Patienten und die bestmögliche Antimyelomtherapie. Der Umsetzungs- und Evidenzgrad der TB-Empfehlungen war mit 94 bzw. 96,5 % sehr zufriedenstellend, alle Nichtbefolgungen waren nachvollziehbar begründet. Studieneinschlüsse wurden durch das TB verbessert, 18,8 % der Patienten konnten in laufende MM-Studien eingeschlossen werden. Das mediane progressionsfreie und Gesamtüberleben der MM-TB-Patienten lag bei 2,9 bzw. 4,7 Jahren, ebenso zeigte sich das von erheblich vortherapierten, rezidiviert/refraktären Patienten vergleichsweise günstig. Die Zufriedenheitsanalyse an 58 Teilnehmern, 33 Zuweisern und 100 MM-Patienten wies das MM-TB als vorteilhaft aus.

Folgerung Die Analysen zum TB-Istzustand, Befolgungs- und Evidenzgrad, Überleben und zur Zufriedenheit von Teilnehmern, Zuweisern und Patienten könnten Beispielcharakter für andere TBs haben und weiterführende Untersuchungen zu TBs anregen.

Abstract

Background The established standard to ensure State-of-the-art cancer treatment – as a prerequisite in the national cancer plan and for comprehensive cancer centers (CCCs) today – is through interdisciplinary tumor boards (TBs).

Methods This analysis assessed a newly founded CCC-TB for multiple myeloma (MM) patients, namely a) questions solved therein, b) level of compliance and c) evidence, d) frequency of clinical trial (CT) inclusion, d) progression free (PFS) and overall survival (OS) and e) satisfaction of TB-participants, referring physicians and MM patients.

Results With initiation of the MM-TB, patients discussed therein substantially increased. TB-questions mostly involved symptomatic patients and recommendations on best treatment. The level of compliance and evidence were 94 % and 96.5 %, respectively; all noncompliance being coherently justified. CT inclusion was improved through the TB, leading to 18.8 % of patients being treated therein. Median PFS and OS were 2.9 and 4.7 years, respectively; also those of substantially pretreated, relapsed/refractory patients were favorable. The satisfaction of 58 participants, 33 referring physicians and 100 MM patients with the MM-TB was rewarding.

Conclusion The detailed assessment of this CCC-TB on TB-questions, compliance and evidence levels, survival and satisfaction responses could serve as a valuable example for other TBs and CCCs and excite subsequent analyses on TBs.

Schlüsselwörter

Tumorboards - Befolgungsgrad - Studienteilnahme - Zufriedenheitsanalyse

Key words

tumor boards - compliance - clinical trial inclusion - satisfaction analysis

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