| Penulis/Author |
Dr. dr. Kartika Widayati, SpPD-KHOM (1) ; Dr. dr. Camelia Herdini, M.Kes., Sp.THT-KL(K), FICS. (2); Aulia S. Brilliant (3); dr. Henry Kusumo Husodoputro, Sp.Rad.(K) (4); dr. Wigati Dhamiyati, Sp.Rad(K)OnkRad (5); Dr. dr. Sagung Rai Indrasari, M.Kes., Sp.T.H.T.K.L(K), FICS. (6); Setiyani P. lestari (7); Yulestrina Widyastuti (8); Herindita Puspitaningtyas (9); Risa Rahmasari (10); Innayah Nur Rachmawati (11); Prof. Dr. dr. Ibnu Purwanto, Sp.PD., K.HOM. (12); dr. Nurhuda Hendra Setyawan., Sp.Rad (13); dr. Ericko Ekaputra, Sp.Onk.Rad(K) (14); dr. Susanna Hilda Hutajulu, Ph.D. Sp.PD-KHOM (15); dr. Sri Retna Dwidanarti, Sp.Rad.(K) Onk.Rad (16); dr. Torana Kurniawan, Sp.Onk.Rad (17); dr. Lidya Meidania, Sp.Onk.Rad. (18); Seize E. Yanuarta (19); dr. Mardiah Suci Hardianti, Ph.D. Sp.PD-KHOM (20); dr. Johan Kurnianda, Sp.PD-KHOM (21) |
| Abstrak/Abstract |
Background
Nasopharyngeal cancer (NPC) is a common cancer in Asia. In many developing countries, most cases are in
advanced stages, compromising the outcome of treatment. The complexity of NPC management for advancedstage NPC requires thorough communication and shared clinical decisions between medical professionals and
allied teams. Incorporating a multidisciplinary team meeting (MDTM) for newly diagnosed NPC patients was
chosen to facilitate clinical collaboration and communication between physicians. This recent study aimed to
compare quality of care, clinical responses and survival between NPC patients treated inside and outside of
MDTM care.
Methods
This was a retrospective study comparing NPC patients treated under the MDTM with NPC patients managed
outsidethe MDTM. Clinical responses, assessment visits, date of progression and date of death were collected.
Data were analyzed with X2 for discrete variables and t tests for continuous variables. Kaplan‒Meier survival
curves with log-rank tests were used to describe the difference in survival estimation between the groups. Cox
regression hazard models were calculated to predict the hazard risk for progression and survival. Signi¦cance
was determined as p < 0.05.
Results
There were 87 patients treated under MDTM and 178 patients treated outside MDTM. Histology type of WHO
type 3 was predominant. Stages IVA and B accounted for more than 60% of patients. Revision of diagnosis
during MDTM accounted for 5.7%, and revision of stage occurred in 52.9%of cases. More clinical responses
were achieved by patients treated under MDTM than by patients outside MDTM (69.0% vs. 32.0%, p < 0.00).
The median progression-free survival of NPC patients under MDTM was 59.89 months compared with 12.68
months outside MDTM (log rank p < 0.00). Overall survival was longer in patients treated under MDTM
compared with patients outside MDT (not reached vs. 13.44 months; p < 0.00). NPC patients who received
treatment recommendations from the MDTM had a lower risk for progression (HR 0.267, 95% CI 0.17-0.40, p <
0.00) and mortality (HR 0.134; 95% CI 0.08 -0.24, p < 0.00).
Conclusion
Incorporating the MDTM approach into NPC management improves the clinical response and survival of
patients. |
