Casus 2 MDO:
- Patient satisfaction
Patients prefer a one-stop diagnostic clinic rather than a multiple-visit approach.
Improvement in satisfaction has been associated with the increased psychosocial
support and involvement of patient and family in treatment decisions as found in a
multidisciplinary clinic.
- Increased accuracy of care
A study found that the radiographic review by the multidisciplinary radiologist found
additional abnormalities in 23% of cases. Alterations in het treatment plan are seen
with regularity in multidisciplinary clinics. An analysis of the reasons for treatment
decision change found that comorbidity, patient choice, new information and doctor
discretion all caused changes in treatment plans in a multidisciplinary setting.
- Improved survival
A brain tumor multidisciplinary clinic found that patients enrolled in the clinic had a
survival time of 18,7 months compared with 11,9 months for patients in traditional
treatment. A breast cancer study found that multidisciplinary care reduced the time
from diagnosis to treatment from 42,2 to 29,6 days.
- Quality of life
Quality of life can be well addressed by a multidisciplinary approach to palliative
care. A randomized study of multidisciplinary versus standard intervention showed
that patients who received multidisciplinary care maintained their quality of life
during treatment while those with standard treatment had their quality of life worsen
(especially prevalent in geriatric population). In lung cancer, patients who received
interdisciplinary care had better improvements in pain and fatigue.
- Graduate medical education and research
Multidisciplinary tumor boards have been shown to enhance graduate medical
education by providing a unique experience not seen in the typical residency and
fellowship. One study found that they enrolled 29% more patients with the use of a
multidisciplinary clinic.
- Decreased variability
One study demonstrated that the multidisciplinary lung cancer group strongly
adhered to national guidelines. Another study found that patients treated by a non-
lung cancer specialist received less lung-specific therapy.
Oncologists:
- Cisplatin = prevents the cell from repairing from radiation damage
side effects: kidney failure meer invloed op neurologische systeem +
cardiovasculaire complicaties
- Cetuximab = antibody binds to EGF receptor. Is overexpressed by head and neck
cancer. Less signaling into the cell.
Bij mensen met cardiovasculaire complicaties wordt cetuximab geadviseerd
Radiation is given 5 days a week. 3 cycles of cisplatin (once every 3 weeks because
of the side effects, hele hoge dosis. Nu doen ze elke week om een lagere dosis te
geven om zo de bijwerkingen zo laag mogelijk te houden.). Cetuximab is given one
time every week, also combined with radiation. Cetuximab and cisplatin are not
combined because it’s too toxic.
Palliative treatment
- Patient satisfaction
Patients prefer a one-stop diagnostic clinic rather than a multiple-visit approach.
Improvement in satisfaction has been associated with the increased psychosocial
support and involvement of patient and family in treatment decisions as found in a
multidisciplinary clinic.
- Increased accuracy of care
A study found that the radiographic review by the multidisciplinary radiologist found
additional abnormalities in 23% of cases. Alterations in het treatment plan are seen
with regularity in multidisciplinary clinics. An analysis of the reasons for treatment
decision change found that comorbidity, patient choice, new information and doctor
discretion all caused changes in treatment plans in a multidisciplinary setting.
- Improved survival
A brain tumor multidisciplinary clinic found that patients enrolled in the clinic had a
survival time of 18,7 months compared with 11,9 months for patients in traditional
treatment. A breast cancer study found that multidisciplinary care reduced the time
from diagnosis to treatment from 42,2 to 29,6 days.
- Quality of life
Quality of life can be well addressed by a multidisciplinary approach to palliative
care. A randomized study of multidisciplinary versus standard intervention showed
that patients who received multidisciplinary care maintained their quality of life
during treatment while those with standard treatment had their quality of life worsen
(especially prevalent in geriatric population). In lung cancer, patients who received
interdisciplinary care had better improvements in pain and fatigue.
- Graduate medical education and research
Multidisciplinary tumor boards have been shown to enhance graduate medical
education by providing a unique experience not seen in the typical residency and
fellowship. One study found that they enrolled 29% more patients with the use of a
multidisciplinary clinic.
- Decreased variability
One study demonstrated that the multidisciplinary lung cancer group strongly
adhered to national guidelines. Another study found that patients treated by a non-
lung cancer specialist received less lung-specific therapy.
Oncologists:
- Cisplatin = prevents the cell from repairing from radiation damage
side effects: kidney failure meer invloed op neurologische systeem +
cardiovasculaire complicaties
- Cetuximab = antibody binds to EGF receptor. Is overexpressed by head and neck
cancer. Less signaling into the cell.
Bij mensen met cardiovasculaire complicaties wordt cetuximab geadviseerd
Radiation is given 5 days a week. 3 cycles of cisplatin (once every 3 weeks because
of the side effects, hele hoge dosis. Nu doen ze elke week om een lagere dosis te
geven om zo de bijwerkingen zo laag mogelijk te houden.). Cetuximab is given one
time every week, also combined with radiation. Cetuximab and cisplatin are not
combined because it’s too toxic.
Palliative treatment
