Multidisciplinary Tumor Board Decision Making for Postoperative Radiotherapy in Thymic Epithelial Tumors: Insights from the RYTHMIC Prospective Cohort

Basse, Clémence; Thureau, S.; Bota, Suzanna; Dansin, Éric; Thomas, Philippe; Pichon, Éric; Léna, H.; Massabeau, C.; Clément-Duchêne, Christelle; Massard, Gilbert; Westeel, Virginie; Quantin, Xavier; Oulkhouir, Youssef; Danhier, S.; Lerouge, D.; Tanguy, R.; Thillays, F.; Péchoux, C. Le; Dubray, Bernard; Thiberville, Luc; Besse, Benjamin; Girard, Nicolas

doi:10.1016/j.jtho.2017.07.023

Cited by 29 publications

(25 citation statements)

References 16 publications

(50 reference statements)

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“…However, only 85% of patients received postoperative radiotherapy, due to excessive delays after surgery for clinical conditions. 30 In order to assess adherence to MTB therapeutic indications and guideline recommendations, an Indian group conducted a study evaluating the level of agreement between IBM's Watson for Oncology (WFO) and MTB recommendations from the Manipal Comprehensive Cancer Center in Bangalore, India. WFO is an artificial intelligence (AI) system helping physicians in cancertreatment decisions.…”

Section: Uniformity Of Standards Of Care For Cancer Patients 2 Open mentioning

confidence: 99%

Benefits and Limitations of a Multidisciplinary Approach in Cancer Patient Management

Berardi¹,

Morgese²,

Rinaldi³

et al. 2020

CMAR

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Over the years, a growing body of literature has confirmed as beneficial the implementation of a multidisciplinary approach in the so-often-intricate scenario of cancer patients' management. Together with the consolidation of tumor-board experience in clinical practice, certain aspects have emerged as controversial and a source of current debate. In this systematic literature review, we focused our attention on the impact of multidisciplinary tumor boards, assessing benefits and limitations as a result of the dissemination of such approaches. On the bright side, adherence to clinical guidelines, treatment outcomes, and overall improvement in decision-making processes have been recognized as advantages. On the other side, our analysis highlights a few limitations that should be taken into account to optimize cancer patients' management. Of note, some issues, such as costs, legal responsibility, geographic barriers, and treatment delays, have yet to be resolved. In order partly to address this matter, software platforms and novel methods of computational analysis may provide the needed support. Therefore, the aim of our analysis was to describe the multidisciplinary approach in cancer care in terms of adherence to clinical guidelines, treatment outcomes, and overall improvement in decision-making processes through a systematic review of the literature.

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Section: Uniformity Of Standards Of Care For Cancer Patients 2 Open mentioning

confidence: 99%

Benefits and Limitations of a Multidisciplinary Approach in Cancer Patient Management

Berardi¹,

Morgese²,

Rinaldi³

et al. 2020

CMAR

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“…The place of intensity-modulated radiotherapy (IMRT) has been recently advocated and allows the administration of beams of variable shapes during a single sequence, possibly proving to be helpful to target tumors that are close to critical tissues. 94 However, the proton beam radiotherapy technic assessed in both postoperative or definitive has been described in a 22 patients series radiotherapy after surgical resection of a thymic tumor to significantly reduce doses to the heart, lungs, left ventricle, esophagus, and spinal cord were significantly reduced, as compared to IMRT. 95…”

Section: Radiation Therapy In Tetsmentioning

confidence: 99%

Optimal management of thymic malignancies: current perspectives

Drevet¹,

Collaud²,

Tronc³

et al. 2019

CMAR

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Thymic epithelial tumors (TETs) belong to orphan oncology. The incidence of TETs is about 1.3-3.2 cases per million worldwide. Following pathology, evolution and prognosis are variable. The World Health Organization classification distinguishes thymomas and thymic carcinomas. TETs are composed of thymic epithelial tumoral cells and normal lymphocytes. The mean age at diagnosis is 50-60 years-old. There are no identified risk factors. TETs are frequently associated with paraneoplastic syndromes as myasthenia gravis. The complete R 0 surgical resection is the most significant prognosis factor on survival. In 2010, the French National Institute of Cancer labeled the RYTHMIC network as a specific tumor board including thoracic surgeons, oncologist, and radiation therapist to define standard of care for the management of TETs. The aim of the review was to update knowledge to optimize the standard of care.

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“…Additionally, decision making on chemotherapy or radiation therapy in the treatment of thymic epithelial malignancies is not based on high level evidence as no prospective randomized study has been conducted so far on such patients. As pointed out by Basse et al, published in this issue, it is not possible to reach conclusions as to whether radiation benefits a patient population or not, while studying a patient cohort retrospectively (19).…”

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confidence: 97%

“…The study of such failure helps shed light into mass implementation of any future guideline on the population at large not that limited to specialty large hospitals. Basse et al evaluated whether decisions made at this multidisciplinary tumor board regarding treatment with postoperative radiation therapy were in accordance with ESMO/RYTHMIC guidelines (19). Additionally, the authors determined how ITMIG definitions and recommendations for dose-volume constraints were adhered to in an actual practice setting.…”

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confidence: 99%

Commentary on “Multidisciplinary tumor board decision-making for postoperative radiotherapy in thymic epithelial tumors: insights from the RYTHMIC prospective cohort”

Carter¹,

Marom²

2018

Mediastinum

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Multidisciplinary Tumor Board Decision Making for Postoperative Radiotherapy in Thymic Epithelial Tumors: Insights from the RYTHMIC Prospective Cohort

Abstract: Our data provide a unique insight into the decision-making process for PORT in TETs, highlighting the need for systematic discussion at an expert MTB, while stressing the value of current available guidelines.

Cited by 29 publications

References 16 publications

<p>Benefits and Limitations of a Multidisciplinary Approach in Cancer Patient Management</p>

<p>Benefits and Limitations of a Multidisciplinary Approach in Cancer Patient Management</p>

<p>Optimal management of thymic malignancies: current perspectives</p>

Commentary on “Multidisciplinary tumor board decision-making for postoperative radiotherapy in thymic epithelial tumors: insights from the RYTHMIC prospective cohort”

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