中国大陆部分医院癌症诊疗模式和临床分期使用情况的调查

吴毓; 蒋珏

doi:10.3969/j.issn.1007-3969.2015.01.012

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中国大陆部分医院癌症诊疗模式和临床分期使用情况的调查

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- 中国大陆部分医院癌症诊疗模式和临床分期使用情况的调查
- The survey of cancer treatment model and staging in mainland China
- 中国癌症杂志 2015年25卷第1期页码：67-72
- 作者机构：
  
  1. 复旦大学附属肿瘤医院国际事务部，复旦大学上海医学院肿瘤学系,上海,200032
  2. 中国抗癌协会肿瘤分期工作委员会,上海,200032
- 作者简介：
- 基金信息：
- DOI：10.3969/j.issn.1007-3969.2015.01.012
  中图分类号：
- 网络出版：2015-05-08，
  
  纸质出版：2015-05-08
- 稿件说明：
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吴毓,蒋珏,贾慧等. 中国大陆部分医院癌症诊疗模式和临床分期使用情况的调查[J]. 中国癌症杂志, 2015, 25(1): 67-72.

吴毓, 蒋珏. The survey of cancer treatment model and staging in mainland China[J]. China Oncology, 2015, 25(1): 67-72.
吴毓,蒋珏,贾慧等. 中国大陆部分医院癌症诊疗模式和临床分期使用情况的调查[J]. 中国癌症杂志, 2015, 25(1): 67-72. DOI： 10.3969/j.issn.1007-3969.2015.01.012.

吴毓, 蒋珏. The survey of cancer treatment model and staging in mainland China[J]. China Oncology, 2015, 25(1): 67-72. DOI： 10.3969/j.issn.1007-3969.2015.01.012.

摘要

背景与目的：目前，肿瘤的多学科综合治疗模式是国际公认的肿瘤最佳治疗模式。肿瘤分期是肿瘤诊断、治疗和预测预后的基础。本研究调查肿瘤多学科综合诊疗模式和国际抗癌联盟或其它国际肿瘤分期系统在我国的应用和推广情况，收集医师在实际使用过程中总结的经验，提出建议，并提供给有关医院行政管理机构和国内外肿瘤分期的学术机构参考，使肿瘤治疗和分期更合理，更符合临床实际情况，更适合国际上的需要。方法：2012—2013年抽样调查33家省、市级肿瘤专科医院和省、市级综合医院，发放调查问卷，并实地考察6家二级综合性医院和1家民营肿瘤专科医院。对目前中国10个主要癌症病种(肝癌、食管癌、鼻咽癌、肺癌、乳腺癌、胃癌、结直肠癌、妇科肿瘤、前列腺癌和淋巴瘤)的治疗情况进行了调查，并对数据进行描述性分析。结果：中国大陆的肿瘤专科及非专科医院都承担着为肿瘤患者提供治疗的责任。我国目前承担肿瘤治疗的医院未普遍采用多学科综合诊疗模式，国际抗癌联盟或美国癌症联合委员会的癌症分期系统已被广泛使用。对于鼻咽癌、肝癌，大部分医院使用国内的分期系统。结论：大量肿瘤患者在非肿瘤专科医院接受诊治，需提高这些医院肿瘤治疗的水平；多学科综合诊疗模式在二级综合性医院治疗肿瘤的过程中还没有很好的建立；肿瘤的TNM分期在三级甲等医院的诊疗中实施较好，但在二级综合性医院中基本没有执行；国际抗癌联盟或美国癌症联合委员会的癌症分期系统已被三级甲等医院中广泛采用；我国肿瘤界应该有责任和义务多向国际肿瘤组织提供我国常见肿瘤的分期经验，使国际肿瘤分期更科学、更符合临床实际。

Abstract

Background and purpose: Cancer is a common disease. Multidisciplinary approach is the best model for cancer treatment. Cancer staging is the basis for diagnosis

treatments and prediction of prognosis.The survey is to give an overview of the current application of cancer multidisciplinary approach and UICC or other international cancer staging in mainland China. We made inquiries to our Chinese oncologists’ experience of using these staging and share their comments and recommendations. For those cancers common in China

Chinese oncologists and academic societies should provide more information of staging

therapies

outcome

prognostic predictors of prognosis

etc. to make international stage systems

like UICC or AJCC

a more appropriate

accurate and acceptable guide to individual patients’ staging and treatment

to predict outcome and to facilitate clinical trials better. Methods: This survey was done from 2012 to 2013 by questionnaires. The questions were answered for 10 major cancers in China (liver cancer

esophageal cancer

nasopharyngeal carcinoma

lung carcinoma

breast cancer

gastric cancer

colorectal cancer

gynecologic cancer

prostate cancer and lymphoma). Thirty-three questionnaires have been answered by national wide hospitals including provincial cancer hospitals

district cancer hospitals and departments of oncology in general hospitals. We also site visited 7 grade B hospitals. Results: Multidisciplinary approach is not widely used in the hospitals. UICC or AJCC stages have been widely used for 10 cancers

but for cancers that were uncommon in the West; while common in China (nasopharyngeal carcinoma

liver cancer) the staging proposed by Chinese society have also been used to replace UICC/AJCC. Conclusion: We suggest a wild implementation of multidisciplinary approach. For those cancers common in China Chinese oncologists and academic societies should provide more information of staging

therapies

outcome

prognostic predictors of prognosis etc. to make international stage systems

like UICC or AJCC

a more appropriate

accurate and acceptable guide to individual patients’ staging and treatments

to predict outcome and to facilitate clinical trials better.

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