Role of a multidisciplinary team in administering radiotherapy for esophageal cancer
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RESEARCH ARTICLE
Open Access
Role of a multidisciplinary team in administering radiotherapy for esophageal cancer Shengguang Zhao, Weixiang Qi* and Jiayi Chen*
Abstract Background: Radiotherapy (RT) is the major part of the treatment strategy set by a multidisciplinary team (MDT) for patients diagnosed with esophageal cancer (EC). The effect of an MDT collaboration on patients with EC who underwent RT is unclear. Methods: We retrospectively collected all patients diagnosed with EC in the radiation oncology department at our institution from January 2015 to May 2017. The patients were divided into groups based on if they had their cases presented or not presented at the MDT meeting (with MDT and non-MDT, respectively). Propensity score matching (PSM) was applied at a ratio of 1:1 and the nearest neighbor matching method to compare the two groups. Results: A total of 212 consecutive patients were analyzed, including 157 with MDT and 55 non-MDT. In the unmatched population, the patients with MDT were more likely to received chemotherapy than the non-MDT patients (84.7% vs. 69.1%; × 2 = 6.373; P = 0.012).MDT-patients had significantly improved overall survival compared with non-MDT patients (p = 0.025). In the multivariate analysis, MDT was an independent prognostic factor for OS in patients with EC who underwent RT (P = 0.019, HR 0.59, 95% CI 0.38–0.92). After PSM for baseline characteristics, the benefit of MDT for OS became more obvious. Additionally, we also found that MDT was an independent predictor of receiving chemotherapy by using logistic regression analysis. Conclusion: In patients who underwent radiotherapy for esophageal cancer, MDT was an independent factor for overall survival, which probably due to the selection of multimodality treatment when compared to non-MDT setting. Keywords: Esophageal neoplasms, Multidisciplinary team, Radiotherapy, Chemotherapy, Survival
Background EC is still one of the most lethal malignancies worldwide with a 5-year survival rate ranging from 15 to 25% [1]. Although the treatment of EC remains a challenge, the guidelines encourage the application of combined modality therapy for EC patients to achieve optimal treatment [2]. The MDT may include thoracic surgeons
without limitations, medical oncologists, radiation oncologists, gastroenterologists, radiologists, and pathologists. Disease management by an MDT improved the staging accuracy, treatment selection and outcomes after surgery for EC patients [3, 4]. However, for EC patients who underwent RT, the role of an MDT remains unclear.
* Correspondence: [email protected]; [email protected]; [email protected] Department of Radiation Oncology, Ruijin Hospital, Shanghai Jiao tong University School of Medicine 197 Second Ruijin Road, Shanghai 200025, China
Methods Study population
The multidisciplinary team (MDT) for esophageal cancer at Ruijin Hospital was established in 2013 with the aim
© The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International Lice
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