The Benefit of a Multidisciplinary Approach to the Patient Treated with (Chemo) Radiation for Head and Neck Cancer
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In the past two decades, multidisciplinary care has emerged as new way to manage cancer given the need to gather together specific areas of expertise and to discuss the variety of treatment approaches available for each patient. Of all the cancer subtypes, head and neck cancer might be considered one of the most valid areas, from an oncological point of view, for a multidisciplinary approach to be applied. Head and Neck Cancer is a complex disease area due to its varied histology and subsites, its numerous feasible treatments, its multiple typical comorbidities, and its treatment-induced toxicities whose management requires the simultaneous involvement of several professionals as part of the same health care team. However, the benefits of a multidisciplinary team approach in this particular area have not yet been properly documented in terms of survival outcomes. Moreover, there are some concerns and the limitations of a multidisciplinary team approach for Head and Neck Cancer patients are still open to question: cost-efficiency, the implications from a medical law perspective, the level of expertise required and the timing of each intervention (fixed or as required; before, during or after oncological treatment), and the role of the leader with other interested specialists to optimize all multidisciplinary care mechanisms.
KeywordsMultidisciplinary team Head and neck cancer Integrated therapeutic approaches
We gratefully thank Mr. Chris Botterill for his precious work in the linguistic review.
Compliance with Ethical Standards
Conflict of Interest
Paolo Bossi has received compensation from Roche, AstraZeneca, and Merck for service on advisory boards.
Salvatore Alfieri declares that he has no conflict of interest.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
References and Recommended Reading
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- 1••.Pillay B, Wootten AC, Crowe H, Corcoran N, Tran B, Bowden P, Crowe J, Costello AJ. The impact of multidisciplinary team meetings on patient assessment, management and outcomes in oncology settings: a systematic review of the literature. Cancer Treat Rev. 2016;42:56–72. A comprehensive systematic review about the role of multidisciplinary team throughout all the patient’s journey in oncologyCrossRefPubMedGoogle Scholar
- 7.Liao CT, Chen SJ, Lee LY, Hsueh C, Yang LY, Lin CY, Fan KH, Wang HM, Ng SH, Lin CH, Tsao CK, Chen IH, Chang KP, Huang SF, Kang CJ, Chen HC, Yen TC. An ultra-deep targeted sequencing gene panel improves the prognostic stratification of patients with advanced oral cavity squamous cell carcinoma. Medicine (Baltimore). 2016;95(8):e2751.CrossRefPubMedCentralGoogle Scholar
- 8.Bergamini C, Locati L, Bossi P, Granata R, Alfieri S, Resteghini C, Imbimbo M, Fallai C, Orlandi E, Tana S, Iacovelli NA, Guzzo M, Ibba T, Colombo S, Bianchi R, Pizzi N, Fontanella W, Licitra L. Does a multidisciplinary team approach in a tertiary referral centre impact on the initial management of head and neck cancer? Oral Oncol. 2016;54:54–7.CrossRefPubMedGoogle Scholar
- 10•.Patil RD, Meinzen-Derr JK, Hendricks BL, Patil YJ. Improving access and timeliness of care for veterans with head and neck squamous cell carcinoma: a multidisciplinary team's approach. Laryngoscope. 2016;126:627–31. This paper analyzes the impact of a multidisciplinary team approach on a timely access to head and neck cancer diagnosis and treatment startCrossRefPubMedGoogle Scholar
- 12•.Murphy CT, Galloway TJ, Handorf EA, Egleston BL, Wang LS, Mehra R, Flieder DB, Ridge JA. Survival impact of increasing time to treatment initiation for patients with head and neck cancer in the United States. J Clin Oncol. 2016;34:169–78. Excellent proof of the impact of time to treatment start on head and neck cancer patients’ prognosisCrossRefPubMedGoogle Scholar
- 13.Lamb BW, Sevdalis N, Taylor C, Vincent C, Green JS. Multidisciplinary team working across different tumour types: analysis of a national survey. Ann Oncol. 2013;1293–1300.Google Scholar
- 14.National Institute for Clinical Excellence. Guidance on cancer services improving outcomes in head and neck cancers. The manual. London 2004.Google Scholar
- 19.Shah BA, Qureshi MM, Jalisi S, Grillone G, Salama A, Cooley T, Zaner K, Sakai O, Truong MT. Analysis of decision making at a multidisciplinary head and neck tumor board incorporating evidence-based National Cancer Comprehensive Network (NCCN) guidelines. Pract Radiat Oncol. 2015.Google Scholar
- 26•.Wissinger E, Griebsch I, Lungershausen J, Foster T, Pashos CL. The economic burden of head and neck cancer: a systematic literature review. Pharmacol Econ. 2014;32:865–82. An interesting paper discussing the existing evidence on resource use and costs associated with the diagnosis and treatment of head and neck cancerCrossRefGoogle Scholar
- 27••.Ke KM, Blazeby JM, Strong S, Carroll FE, Ness AR, Hollingworth W. Are multidisciplinary teams in secondary care cost-effective? A systematic review of the literature. Cost Eff Resour Alloc. 2013;11:7. Review on the cost-effectiveness of a multidisciplinary approach in medicine according to the Consensus on Health and Economic CriteriaCrossRefPubMedPubMedCentralGoogle Scholar
- 34•.Beswick DM, Vashi A, Song Y, Pham R, Holsinger FC, Rayl JD, Walker B, Chardos J, Yuan A, Benadam-Lenrow E, Davis D, Sung CK, Divi V, Sirjani DB. Consultation via telemedicine and access to operative care for patients with head and neck cancer in a veterans health administration population. Head Neck. 2016;38:925–9. The impact of telemedicine applied to head and neck cancer patients’ managementCrossRefPubMedGoogle Scholar