■确定定义更差疾病预后或“高肿瘤负荷”(HTB)状态的患者特征对于转移性非小细胞肺癌(mNSCLC)的临床决策和治疗选择至关重要。我们旨在根据肿瘤学家在临床实践中的经验来定义这一概念。
■选择了西班牙专家的代表性样本,并要求他们根据个人经验完成有关HTB定义的在线调查。
■HTB被肿瘤学家(N=81)确定为影响一线治疗决策的主要因素之一。根据专家的说法,HTB主要由转移灶的数量定义(n=45,56%),位置(n=34,42%),肿瘤大小(靶病变直径之和;n=26,32%)和肝脏受累(n=24,30)。高乳酸脱氢酶(LDH)水平也与HTB相关。几乎一半的受访者(n=33,41%)认为一个转移灶足以认为患者存在HTB,72%(n=58)认为两个是必需的,99%(n=80)三个。肝脏(n=76,100%),其次是大脑(n=65,86%)是与HTB相关的主要转移部位。肿瘤大小从6厘米到10厘米以及高LDH水平(上限的三倍)定义了82%(n=62)和100%(n=76)的肿瘤学家的概念。分别。
■在现实世界中,据专家介绍,HTB由转移性病变的数量定义,转移的位置,肿瘤大小和高LDH水平。鉴于这个概念的相关性,应努力统一其定义,并进一步探索其作为mNSCLC患者预后因素的潜力。
UNASSIGNED: Identifying patient characteristics that define a worse disease prognosis or \"high tumor burden\" (HTB) status is essential for clinical decision-making and treatment selection in metastatic non-small cell lung cancer (mNSCLC). We aimed to define this concept based on the experience of oncologists in clinical practice.
UNASSIGNED: A representative sample of Spanish experts was selected and asked to complete an online survey regarding the definition of HTB according to their personal experience.
UNASSIGNED: HTB was identified by the oncologists (N = 81) as one of the principle factors influencing first-line treatment decision-making. According to the experts, HTB is mainly defined by the number of metastatic lesions (n = 45, 56%), location (n = 34, 42%), tumor size (sum of diameters of target lesions; n = 26, 32%) and liver involvement (n = 24, 30). High lactate dehydrogenase (LDH) levels were also associated with HTB. Almost half of respondents (n = 33, 41%) believed that one metastatic lesion was sufficient to consider a patient as presenting HTB, 72% (n = 58) considered that two were necessary and 99% (n = 80) three. Liver (n = 76, 100%) followed by brain (n = 65, 86%) were the main metastatic sites associated with HTB. Tumor size ranging from 6 cm to 10 cm as well as high LDH levels (three times the upper limit) defined the concept for 82% (n = 62) and 100% (n = 76) of oncologists, respectively.
UNASSIGNED: In the real-world setting, according to experts, HTB is defined by the number of metastatic lesions, location of metastases, tumor size and by high LDH levels. Given the relevance of this concept, efforts should be made to unify its definition and to further explore its potential as a prognostic factor for mNSCLC patients.