Treatment success

from Wikipedia, the free encyclopedia

In medicine is a treatment success or treatment outcome ( English treatment outcome ), the result of an exactly specified in the rule procedure or series of procedures.

The treatment result is determined after the intervention at a point in time (usually precisely specified) based on a criterion or a set of several criteria. The consideration of the treatment result helps to determine the effectiveness and suitability of medical interventions and to evaluate them in relation to alternatives, in particular to non-intervention.

In medical research , “outcome analyzes” often focus on changes in quality of life ; The respective preventive or therapeutic measures should thus be evaluated more meaningfully for future patients than is possible with the so-called surrogate markers , parameters or endpoints (these are measurable but not directly relevant variables for the person affected, such as measurement and Laboratory values, tumor diameter, etc.).

oncology

The end result of cancer treatment is particularly often referred to in German medical literature as outcome . Instead of the surrogate parameters or an intuitive description of the case ("cured" / "not cured" or similar), a description of the overall situation that is as precisely defined as possible should be used. This is especially necessary for studies and for cancer registries .

The common abbreviations and their definitions originally come from the US American Centralized Cancer Patient Data System (CCPDS, 1977) and the International Cancer Patient Data Exchange System (ICPDES, 1977). In Germany there has been the basic documentation for tumor patients developed at the University of Giessen since 1979 (last updated in 1999). Modern catalogs of criteria define tumor-specific, very detailed criteria, especially for healing ( remission ).

The abbreviations R0-2 are used after operations , CR / PR / NC / PD after radiation or chemotherapy .

  • R0 = postoperatively ( resected ) the patient is completely tumor-free. Under the microscope, the edge of the resected material must be free of cancer cells. Synonym is free of tumor , FT.
  • R0b = tumor marker increased postoperatively
  • R1 = microscopically the edge of the resected tissue is not free of cancerous tissue.
  • R2 = Macroscopic parts of the tumor (visible to the naked eye) could not be removed.
  • CR = complete remission ; Tumor completely destroyed by radiation or chemotherapy (usually evidence by imaging is sufficient ), symptoms regressed, tumor markers normalized. The remission must last at least a month.
  • VGPR = Very good partial remission . Minimal tumor signs (e.g. an elevated tumor marker, or circulating tumor cells in the patient's blood) are still detectable. Synonym for minimal signs of disease .
  • PR = partial remission occurs when at least 50% of the tumor mass has regressed. Occasionally, a regression of the tumor diameter to 50% is also used in study protocols. The particularly precise RECIST criteria demand a 30% reduction in the sum of the largest diameters of all target lesions (up to five metastases per organ).
  • MR = minimal remission, minimal response : at least 25, but less than 50% of the tumor mass has regressed.
  • NC = no change or change in tumor mass by less than 25%.
  • PD = Progression ( progressive disease ): tumor mass has increased by more than 25% or new cancer foci have appeared. RECIST criteria: The sum of the largest diameters of all target lesions has increased by at least 20%. PPD ( primarily progressive disease ) can be used to distinguish progression from previous remission.
  • Local control means remission or at least unchanged size of the main tumor, regardless of a possible metastasis . A therapy can definitely be assessed as successful in palliative care if it achieves local control without stopping the metastasis, for example in the case of painful tumors in the neck region.

See also

Web links

Individual evidence

  1. ↑ Harald Schmalenberg, Rainer Hartmann, Walter Baumann: Quality management and certification in oncology . Springer DE, January 1, 2010, ISBN 978-3-642-12840-0 , p. 22 (accessed on May 15, 2013).
  2. ↑ Georg Rüter: Health Economics and Economic Policy: Festschrift for the 70th birthday of Prof. Dr. Dr. H. c. Peter Oberender . Lucius & Lucius DE, 2011, ISBN 978-3-8282-0543-7 , p. 626 (accessed on May 15, 2013).
  3. ↑ Handbook for Standardized Cancer Registries (1976, ISBN 9241700254 )