Is an Interventional Oncology Center an advantage in the service of cancer patients or in the education? The Gemelli Hospital and INTERACTS experience

Modern oncology needs to offer personalized treatments. The process of choosing the best possible treatment should be based on efficacy, feasibility, and cost benefit, but also considering the patient’s age, clinical condition, presentation of disease, and the patient’s individual needs (travel, work, family, etc.). Interdisciplinarity is playing a major role in the diagnostic workout and in the treatment decision, as well as in the performance and effectiveness of the procedures. Minimal invasive procedures are preferred, but the performance needs highly specialized teams.
Treatment decisions usually depend on ‘through which door the patient enters’, i.e. which specialist has the first contact with the patient. Frequently, anatomic siterelated multidisciplinary tumor boards (MDT) are in lack of experts of all kind of interventional procedures. Therefore, the idea was born to create a platform directly linked to the anatomic site-related MDT´s. Interventional expert knowledge was collected under the name of ‘interventional oncology’, in order to connect highly specialized technology, anatomic site related MDT knowledge, as well education (INTERACTS) and research (COBRA) in the field. Four main interventional fields were identified:
1) interventional radiology: treatment/procedure perform­ed under image guidance without the use of radio­isotopes like MWA (microwave ablation), RFA (radio­frequency ablation), TAE (transcatheter arterial embolization), biopsy, positioning of fiducials, and/or catheters and stents;
2) interventional radiotherapy: treatment/procedure using radioisotopes like brachytherapy or TARE (trans­arterial radioembolization);
3) interventional chemotherapy: treatment/procedure using focused chemotherapy like TACE (transarterial chemoembolization), electrochemotherapy;
4) interventional endoscopy: treatment/procedure using an endoscopic approach like PEG (percutaneous gastro­stomy), biopsy, positioning of fiducials, and/or catheters and stents.
Many procedures could be equally introduced among the above interventional fields, and only a detailed multidisciplinary case evaluation and discussion could be offered to the patient as the best therapeutic method. This complex procedure needs eligible physicians working together and in close cooperation with other institutional MDT’s; an Interventional Oncology Center (IOC) can offer a possible solution. By definition, the IOC is an ‘interdisciplinary service...


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