METRO MINNESOTA COMMUNITY CLINICAL ONCOLOGY PROGRAM

Metro-Minnesota社区临床肿瘤项目（MMCCOP）代表了一个由九家医院组成的联盟，通过其nci资助的社区医院肿瘤项目（CHOP）和CCOP手术，开发了一种管理癌症患者的通用方法，并建立了识别、进入和跟踪患者治疗和癌症预防和控制方案的机制。该联盟拥有一个社区范围的计算机数据管理系统，能够进行前瞻性数据收集。社区提供PPOs、hmo和商业医疗保健项目，所有这些都在这9家联盟医院中有代表。这九家医院每年平均收治8900名新的分析性癌症患者。88名核心研究人员，分别代表肿瘤学、血液学、放射学、肿瘤学、泌尿学、妇科肿瘤学、神经病学、耳鼻喉科、家庭外科、普通外科和专科外科医生，在癌症项目开发和方案管理方面进行了广泛的合作。MMCCOP的工作人员在肿瘤学和数据管理方面经过合格的培训，并参与了当前项目结构和运营的开发。在最近的nci资助年度（6/98-5/99），MMCCOP将344名新患者/参与者（209.9治疗积分/185.1癌症控制积分）纳入nci批准的研究。MMCCOP打算维持一个区域范围的社区和医院联合体，向社区提供癌症预防、控制和治疗方面的最新进展。这将通过将CCOP扩大到已建立的外联社区来实现；与医院、基金会、保险公司和综合服务网络（ISNs）合作，为参与临床试验提供资金和报销支持；增加初级保健医生的参与；通过与NCI、ECOG、M.D. Anderson、NSABP、RTOG、URCC的合作以及与NCCTG的试点项目，提供专业知识、资源和庞大的人口基础，以开发、实施和评估临床癌症治疗和控制试验；改进和扩展现有的MMCCOP数据管理和通信系统，以增加研究人员参与权责计、项目操作和研究基地活动的数量和肝脏；实施新战略，改善少数群体和服务不足群体的机会和参与；并提高专业人士和非专业人士对CCOP和临床癌症试验益处的认识。基于过去的经验，两项大型预防试验的可用性，增加了一家新医院和第六个研究基地，以及改进的癌症控制实施模型，MMCCOP研究人员打算在第一年累计532名（4370学分）患者/参与者参加NCI批准的癌症治疗和对照研究，目标是不断超过NCI对这两类研究的要求。在最后一份MMCCOP申请中提出的350名患者的预期累积被当时的评审认为是“过于乐观”，但在资助的第一年（1995-96）就超过了33名患者。该赠款第一年的目标仍然是乐观的，但考虑到该小组的专业知识、可用的协议、已建立的系统以及医生和医院的大力支持，这一目标是现实的。

The Metro-Minnesota Community Clinical Oncology Program (MMCCOP) represents a consortium of nine hospitals which, through its NCI-funded Community Hospital Oncology Program ("CHOP") and operation CCOP, has developed a common approach to the management of cancer patients and has an established mechanism for identifying, entering and following patients on treatment and cancer prevention and control protocols. The consortium has a community wide-computerized data management system capable of prospective data collection. The community offers PPOs, HMOs and commercial healthcare programs, all of which are represented among these nine consortium hospitals. Together, the nine hospitals see an average of 8900 new analytic cancer patients per year. The 88 core investigators, representing oncology, hematology, radiation, oncology, urology, gynecologic oncology, neurology, ENT, Family Practice, general and specialty surgeons, have worked extensively together on cancer program development and protocol management. The MMCCOP staff is qualified and trained in oncology and data management, and has been involved in the development of the current program structure and operation. During the most recent NCI-funded grant year (6/98-5/99), the MMCCOP entered 344 new patients/participants (209.9 treatment credits/185.1 cancer control credits) into NCI-approved studies. The MMCCOP intends to sustain a region wide community and hospital consortium, which provides the community with the most recent advances in cancer prevention, control and treatment. This will be accomplished through expansion of the CCOP into established outreach communities; work with hospitals, foundations, insurers and Integrated Service Networks (ISNs) to develop funding and reimbursement support for participation in clinical trials; increased involvement of primary care physicians; providing the expertise, resources, and large population base to develop, implement and evaluate clinical cancer treatment and control trials through affiliation with the NCI, ECOG, M.D. Anderson, NSABP, RTOG, URCC and pilot project with the NCCTG; improve and expand the current MMCCOP data management and communication system to increase the number and liver of participation of the investigators in accrual, program operations and research base activities; implement new strategies to improve access and participation of minority and underserved groups; and increase the professional and lay community awareness of the CCOP and benefits of clinical cancer trials. Based upon past experience, the availability of two large prevention trials, addition of a new hospital and a sixth research base, and improved cancer control implementation models, MMCCOP investigators intend to accrue 532 (4370 credits) patients/participants onto NCI-approved cancer treatment and control studies during the first year, with the goal of continually exceeding the NCI requirements for both types of studies. The projected accrual of 350 patients stated in the last MMCCOP application was viewed by reviews at that time as "overly optimistic", but was exceeded by 33 patients in the first year of funding (1995-96). The goal for the first year of this grant is again optimistic, but realistic given the expertise of the group, available protocols, the established systems and strong support of the physicians and hospitals.