METRO MINNESOTA COMMUNITY CLINICAL ONCOLOGY PROGRAM

大都会-明尼苏达社区临床肿瘤学计划(MMCCOP)代表了一个由九家医院组成的联盟，这些医院通过其NCI资助的社区医院肿瘤学计划(CHOP)和CCOP行动，开发了一种共同的癌症患者管理方法，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化数据管理系统，能够进行前瞻性的数据收集。该社区提供PPO、HMO和商业医疗计划，所有这些都代表了这九家联盟医院。这九家医院加在一起，平均每年新增8900名癌症分析患者。88名核心研究人员代表肿瘤学、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、家庭医学、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具有资质和培训，并参与了当前方案结构和操作的开发。在最近的国家癌症研究所资助的拨款年度(1999年6月至1999年5月)，MMCCOP将344名新患者/参与者(209.9个治疗学分/185.1个癌症控制学分)纳入了国家医学会批准的研究。MMCCOP打算维持一个区域范围的社区和医院联盟，向社区提供癌症预防、控制和治疗方面的最新进展。这将通过以下方式实现：将癌症治疗方案扩展到现有的外联社区；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和NCCTG的试点项目建立联系，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；改进和扩大目前的MMCCOP数据管理和通信系统，以增加研究人员参与累积、方案业务和研究基地活动的次数和人数；实施新的战略，改善少数群体和未得到充分服务的群体的机会和参与；提高专业和非专业社区对CCOP和癌症临床试验好处的认识。根据过去的经验、两个大型预防试验的可获得性、新医院和第六个研究基地的增加以及癌症控制实施模式的改进，MMCCOP调查人员打算在第一年内让532名患者/参与者参加NCI批准的癌症治疗和控制研究，目标是继续超过NCI对这两种类型研究的要求。上一次MMCCOP申请中所述的350名患者的预期收益在当时的审查中被认为“过于乐观”，但在资助的第一年(1995-96)，有33名患者超过了这一数字。这笔赠款的第一年的目标再次乐观，但考虑到该小组的专业知识、可用的方案、既定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.