COVID-19疫情下胸部恶性肿瘤患者常见化疗不良反应管理

自2019年12月以来,新型冠状病毒肺炎疫情在我国广泛蔓延,对各行各业产生了重大影响,也给肿瘤患者正常诊疗带来了疫情和自身疾病的双重考验。胸部恶性肿瘤是中国乃至全球常见的肿瘤,大部分患者确诊时已处于中晚期。在疫情期间,部分晚期胸部肿瘤患者在做好防护的前提下继续接受全身化疗,化疗药物可给胸部肿瘤患者带来不同程度的急性或亚急性不良反应,文章结合新型冠状病毒肺炎疫情现况,根据患者化疗后不良反应的表现,为胸部恶性肿瘤患者提供较合适的管理和处置建议。     

新型冠状病毒肺炎疫情下肿瘤患者的心理状态及调整策略

自2019年12月起，我国爆发了一场进展迅猛的新型冠状病毒肺炎疫情。病原体新型冠状病毒（2019 novel coronavirus，2019-nCov），其传播性强、传播范围广、人群普遍易感的疫情现状，对全国人民造成了不小的影响和心理压力。肿瘤患者群体，因其基础心理状态的特殊性，则需承受相比常人更大的心理压力。对其自身肿瘤基础疾病的治疗、感染新型冠状病毒的风险以及疫情防控工作的有序开展等，都影响患者的心理状态。本文旨在分析新型冠状病毒肺炎疫情下肿瘤患者的心理状态，并探讨相应的调整策略。为当前新型冠状病毒肺炎疫情时期肿瘤患者防控工作提供新的思路和方案。     

新型冠状病毒肺炎疫情期间肿瘤患者的健康教育管理

2019年12月，新型冠状病毒肺炎疫情在湖北武汉发生，并迅速向全国蔓延。新型冠状病毒肺炎疫情发生后，打破了很多患者原有的治疗计划，患者健康教育也受到了较大影响。在这样的特殊形势下，应提倡减少外出、避免人群聚集，缩短患者在院停留时间，因此如何做好肿瘤患者的健康教育成为了一个紧迫的问题。针对新型冠状病毒肺炎对肿瘤患者的影响，肿瘤患者健康教育的需求及重要性，疫情期间如何针对肿瘤患者采取更加合理的方式做好健康教育等问题，本文进行了简要的阐述。希望能够引发肿瘤健康教育工作者对新型冠状病毒肺炎疫情下如何实施肿瘤患者健康教育的思考，最大程度上降低疫情带来的不良影响，保证肿瘤患者健康教育的科学性、连贯性。     

肺部结节及肺癌患者新型冠状病毒感染后肺部手术时机的初步建议

近年来，新型冠状病毒感染疫情给全球医疗、政治、经济领域带来了巨大的影响。自新型冠状病毒感染疫情流行开始以来，我们对新型冠状病毒感染影响的了解有了几何数级的增长，近期国内新型冠状病毒感染疫情变化迅速，对于肺部发现肿瘤性病变患者的外科手术如何开展也因近期疫情的变化而出现了争议。一些研究表明，接受肺癌手术的患者感染新型冠状病毒后较普通患者更易发生呼吸衰竭和围术期死亡事件，然而，癌症治疗的推迟也与患者死亡率的上升有关。特别是新型冠状病毒奥密克戎变异株具有更高的传播性，并有可能逃避通过以前的新型冠状病毒感染、疫苗接种获得的免疫力，为了将手术患者发生新型冠状病毒感染的风险降至最低，有必要制定新的治疗指南、专家共识和预防措施，但目前疫情的快速变化导致我们没有充足的时间和证据来制定指南和共识。胸外科医生急需在术前评估发生严重并发症风险较高的特定患者人群的标准，权衡外科治疗的获益与新型冠状病毒感染的风险孰轻孰重。因此，我们尝试结合在新型冠状病毒感染流行情况下不同地区肿瘤学及胸外科学组织对于肺癌手术的指南及共识，给出一些目前国内疫情期间肺部结节及肺癌患者新型冠状病毒感染后肺部手术时机的初步建议，并希望能引...     

新型冠状病毒感染肺炎疫情下肿瘤放疗患者治疗流程及医患防护措施

放疗科积极响应浙江省启动重大突发公共卫生事件一级响应，增强患者对新型冠状病毒肺炎这一突发疾病的认知，确保肿瘤患者放射治疗安全。本文重点阐述疫情期间肿瘤患者放射治疗检查流程，制定医患防护策略，加强消毒隔离措施和医疗废物管理，高度关注肿瘤患者心理支持等方面，为战胜新型冠状病毒肺炎疫情和患者安全治疗提供参考。     

新型冠状病毒感染对肺癌外科治疗的影响

新型冠状病毒感染疫情自2019年末爆发,迄今为止已经对全世界的医疗系统产生了巨大的影响。肺癌患者是此次疫情中受影响最明显的群体之一。手术治疗是肺癌患者重要的治疗手段之一,但在疫情期间外科手术系统受到明显影响,同时疫情期间手术治疗的安全性尚不明确。该文总结新型冠状病毒感染疫情对肺癌患者外科治疗的影响,并汇总外科手术治疗时机、术后并发症及危险因素相关研究结果,为肺癌患者的外科手术治疗决策提供理论支持。     

肺癌患者新型冠状病毒感染防治专家共识

新型冠状病毒感染已成为影响人类健康的重大公共卫生问题。我国现阶段疫情防控主要目标是“保健康,防重症”。接受抗肿瘤治疗的肺癌患者免疫功能低下,一旦感染,引发重症和死亡的风险远高于健康人群,是新型冠状病毒感染的脆弱人群。目前国内指南和共识较少关注肺癌患者新型冠状病毒感染的预防和治疗。本文基于已发表的国内外资料,就肺癌患者的新型冠状病毒疫苗接种、新型冠状病毒中和抗体和小分子抗病毒药物的使用提出建议并形成专家共识,以供临床医生参考。     

新型冠状病毒肺炎疫情期间抗肿瘤药物临床试验的管理

2019年12月以来,新型冠状病毒肺炎的病例数不断扩增,随着疫情的蔓延,抗肿瘤药物临床试验面临着巨大的挑战,肿瘤患者由于疾病本身、手术、放化疗等治疗处于特殊免疫状态下,是新型冠状病毒的易感人群,较正常人群更易罹患感染新型冠状病毒。为此,本文将从新型冠状病毒肺炎疫情下抗肿瘤药物临床试验受试者的特殊性、临床试验的管理、存在的问题及应对措施等方面阐述,期待通过优化流程、合理安排,在确保受试者安全的前提下保证临床试验的顺利进行。     

《新型冠状病毒肺炎疫情期间乳腺癌合理化诊疗指南》解读

新型冠状病毒肺炎在全球的暴发占用大量医疗资源，极大影响乳腺癌的正常诊疗。乳腺癌患者机体免疫力差，是新型冠状病毒肺炎的易感人群，感染后引发重症的风险极高。如何平衡新型冠状病毒肺炎疫情的有效防控和合理化安排肿瘤诊疗行为，是疫情期间亟待解决的主要临床问题。为此国家肿瘤质控中心乳腺癌专家委员会组织相关领域专家，紧急编撰《新型冠状病毒肺炎疫情期间乳腺癌合理化诊疗指南》，希望为疫情期间乳腺癌诊疗提供科学、可行的解决方案。本文将从乳腺癌诊疗各环节，对指南核心内容进行解读。      

肿瘤患者新冠疫苗接种:临床研究进展与初步临床推荐

新型冠状病毒肺炎(coronavirus disease 2019,COVID-19,简称新冠肺炎)疫情对全球公众健康产生了严重影响.广泛接种新型冠状病毒疫苗(简称新冠疫苗)成为终止新冠疫情的最可能有效的手段之一.肿瘤患者在新冠肺炎疫情中感染风险大、严重事件发生率高、死亡率高,应是疫情防治的重点对象.目前肿瘤患者新冠疫...     

The Impact of COVID-19 on the Diagnosis and Treatment of Lung Cancer at a Canadian Academic Center: A Retrospective Chart Review

The large burden of COVID-19 on health care systems worldwide has raised concerns among medical oncologists about the impact of COVID-19 on the diagnosis and treatment of lung cancer patients. In this retrospective cohort study, we investigated the impact of COVID-19 on lung cancer diagnosis and treatment before and during the COVID-19 era. New lung cancer diagnoses decreased by 34.7% during the pandemic with slightly more advanced stages of disease, there was a significant increase in the utilization of radiosurgery as the first definitive treatment, and a decrease in both systemic treatment as well as surgery compared to the pre-COVID-19 era. There was no significant delay in starting chemotherapy and radiation treatment during the pandemic compared to pre-COVID-19 time. However, we observed a delay to lung cancer surgery during the pandemic time. COVID-19 seems to have had a major impact at our lung cancer center on the diagnoses and treatment patterns of lung cancer patients. Many oncologists fear that they will see an increase in newly diagnosed lung cancer patients in the coming year. This study is still ongoing and further data will be collected and analyzed to better understand the total impact of the COVID-19 pandemic on our lung cancer patient population.     

新型冠状病毒肺炎疫情期间结直肠癌患者的个人管理策略

新型冠状病毒肺炎（COVID-19）疫情爆发以来，其传染性强、传播范围广、人群普遍易感的特点使得疫情进展迅猛。结直肠癌在我国发病率及病死率均较高，且患者往往免疫力低下，为COVID-19的易感人群，而当前全国正处于COVID-19防控工作的紧张阶段，给结直肠癌患者的诊疗带来了巨大的挑战。本文就疫情期间结直肠癌患者的日常防护、就医诊疗、营养管理、心理支持及合理随访等展开探讨，为结直肠癌患者的安全管理提供参考。     

Lung Cancer and Severe Acute Respiratory Syndrome Coronavirus 2 Infection: Identifying Important Knowledge Gaps for Investigation

Patients with lung cancer are especially vulnerable to coronavirus disease 2019 (COVID-19) with a greater than sevenfold higher rate of becoming infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) COVID-19, a greater than threefold higher hospitalization rate with high complication rates, and an estimated case fatality rate of more than 30%. The reasons for the increased vulnerability are not known. In addition, beyond the direct impact of the pandemic on morbidity and mortality among patients with lung cancer, COVID-19, with its disruption of patient care, has also resulted in substantial impact on lung cancer screening and treatment/management.COVID-19 vaccines are safe and effective in people with lung cancer. On the basis of the available data, patients with lung cancer should continue their course of cancer treatment and get vaccinated against the SARS-CoV-2 virus. For unknown reasons, some patients with lung cancer mount poor antibody responses to vaccination. Thus, boosting vaccination seems urgently indicated in this subgroup of vulnerable patients with lung cancer. Nevertheless, many unanswered questions regarding vaccination in this population remain, including the magnitude, quality, and duration of antibody response and the role of innate and acquired cellular immunities for clinical protection. Additional important knowledge gaps also remain, including the following: how can we best protect patients with lung cancer from developing COVID-19, including managing care in patient with lung cancer and the home environment of patients with lung cancer; are there clinical/treatment demographics and tumor molecular demographics that affect severity of COVID-19 disease in patients with lung cancer; does anticancer treatment affect antibody production and protection; does SARS-CoV-2 infection affect the development/progression of lung cancer; and are special measures and vaccine strategies needed for patients with lung cancer as viral variants of concern emerge.     

Breast Cancer Management During COVID-19 Pandemic in Madrid: Surgical Strategy

BackgroundFrom the first case of SARS-CoV-2 infection in Wuhan (China), the infection spread all around the world causing a pandemic of coronavirus disease-2019 (COVID-19). Spain has been one of the most severely affected countries, and Madrid has reported a high number of cases and deaths. We discuss our strategies for optimal breast cancer management during COVID-19 pandemic.Patients and MethodsThis was a retrospective observational study at Clínico San Carlos Hospital to analyze the management of patients with breast cancer during the pandemic outbreak and the surgical strategy after the pandemic outbreak. We created a practical and dynamic tool based on a “traffic light” system for prioritizing surgical time. Every patient was contacted by telephone with a preoperative COVID-19 protocol. After surgical procedures, patient satisfaction was assessed using the European Organisation for Research and Treatment of Cancer in-patient satisfaction with cancer care questionnaire (EORTC IN-PATSAT32).ResultsPatients with breast cancer actively treated with surgical procedures were put on a waiting list and received systemic therapy. Telemedicine was used to evaluate any side effects and to avoid unnecessary hospital visits. Surgery was only considered after the pandemic outbreak, and then, only those procedures designed to minimize surgical complications and, therefore, reduce hospital stay. We also measured patients’ satisfaction with medical and nursing scales that resulted in a “very good” evaluation tending to “excellent”.ConclusionIt is necessary to adapt management of oncology treatment and surgical strategy to optimize resources during the COVID-19 pandemic. Patients’ perception of care quality and the degree of patients’ satisfaction with health services has potential relevance in the absence of outcome data.     

The National Lung Cancer Audit: The Impact of COVID-19

Since 2014, the National Lung Cancer Audit (NLCA) has been evaluating the performance of the UK NHS lung cancer services against established standards of care. Prior to the onset of the COVID-19 pandemic, the NLCA's annual reports revealed a steady stream of improvements in early diagnosis, access to surgery, treatment with anti-cancer therapies, input from specialist nursing and survival for patients with lung cancer in the NHS. In January 2022, the NLCA reported on the negative impact COVID-19 has had on all aspects of the lung cancer diagnosis and treatment pathway within the NHS. This article details the fundamental changes made to the NLCA data collection and analysis process during the COVID-19 pandemic and details the negative impact COVID-19 had on NHS lung cancer patient outcomes during 2020.     

Characteristics and patterns of care of endometrial cancer before and during COVID-19 pandemic

ObjectiveCoronavirus disease 2019 (COVID-19) outbreak has correlated with the disruption of screening activities and diagnostic assessments. Endometrial cancer (EC) is one of the most common gynecological malignancies and it is often detected at an early stage, because it frequently produces symptoms. Here, we aim to investigate the impact of COVID-19 outbreak on patterns of presentation and treatment of EC patients.MethodsThis is a retrospective study involving 54 centers in Italy. We evaluated patterns of presentation and treatment of EC patients before (period 1: March 1, 2019 to February 29, 2020) and during (period 2: April 1, 2020 to March 31, 2021) the COVID-19 outbreak.ResultsMedical records of 5,164 EC patients have been retrieved: 2,718 and 2,446 women treated in period 1 and period 2, respectively. Surgery was the mainstay of treatment in both periods (p=0.356). Nodal assessment was omitted in 689 (27.3%) and 484 (21.2%) patients treated in period 1 and 2, respectively (p<0.001). While, the prevalence of patients undergoing sentinel node mapping (with or without backup lymphadenectomy) has increased during the COVID-19 pandemic (46.7% in period 1 vs. 52.8% in period 2; p<0.001). Overall, 1,280 (50.4%) and 1,021 (44.7%) patients had no adjuvant therapy in period 1 and 2, respectively (p<0.001). Adjuvant therapy use has increased during COVID-19 pandemic (p<0.001).ConclusionOur data suggest that the COVID-19 pandemic had a significant impact on the characteristics and patterns of care of EC patients. These findings highlight the need to implement healthcare services during the pandemic.     

Experiences of Shaukat Khanum Memorial Cancer Hospital and Research Centre Biobank during COVID-19 Pandemic

Pakistan has an approximate population of 228.9 million. In 2020, 178,388 new cancer cases were diagnosed in Pakistan. In 2019, we established the biobanking facility at Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan. Shaukat Khanum Memorial Cancer Hospital and Research Centre is a tertiary care charitable, not-for-profit cancer hospital in Pakistan. In 2020-21, 22,745 new cancer patients were registered in the Shaukat Khanum Memorial Cancer Hospital and Research Centre for cancer treatment. The hospital treats around 75% of accepted cancer patients free of charge, regardless of race or nationality. In December 2019, a novel coronavirus SARS-Cov-2 (COVID-19) was identified in China. The World Health Organization acknowledged the COVID-19 outbreak as a pandemic. Pakistan was hit by the first wave of COVID-19 in March 2020. We have highlighted the challenges faced during the COVID-19 pandemic. We emphasized the significance of collaborations between low and middle-income countries’ biobanks and international biobanks to achieve the global perspective of biobanking.     

Management of patients with ovarian cancer in the COVID-19 era

At the beginning of 2020, coronavirus disease 2019 (COVID-19) spreads worldwide. Patients with ovarian cancer should be considered at high-risk of developing severe morbidity related to COVID-19. Most of them are diagnosed in advanced stages of disease, and they are fragile. Here, we evaluated the major impact of COVID-19 on patients with ovarian cancer, discussing the effect of the outbreak on medical and surgical treatment.     

新型冠状病毒病疫情期间乳腺癌患者的术后辅助放疗

乳腺癌是中国女性发病率最高的恶性肿瘤,术后辅助放疗是乳腺癌综合治疗的重要组成部分。新型冠状病毒病疫情给乳腺癌的放疗带来很大的挑战。新型冠状病毒感染的患者中,院内感染占很大比重。新型冠状病毒感染的肿瘤患者比非肿瘤患者的极重症比例高。在新型冠状病毒病疫情期间,为减少患者感染的风险,需要从严掌握放疗指征,必要时可以适当延迟放疗。必须放疗时,建议采用大分割放疗模式。     

Review on the Oncology Practice in the Midst of COVID-19 Crisis: The Challenges and Solutions

As of late 2019, the outbreak of novel coronavirus disease (COVID-19) –that started in China– has rapidly afflicted all over the world. The COVID-19 pandemic has challenged health-care facilities to provide optimal care. In this context, cancer care requires special attention because of its peculiar status by including patients who are commonly immunocompromised and treatments that are often highly toxic. In this review article, we have classified the main impacts of the COVID-19 pandemic on oncology practices –followed by their solutions– into ten categories, including impacts on (1) health care providers, (2) medical equipment, (3) access to medications, (4) treatment approaches, (5) patients’ referral, (6) patients’ accommodation, (7) patients’ psychological health, (8) cancer research, (9) tumor board meetings, and (10) economic income of cancer centers. The effective identification and management of all these challenges will improve the standards of cancer care over the viral pandemic and can be a practical paradigm for possible future crises.