Perelman School of Medicine, the University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Department of Otorhinolaryngology: Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Head Neck. 2020 Jun;42(6):1131-1136. doi: 10.1002/hed.26165. Epub 2020 Apr 22.
There is an added level of complexity in the management of head and neck cancer patients with underlying immunosuppressive disorders during the COVID-19 pandemic. Head and neck oncologists are tasked with balancing the dual risks of cancer progression in the setting of impaired tumor immunity and increased susceptibility to life-threatening complications from exposure to viral infection for patients and providers. Through two cases of immunocompromised patients with newly diagnosed head and neck malignancies, we aim to provide guidance to clinicians struggling with how to best counsel and manage this unique subset of patients under these difficult circumstances.
After careful consideration of the options, we took different approaches in the care of these two patients.
Ultimately, there is no uniform set of rules to apply to this heterogeneous group of immunocompromised patients. We provide some general principles to help guide patient management during the current pandemic.
在 COVID-19 大流行期间,管理患有潜在免疫抑制性疾病的头颈部癌症患者增加了一层复杂性。头颈部肿瘤学家的任务是平衡肿瘤免疫受损情况下癌症进展的双重风险,以及患者和医务人员因暴露于病毒感染而导致危及生命的并发症的易感性增加。通过两例新诊断为头颈部恶性肿瘤的免疫功能低下患者,我们旨在为在这些困难情况下努力为如何最好地为这一独特亚组患者提供咨询和管理的临床医生提供指导。
经过仔细考虑各种选择,我们对这两名患者采取了不同的治疗方法。
最终,没有一套统一的规则适用于这组异质性免疫功能低下的患者。我们提供了一些一般原则,以帮助指导当前大流行期间的患者管理。