Yerramilli Divya, Xu Amy J, Gillespie Erin F, Shepherd Annemarie F, Beal Kathryn, Gomez Daniel, Yamada Josh, Tsai C Jillian, Yang T Jonathan
PROMISE (Precision Radiation for Oligometastatic and Metastatic Disease) Program, Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York.
Adv Radiat Oncol. 2020 Apr 8;5(4):589-594. doi: 10.1016/j.adro.2020.04.001. eCollection 2020 Jul-Aug.
Palliation of metastatic disease compromises a significant portion of radiation treatments in the United States. These patients present a unique challenge in resource-limited settings, as expeditious treatment is often required to prevent serious morbidity. In order to reduce the risk of infection with severe acute respiratory syndrome coronavirus-2 and maximize the benefit to patients, we present evidence-based recommendations for radiation in patients with oncologic emergencies. Radiation oncologists with expertise in the treatment of metastatic disease at a high-volume comprehensive cancer center reviewed the available evidence and recommended best practices for the treatment of common oncologic emergencies, with attention to balancing the risk of infection with severe acute respiratory syndrome coronavirus-2 and the potential morbidity of delaying treatment. Many prospective trials and national guidelines support the use of abbreviated courses of radiotherapy for patients with oncologic emergencies. As such, in the setting of the current coronavirus disease 2019 pandemic, the use of hypofractionated radiation therapy for patients requiring palliation for oncologic emergencies achieves desirable functional outcomes without compromising care.
在美国，转移性疾病的姑息治疗占放射治疗的很大一部分。这些患者在资源有限的环境中面临着独特的挑战，因为通常需要迅速治疗以防止严重发病。为了降低感染严重急性呼吸综合征冠状病毒2的风险并使患者受益最大化，我们针对肿瘤急症患者的放射治疗提出基于证据的建议。一家大型综合癌症中心中在转移性疾病治疗方面具有专业知识的放射肿瘤学家审查了现有证据，并推荐了治疗常见肿瘤急症的最佳实践，同时关注平衡感染严重急性呼吸综合征冠状病毒2的风险与延迟治疗的潜在发病率。许多前瞻性试验和国家指南支持对肿瘤急症患者使用缩短疗程的放射治疗。因此，在当前2019冠状病毒病大流行的背景下，对需要姑息治疗的肿瘤急症患者使用大分割放射治疗可实现理想的功能结果，而不会影响治疗。
