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COVID-19大流行期间的神经肿瘤管理,重点关注世界卫生组织III级和IV级胶质瘤

Neuro-oncology Management During the COVID-19 Pandemic With a Focus on WHO Grade III and IV Gliomas.

作者信息

Bernhardt Denise, Wick Wolfgang, Weiss Stephanie E, Sahgal Arjun, Lo Simon S, Suh John H, Chang Eric L, Foote Matthew, Perry James, Meyer Bernhard, Vajkoczy Peter, Wen Patrick Y, Straube Christoph, Pigorsch Steffi, Wilkens Jan J, Combs Stephanie E

机构信息

Technical University of Munich (TUM), School of Medicine and Klinikum rechts der Isar, Department of Radiation Oncology, Munich.

Institute of Radiation Medicine (IRM), Department of Radiation Sciences (DRS), Neuherberg.

出版信息

Neuro Oncol. 2020 May 5;22(7):928-35. doi: 10.1093/neuonc/noaa113.

Abstract

BACKGROUND

Because of the increased risk in cancer patients of developing complications caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), physicians have to balance the competing risks of the negative impact of the pandemic and the primary tumor. In this consensus statement, an international group of experts present mitigation strategies and treatment guidance for patients suffering from high grade gliomas (HGG) during the coronavirus disease 2019 (COVID-19) pandemic.

METHOD / RESULTS: 16 international experts in the treatment of HGG contributed to this consensus-based practice recommendation including neuro-oncologists, neurosurgeons, radiation -oncologists and a medical physicist. Generally, treatment of neuro-oncological patients cannot be significantly delayed and initiating therapy should not be outweighed by COVID-19. We present detailed interdisciplinary treatment strategies for molecular subgroups in two pandemic scenarios, a scale-up phase and a crisis phase.

CONCLUSION

This practice recommendation presents a pragmatic framework and consensus-based mitigation strategies for the treatment of HGG patients during the SARS-CoV-2 pandemic.

摘要

背景

由于癌症患者感染严重急性呼吸综合征冠状病毒2(SARS-CoV-2)而引发并发症的风险增加,医生必须在大流行的负面影响和原发性肿瘤的相互竞争风险之间取得平衡。在本共识声明中,一个国际专家小组针对2019冠状病毒病(COVID-19)大流行期间患有高级别胶质瘤(HGG)的患者提出了缓解策略和治疗指南。

方法/结果:16位HGG治疗领域的国际专家参与了这项基于共识的实践建议,其中包括神经肿瘤学家、神经外科医生、放射肿瘤学家和一名医学物理学家。一般来说,神经肿瘤患者的治疗不能显著延迟,启动治疗不应因COVID-19而受到影响。我们针对两种大流行情况(扩大阶段和危机阶段)的分子亚组提出了详细的跨学科治疗策略。

结论

本实践建议为SARS-CoV-2大流行期间HGG患者的治疗提供了一个务实的框架和基于共识的缓解策略。

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