Department of Pulmonology, Erasmus University Medical Center, Rotterdam, The Netherlands; GROW, School for Oncology and Developmental Biology, University Maastricht, Maastricht, The Netherlands.
Department of Hematology-Oncology, National University Cancer Institute, Singapore.
J Thorac Oncol. 2020 Jul;15(7):1119-1136. doi: 10.1016/j.jtho.2020.05.001. Epub 2020 May 15.
The global coronavirus disease 2019 pandemic continues to escalate at a rapid pace inundating medical facilities and creating substantial challenges globally. The risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in patients with cancer seems to be higher, especially as they are more likely to present with an immunocompromised condition, either from cancer itself or from the treatments they receive. A major consideration in the delivery of cancer care during the pandemic is to balance the risk of patient exposure and infection with the need to provide effective cancer treatment. Many aspects of the SARS-CoV-2 infection currently remain poorly characterized and even less is known about the course of infection in the context of a patient with cancer. As SARS-CoV-2 is highly contagious, the risk of infection directly affects the cancer patient being treated, other cancer patients in close proximity, and health care providers. Infection at any level for patients or providers can cause considerable disruption to even the most effective treatment plans. Lung cancer patients, especially those with reduced lung function and cardiopulmonary comorbidities are more likely to have increased risk and mortality from coronavirus disease 2019 as one of its common manifestations is as an acute respiratory illness. The purpose of this manuscript is to present a practical multidisciplinary and international overview to assist in treatment for lung cancer patients during this pandemic, with the caveat that evidence is lacking in many areas. It is expected that firmer recommendations can be developed as more evidence becomes available.
全球 2019 年冠状病毒病大流行仍在迅速升级,淹没了医疗设施,给全球带来了巨大挑战。癌症患者感染严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)的风险似乎更高,尤其是因为他们更容易出现免疫功能低下的情况,这可能是癌症本身引起的,也可能是他们接受的治疗引起的。在大流行期间提供癌症护理的一个主要考虑因素是平衡患者暴露和感染的风险与提供有效癌症治疗的需要。目前,SARS-CoV-2 感染的许多方面仍未得到充分描述,而对于癌症患者感染的过程,人们了解得更少。由于 SARS-CoV-2 具有高度传染性,感染的风险直接影响正在接受治疗的癌症患者、近距离接触的其他癌症患者和医疗保健提供者。无论患者还是提供者在任何层面受到感染,都会对即使是最有效的治疗计划造成严重干扰。肺癌患者,尤其是那些肺功能降低和心肺合并症的患者,因冠状病毒病 2019 的风险和死亡率更高,因为其常见表现之一是急性呼吸道疾病。本文的目的是提供一个实用的多学科和国际综述,以帮助在大流行期间治疗肺癌患者,但许多领域缺乏证据。随着更多证据的出现,预计可以制定更明确的建议。