肺癌与 COVID-19 大流行:巴西胸肿瘤学组的建议。

Lung Cancer and the COVID-19 pandemic: Recommendations from the Brazilian Thoracic Oncology Group.

机构信息

Oncologia, Instituto D'Or de Pesquisa e Ensino, Rio de Janeiro, RJ, BR.

Grupo Brasileiro de Oncologia Toracica, Porto Alegre, RS, BR.

出版信息

Clinics (Sao Paulo). 2020 Jun 22;75:e2060. doi: 10.6061/clinics/2020/e2060. eCollection 2020.

Abstract

New cases of the novel coronavirus disease 2019 (COVID-19), also known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), continue to rise worldwide following the declaration of a pandemic by the World Health Organization (WHO). The current pandemic has completely altered the workflow of health services worldwide. However, even during this critical period, patients with other diseases, like cancer, need to be properly treated. A few reports have shown that mortality due to SARS-CoV-2 is higher in elderly patients and those with other active comorbidities, including cancer. Patients with lung cancer are at risk of pulmonary complications from COVID-19, and as such, the risk/benefit ratio of local and systemic anticancer treatment has to be considered. For each patient, several factors, including age, comorbidities, and immunosuppression, as well as the number of hospital visits for treatment, can influence this risk. The number of cases is rising exponentially in Brazil, and it is important to consider the local characteristics when approaching the pandemic. In this regard, the Brazilian Thoracic Oncology Group has developed recommendations to guide decisions in lung cancer treatment during the SARS-CoV-2 pandemic. Due to the scarcity of relevant data, discussions based on disease stage, evaluation of surgical treatment, radiotherapy techniques, systemic therapy, follow-up, and supportive care were carried out, and specific suggestions issued. All recommendations seek to reduce contagion risk by decreasing the number of medical visits and hospitalization, and in the case of immunosuppression, by adapting treatment schemes when possible. This statement should be adjusted according to the reality of each service, and can be revised as new data become available.

摘要

新型冠状病毒病 2019(COVID-19),也称为严重急性呼吸系统综合征冠状病毒 2(SARS-CoV-2),自世界卫生组织(WHO)宣布大流行以来,全球新发病例持续上升。目前的大流行已经彻底改变了全球卫生服务的工作流程。然而,即使在这个关键时刻,患有其他疾病(如癌症)的患者也需要得到妥善治疗。有一些报告表明,COVID-19 导致的死亡率在老年患者和其他患有活动性合并症的患者中更高,包括癌症。肺癌患者有因 COVID-19 而出现肺部并发症的风险,因此,必须考虑局部和全身抗癌治疗的风险/获益比。对于每位患者,包括年龄、合并症和免疫抑制在内的几个因素,以及治疗的住院次数,都会影响这种风险。巴西的病例数量呈指数级增长,在处理大流行时,考虑当地特点非常重要。在这方面,巴西胸肿瘤学组制定了建议,以指导 COVID-19 大流行期间肺癌治疗的决策。由于相关数据匮乏,根据疾病分期、手术治疗评估、放射治疗技术、全身治疗、随访和支持性护理进行了讨论,并提出了具体建议。所有建议都旨在通过减少医疗就诊次数和住院次数来降低感染风险,在免疫抑制的情况下,尽可能调整治疗方案。根据每个服务的实际情况,应调整本声明,并可根据新数据进行修订。

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