Crisà Francesco Maria, Leocata Filippo, Arienti Virginia Maria, Picano Marco, Berta Luca, Mainardi Hae Song, Monti Angelo Filippo, Musca Francesco, Colombo Silvia, Palazzi Mauro, La Camera Alessandro
Neurosurgery, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy,
Università degli Studi di Milano, Milan, Italy,
Stereotact Funct Neurosurg. 2020;98(5):319-323. doi: 10.1159/000510271. Epub 2020 Jul 29.
The WHO declared 2019 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) a public health emergency of international concern. The National and Regional Health System has been reorganized, and many oncological patients died during this period or had to interrupt their therapies. This study summarizes a single-centre experience, during the COVID-19 period in Italy, in the treatment of brain metastases with Gamma Knife stereotactic radiosurgery (GKRS).
We retrospectively analysed our series of patients with brain metastases who underwent GKRS at the Niguarda Hospital from February 24 to April 24, 2020.
We treated 30 patients with 66 brain metastases. A total of 22 patients came from home and 8 patients were admitted to the emergency room for urgent neurological symptoms. Duration of stay was limited to 0-1 day in 17 patients. We chose to treat a cluster of 9 patients, whose greater lesion exceeded 10 cm3, with 2-stage modality GKRS to minimize tumour recurrence and radiation necrosis.
Due to the COVID-19 pandemic, the whole world is at a critical crossroads about the use of health care resources. During the COVID-19 outbreak, the deferral of diagnostic and therapeutic procedures and a work backlog in every medical specialty are the natural consequences of reservation of resources for COVID-19 patients. GKRS improved symptoms and reduced the need for open surgeries, allowing many patients to continue their therapeutic path and sparing beds in ICUs. Neurosurgeons have to take into account the availability of stereotactic radiosurgery to reduce hospital stay, conciliating safety for patients and operators with the request for health care coming from the oncological patients and their families.
世界卫生组织宣布2019年严重急性呼吸综合征冠状病毒2（SARS-CoV-2）构成国际关注的突发公共卫生事件。国家和地区卫生系统进行了重组，在此期间许多肿瘤患者死亡或不得不中断治疗。本研究总结了意大利新冠疫情期间，一家单中心使用伽玛刀立体定向放射外科（GKRS）治疗脑转移瘤的经验。
我们回顾性分析了2020年2月24日至4月24日在尼瓜尔达医院接受GKRS治疗的脑转移瘤患者系列。
我们治疗了30例患者的66个脑转移瘤。共有22例患者来自家中，8例因紧急神经症状被收治入急诊室。其中17例患者的住院时间限制在0至1天。我们选择采用两阶段模式的GKRS治疗9例较大病灶超过10 cm³的患者群，以尽量减少肿瘤复发和放射性坏死。
由于新冠疫情大流行，全世界在医疗资源使用方面正处于关键的十字路口。在新冠疫情爆发期间，诊断和治疗程序的推迟以及每个医学专科的工作积压，是为新冠患者预留资源的自然结果。GKRS改善了症状并减少了开颅手术的需求，使许多患者能够继续他们的治疗进程，并节省了重症监护病房的床位。神经外科医生必须考虑立体定向放射外科的可用性，以减少住院时间，在确保患者和操作人员安全的同时，兼顾肿瘤患者及其家属对医疗保健的需求。
