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新冠疫情期间妇科癌症治疗的合理化:印度经验

Rationalizing Treatment for Gynecological Cancers During the COVID-19 Pandemic: An Indian Experience.

作者信息

Srinivasa G Y, Dey Treshita, Suri Vanita, Bagga Rashmi, Jain Vanita, Gadela Sandeep, Gupta Ankita, Rai Bhavana, Rana Sakshi, Ghoshal Sushmita

机构信息

Department of Radiotherapy and Oncology, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012 India.

Department of Obstetrics and Gynecology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.

出版信息

Indian J Gynecol Oncol. 2020;18(3):101. doi: 10.1007/s40944-020-00448-x. Epub 2020 Aug 31.

Abstract

PURPOSE

The entire world is currently facing a devastating crisis due to growing coronavirus pandemic, which was declared as a public health emergency by the World Health Organization on March 11, 2020. Management of cancer patients at this time is an overwhelming task. This study highlights our experience in the management of patients of gynecological malignancies over a period of 2 months during the COVID-19 pandemic.

METHODS

Patients of confirmed gynecological malignancies who visited our outpatient clinic and those who received radiotherapy/chemotherapy in March and April 2020 were included for analysis. Guidelines issued by the National Institute of Health and Care Excellence, National Health Service, MD Anderson Cancer Centre and those by young oncologists in Italy were followed with minor modifications while managing the logistics and health worker safety.

RESULTS

A total of 160 patients were treated in our department during this time period. In total, 44.4% of patients on treatment had associated comorbidities that imposed an additional risk. One hundred twenty-three patients continued treatment with their initial plan of radiotherapy or chemotherapy. New patients were prioritized based on the severity of clinical symptoms and whether the expected outcome would significantly affect their survival and quality of life. Patients were monitored for the development of treatment-related toxicities and COVID-19-related symptoms.

CONCLUSIONS

All oncology personnel need to identify the correct balance between risks and benefit and then proceed with further management. Thus, it is essential to cautiously select patients for treatment, minimizing the risk of exposure but adequately addressing the underlying disease.

摘要

目的

由于不断蔓延的冠状病毒大流行,整个世界目前正面临一场毁灭性危机,世界卫生组织于2020年3月11日宣布这一情况为突发公共卫生事件。当前对癌症患者的管理是一项艰巨的任务。本研究重点介绍了我们在2019冠状病毒病大流行期间2个月内对妇科恶性肿瘤患者的管理经验。

方法

纳入2020年3月和4月到我们门诊就诊的确诊妇科恶性肿瘤患者以及接受放疗/化疗的患者进行分析。在管理后勤工作和保障医护人员安全时,遵循了英国国家卫生与临床优化研究所、英国国家医疗服务体系、MD安德森癌症中心发布的指南以及意大利年轻肿瘤学家制定的指南,并做了一些小的调整。

结果

在此期间,我们科室共治疗了160例患者。总的来说,44.4%正在接受治疗的患者伴有合并症,这带来了额外风险。123例患者按照其最初的放疗或化疗计划继续治疗。新患者根据临床症状的严重程度以及预期结果是否会显著影响其生存和生活质量来确定优先顺序。对患者进行治疗相关毒性反应和2019冠状病毒病相关症状的监测。

结论

所有肿瘤学专业人员都需要在风险和益处之间找到正确的平衡,然后再进行进一步的管理。因此,谨慎选择治疗患者至关重要,要将暴露风险降至最低,同时充分处理基础疾病。

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