Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran.
Department of General Surgery, Subdivision of Surgical Oncology, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran.
Am J Otolaryngol. 2020 Nov-Dec;41(6):102738. doi: 10.1016/j.amjoto.2020.102738. Epub 2020 Sep 18.
With the onset of the COVID-19 crisis in late 2019, the health care systems of different countries are experiencing stressful conditions. Many patients need care in hospital wards and intensive care units (ICU). Head & neck cancers (HNC) are in a special condition in this pandemic. The main treatment in these patients is surgery. Most of these patients need care in the ICU, which is reduced in capacity in pandemic conditions. It's important to note that delays in the surgery of these patients make them non-operable and on the other hand increase mortality and morbidity. Numerous non-surgical alternative therapies have been proposed in these conditions, but there are fundamental questions about these suggestions. 1 How long should we look for alternative therapies? Because many countries are facing a second wave of the disease. 2 What's the effect of these alternative therapies and the delay in starting standard treatments in patients' survival? Different countries have different financial resources; many countries, patients face restrictions on receiving alternative therapies to standard treatments, and in non-pandemic conditions, long queues are given for non-surgical treatments such as chemo-radiotherapy. There are numerous guidelines to guide head and neck surgeons to the best choice in this situation. It seems that different countries have to make individual decisions based on the prevalence of COVID-19 and the financial resources and facilities of the health care system. In this review article, we have collected the opinions of world-renowned guidelines and institutions on how to treat HNCs during the pandemic.
随着 2019 年末 COVID-19 危机的爆发,不同国家的医疗体系正面临着巨大的压力。许多患者需要在医院病房和重症监护病房(ICU)接受治疗。在这场大流行中,头颈部癌症(HNC)患者处于特殊情况。这些患者的主要治疗方法是手术,大多数患者需要在 ICU 接受治疗,但在大流行期间 ICU 的容量会减少。需要注意的是,这些患者的手术延迟会导致他们无法手术,另一方面也会增加死亡率和发病率。在这些情况下已经提出了许多非手术的替代疗法,但这些建议存在一些基本问题。1. 我们应该寻找替代疗法多长时间?因为许多国家正面临着第二波疫情。2. 这些替代疗法的效果以及延迟开始标准治疗对患者生存的影响是什么?不同国家的财政资源不同;许多国家的患者在接受替代疗法方面受到限制,而且在非大流行期间,许多国家的患者需要排队接受非手术治疗,如化疗和放疗。有许多指南可以指导头颈部外科医生做出最佳选择。似乎不同的国家必须根据 COVID-19 的流行情况以及医疗体系的财政资源和设施来做出个别决定。在这篇综述文章中,我们收集了世界知名指南和机构关于在大流行期间治疗 HNC 的意见。