Universidade Federal de São Paulo, Escola Paulista de Medicina, Departamento de Neurologia e Neurocirurgia, São Paulo SP, Brazil.
Hospital Beneficência Portuguesa de São Paulo, Departamento de Oncologia de Radiação, São Paulo SP, Brazil.
Arq Neuropsiquiatr. 2021 Feb;79(2):167-172. doi: 10.1590/0004-282X-anp-2020-0434.
Cancer patients in general and glioblastoma patients, in particular, have an increased risk of developing complications from the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and reaching a balance between the risk of exposure to infection and the clinical benefit of their treatment is ideal. The aggressive behavior of this group of tumors justifies the need for a multidisciplinary team to assist in clinical decisions during the current pandemic. Brazil is now ranked #2 in the number of cases and deaths from COVID-19 pandemic, and existing disparities in the treatment of neuro-oncology patients in Brazil will challenge the clinical and surgical decisions of this population, possibly affecting global survival.
To search the literature about the management of glioblastomas during COVID-19 pandemic to guide surgical and clinical decisions in this population of patients in Brazil.
We performed a systematic search on the PubMed electronic database targeting consensus statements concerning glioblastoma approaches during COVID-19 pandemic up to July 18, 2020.
When approaching glioblastoma during the COVID-19 pandemic, important parameters that help in the decision-making process are age, performance status, tumor molecular profile, and patient consent. Younger patients should follow the standard protocol after maximal safe resection, mainly those with MGMT methylated tumors. Aged and underperforming patients should be carefully evaluated, and probably a monotherapy scheme is to be considered. Centers are advised to engage in telemedicine and to elaborate means to reduce local infection.
Approaching glioblastoma during the COVID-19 pandemic will be challenging worldwide, but particularly in Brazil, where a significant inequality of healthcare exists.
一般癌症患者，尤其是胶质母细胞瘤患者，感染严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）后发生并发症的风险增加，在暴露于感染的风险和治疗的临床获益之间达到平衡是理想的。这群肿瘤的侵袭性行为证明需要多学科团队在当前大流行期间协助临床决策。巴西目前在 COVID-19 大流行的病例和死亡人数方面排名第二，巴西神经肿瘤学患者治疗方面的现有差异将挑战这一人群的临床和手术决策，可能会影响全球生存率。
搜索有关 COVID-19 大流行期间胶质母细胞瘤管理的文献，以指导巴西这一患者群体的手术和临床决策。
我们在 PubMed 电子数据库中进行了系统搜索，针对 COVID-19 大流行期间胶质母细胞瘤治疗方法的共识声明，截至 2020 年 7 月 18 日。
在 COVID-19 大流行期间处理胶质母细胞瘤时，有助于决策过程的重要参数是年龄、表现状态、肿瘤分子谱和患者同意。年轻患者应在最大安全切除后遵循标准方案，主要是那些 MGMT 甲基化肿瘤患者。应仔细评估年龄较大和表现不佳的患者，可能需要考虑单药治疗方案。建议各中心开展远程医疗，并制定减少本地感染的措施。
在 COVID-19 大流行期间处理胶质母细胞瘤将在全球范围内具有挑战性，但在巴西尤其如此，巴西的医疗保健存在显著不平等。
