Lee Alvin J X, Purshouse Karin
UCL Cancer Institute, University College London, London, UK.
CRUK Edinburgh Cancer Research Centre, The University of Edinburgh, Edinburgh, UK.
Br J Cancer. 2021 May;124(11):1777-1784. doi: 10.1038/s41416-021-01324-x. Epub 2021 Mar 25.
The SARS-Cov-2 pandemic in 2020 has caused oncology teams around the world to adapt their practice in the aim of protecting patients. Early evidence from China indicated that patients with cancer, and particularly those who had recently received chemotherapy or surgery, were at increased risk of adverse outcomes following SARS-Cov-2 infection. Many registries of cancer patients infected with SARS-Cov-2 emerged during the first wave. We collate the evidence from these national and international studies and focus on the risk factors for patients with solid cancers and the contribution of systemic anti-cancer treatments (SACT-chemotherapy, immunotherapy, targeted and hormone therapy) to outcomes following SARS-Cov-2 infection. Patients with cancer infected with SARS-Cov-2 have a higher probability of death compared with patients without cancer. Common risk factors for mortality following COVID-19 include age, male sex, smoking history, number of comorbidities and poor performance status. Oncological features that may predict for worse outcomes include tumour stage, disease trajectory and lung cancer. Most studies did not identify an association between SACT and adverse outcomes. Recent data suggest that the timing of receipt of SACT may be associated with risk of mortality. Ongoing recruitment to these registries will enable us to provide evidence-based care.
2020年的新型冠状病毒肺炎疫情促使世界各地的肿瘤学团队调整其医疗实践,以保护患者。来自中国的早期证据表明,癌症患者,尤其是那些近期接受过化疗或手术的患者,在感染新型冠状病毒后出现不良后果的风险增加。在第一波疫情期间,出现了许多感染新型冠状病毒的癌症患者登记处。我们整理了这些国内和国际研究的证据,并重点关注实体癌患者的风险因素以及全身抗癌治疗(SACT——化疗、免疫治疗、靶向治疗和激素治疗)对新型冠状病毒感染后预后的影响。与未患癌症的患者相比,感染新型冠状病毒的癌症患者死亡概率更高。新型冠状病毒肺炎后死亡的常见风险因素包括年龄、男性、吸烟史、合并症数量和身体状况不佳。可能预示预后较差的肿瘤学特征包括肿瘤分期、疾病进展过程和肺癌。大多数研究未发现全身抗癌治疗与不良后果之间存在关联。近期数据表明,接受全身抗癌治疗的时间可能与死亡风险有关。持续招募患者加入这些登记处将使我们能够提供循证医疗服务。