Fountain Daniel M, Piper Rory J, Poon Michael T C, Solomou Georgios, Brennan Paul M, Chowdhury Yasir A, Colombo Francesca, Elmoslemany Tarek, Ewbank Frederick G, Grundy Paul L, Hasan Md T, Hilling Molly, Hutchinson Peter J, Karabatsou Konstantina, Kolias Angelos G, McSorley Nathan J, Millward Christopher P, Phang Isaac, Plaha Puneet, Price Stephen J, Rominiyi Ola, Sage William, Shumon Syed, Silva Ines L, Smith Stuart J, Surash Surash, Thomson Simon, Lau Jun Y, Watts Colin, Jenkinson Michael D
Manchester Centre for Clinical Neurosciences, Salford Royal NHS Foundation Trust, Salford, UK.
University of Manchester, Manchester, UK.
Neurooncol Adv. 2021 Jan 28;3(1):vdab014. doi: 10.1093/noajnl/vdab014. eCollection 2021 Jan-Dec.
The COVID-19 pandemic has profoundly affected cancer services. Our objective was to determine the effect of the COVID-19 pandemic on decision making and the resulting outcomes for patients with newly diagnosed or recurrent intracranial tumors.
We performed a multicenter prospective study of all adult patients discussed in weekly neuro-oncology and skull base multidisciplinary team meetings who had a newly diagnosed or recurrent intracranial (excluding pituitary) tumor between 01 April and 31 May 2020. All patients had at least 30-day follow-up data. Descriptive statistical reporting was used.
There were 1357 referrals for newly diagnosed or recurrent intracranial tumors across 15 neuro-oncology centers. Of centers with all intracranial tumors, a change in initial management was reported in 8.6% of cases ( = 104/1210). Decisions to change the management plan reduced over time from a peak of 19% referrals at the start of the study to 0% by the end of the study period. Changes in management were reported in 16% ( = 75/466) of cases previously recommended for surgery and 28% of cases previously recommended for chemotherapy ( = 20/72). The reported SARS-CoV-2 infection rate was similar in surgical and non-surgical patients (2.6% vs. 2.4%, > .9).
Disruption to neuro-oncology services in the UK caused by the COVID-19 pandemic was most marked in the first month, affecting all diagnoses. Patients considered for chemotherapy were most affected. In those recommended surgical treatment this was successfully completed. Longer-term outcome data will evaluate oncological treatments received by these patients and overall survival.
新型冠状病毒肺炎(COVID-19)大流行对癌症服务产生了深远影响。我们的目的是确定COVID-19大流行对新诊断或复发性颅内肿瘤患者决策及最终结果的影响。
我们对2020年4月1日至5月31日期间在每周神经肿瘤学和颅底多学科团队会议上讨论的所有成年新诊断或复发性颅内(不包括垂体)肿瘤患者进行了一项多中心前瞻性研究。所有患者均有至少30天的随访数据。采用描述性统计报告。
15个神经肿瘤中心共收到1357例新诊断或复发性颅内肿瘤转诊。在所有颅内肿瘤的中心中,8.6%(n = 104/1210)的病例报告初始治疗发生了变化。改变治疗计划的决策随着时间推移从研究开始时转诊病例的19%峰值降至研究期结束时的0%。在先前建议手术的病例中有16%(n = 75/466)报告治疗发生改变,在先前建议化疗的病例中有28%(n = 20/72)报告治疗发生改变。手术患者和非手术患者报告的严重急性呼吸综合征冠状病毒2(SARS-CoV-2)感染率相似(2.6%对2.4%,P > 0.9)。
COVID-19大流行导致英国神经肿瘤学服务中断在第一个月最为明显,影响所有诊断。考虑化疗的患者受影响最大。对于那些建议手术治疗的患者,手术成功完成。长期结果数据将评估这些患者接受的肿瘤治疗及总生存期。