COVID-19 期间泌尿系统癌症患者全身抗癌治疗的安全提供：COVID-19 第一波期间的一家三级中心经验。
Safe provision of systemic anti-cancer treatment for urological cancer patients during COVID-19: a tertiary centre experience in the first wave of COVID-19.
机构信息
Department of Oncology, Guy's and St Thomas' NHS Foundation Trust, London, SE1 9RT, UK.
Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King's College London, London, SE1 9RT, UK.
出版信息
BMC Urol. 2022 Apr 29;22(1):71. doi: 10.1186/s12894-022-01023-6.
BACKGROUND
Safe provision of systemic anti-cancer treatment (SACT) during the COVID-19 pandemic remains an ongoing concern amongst clinicians.
METHODS
Retrospective analysis on uro-oncology patients who continued or started SACT between 1st March and 31st May 2020 during the pandemic (with 2019 as a comparator).
RESULTS
441 patients received SACT in 2020 (292 prostate, 101 renal, 38 urothelial, 10 testicular) compared to 518 patients in 2019 (340 prostate, 121 renal, 42 urothelial, 15 testicular). In 2020, there were 75.00% fewer patients with stage 3 cancers receiving SACT (p < 0.0001) and 94.44% fewer patients receiving radical treatment (p = 0.00194). The number of patients started on a new line of SACT was similar between both years (118 in 2019 vs 102 in 2020; p = 0.898) but with 53.45% fewer patients started on chemotherapy in 2020 (p < 0.001). Overall, 5 patients tested positive for COVID-19 (one asymptomatic, one mild, two moderate, one severe resulting in death). Compared to 2019, 30-day mortality was similar (1.69% in 2019 vs 0.98% in 2020; p = 0.649) whereas 6-month mortality was lower (9.32% in 2019 vs 1.96% in 2020; p = 0.0209) in 2020.
CONCLUSION
This study suggests that delivery of SACT to uro-oncology patients during COVID-19 pandemic may be safe in high-incidence areas with appropriate risk-reduction strategies.
背景
在 COVID-19 大流行期间，安全提供全身性抗癌治疗（SACT）仍然是临床医生关注的一个持续问题。
方法
对 2020 年 3 月 1 日至 5 月 31 日期间（以 2019 年作为对照）患有泌尿系统癌症并继续或开始 SACT 的患者进行回顾性分析。
结果
与 2019 年（340 例前列腺癌、121 例肾癌、42 例膀胱癌、15 例睾丸癌）相比，2020 年有 441 例患者接受了 SACT（292 例前列腺癌、101 例肾癌、38 例膀胱癌、10 例睾丸癌）。2020 年，接受 SACT 的 III 期癌症患者减少了 75.00%（p<0.0001），接受根治性治疗的患者减少了 94.44%（p=0.00194）。在这两年中，开始新的 SACT 治疗的患者数量相似（2019 年 118 例，2020 年 102 例；p=0.898），但 2020 年接受化疗的患者减少了 53.45%（p<0.001）。总体而言，有 5 名患者新冠病毒检测呈阳性（1 例无症状、1 例轻度、2 例中度、1 例重度导致死亡）。与 2019 年相比，30 天死亡率相似（2019 年为 1.69%，2020 年为 0.98%；p=0.649），但 2020 年 6 个月死亡率较低（2019 年为 9.32%，2020 年为 1.96%；p=0.0209）。
结论
这项研究表明，在 COVID-19 大流行期间，在高发病率地区，通过采取适当的降低风险策略，向泌尿系统癌症患者提供 SACT 可能是安全的。
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