Department of Biomedical Sciences and Human Oncology, University of Bari "Aldo Moro", Bari, Italy.
Department of Medical Oncology, Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology, Barcelona, Spain.
J Neuroendocrinol. 2022 Oct;34(10):e13196. doi: 10.1111/jne.13196. Epub 2022 Sep 7.
The COVID-19 outbreak has added complexity in the management of patients with neuroendocrine tumors (NETs). Little information is currently available regarding the real impact of the pandemic in current practice. The present study aimed to capture patients' and healthcare professionals' experiences on how the NET management has changed during the pandemic and how it should be modified in a foreseeable post-pandemic environment. Physicians and nurses working in ENETS Centers of Excellence or other hospitals with high volume of NET patients (n = 48), as well as NET patients residing worldwide (n = 353), were asked to respond to two online anonymous surveys addressing different aspects of NET care. Deferred diagnoses, delayed surveillance procedures and postponed elective surgeries were among the main negative consequences of the COVID-19 outbreak according to 40%, 54% and 46% of healthcare professionals (HPs) respectively. Somatostatin analogs were increasingly used as bridging strategy for delaying surgery based on the views of 31% of HPs and were self-injected or delivered by home care services more frequently than before the initiation of the pandemic (53% of patients during the pandemic vs. 44% before the pandemic). Multidisciplinary tumor boards kept their usual schedule according to 58% of HPs, but were held virtually in the 77% of cases. The contact with healthcare professionals was maintained by remote methods more often than in the past (69% of patients), but only 34% of patients (59% among subjects < 41 years) would prefer telemedicine to face-to-face consultations in the future. New health policy measures should guarantee the highest standard of treatment to NET patients, regardless of the trajectory followed by the COVID-19 pandemic in the next months. Pros and cons of telemedicine should be carefully weighted before systematic implementation.
COVID-19 疫情的爆发给神经内分泌肿瘤（NET）患者的管理带来了复杂性。目前关于疫情对当前实践的实际影响的信息很少。本研究旨在了解患者和医疗保健专业人员的经验，了解 NET 管理在疫情期间发生了哪些变化，以及在可预见的疫情后环境中应如何进行修改。来自 ENETS 卓越中心或其他 NET 患者数量较高的医院（n=48）的医生和护士，以及全球范围内的 NET 患者（n=353），被要求对两个在线匿名调查做出回应，这些调查涉及 NET 护理的不同方面。据 40%、54%和 46%的医疗保健专业人员（HPs）分别称，推迟诊断、延迟监测程序和推迟择期手术是 COVID-19 爆发的主要负面后果之一。根据 31%的 HPs 的观点，生长抑素类似物被越来越多地用作延迟手术的桥接策略，并且在疫情期间比疫情前更频繁地自行注射或通过家庭护理服务进行（疫情期间 53%的患者 vs. 疫情前 44%）。根据 58%的 HPs，多学科肿瘤委员会保持了其通常的时间表，但其中 77%的病例是通过虚拟方式进行的。与过去相比，通过远程方式与医疗保健专业人员保持联系的情况更为常见（69%的患者），但只有 34%的患者（59%的年龄<41 岁）在未来更愿意选择远程医疗而不是面对面咨询。新的卫生政策措施应保证 NET 患者获得最高标准的治疗，无论 COVID-19 疫情在未来几个月的轨迹如何。在系统实施之前，应仔细权衡远程医疗的利弊。
