Department of Radiation Oncology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich (TUM), Ismaninger Strasse 22, 81675, Munich, Germany.
Institute for Radiation Medicine (IRM), Department of Radiation Sciences (DRS), Helmholtz Zentrum München, Ingolstädter Landstrasse 1, 85764, Neuherberg, Germany.
Sci Rep. 2023 Feb 16;13(1):2766. doi: 10.1038/s41598-023-29790-8.
The severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) has changed the clinical day-to-day practice. The aim of this study was to evaluate the impact of the pandemic on patients with high-grade glioma (HGG) as well as to derive best practice recommendations. We compared a multi-institutional cohort with HGG (n = 251) from 03/2020 to 05/2020 (n = 119) to a historical cohort from 03/2019 to 05/2019 (n = 132). The endpoints were outcome (progression-free survival (PFS) and overall survival (OS)) as well as patterns of care and time intervals between treatment steps. The median OS for WHO grade 4 gliomas was 12 months in 2019 (95% Confidence Interval 9.7-14.3 months), and not reached in 2020 (p = .026). There were no other significant differences in the Kaplan-Meier estimates for OS and PFS between cohorts of 2019 and 2020, neither did stratification by WHO grade reveal any significant differences for OS, PFS or for patterns of care. The time interval between cranial magnetic resonance imaging (cMRI) and biopsy was significantly longer in 2020 cohort (11 versus 21 days, p = .031). Median follow-up was 10 months (range 0-30 months). Despite necessary disease containment policies, it is crucial to ensure that patients with HGG are treated in line with the recent guidelines and standard of care (SOC) algorithms. Therefore, we strongly suggest pursuing no changes to SOC treatment, a timely diagnosis and treatment with short time intervals between first symptoms, initial diagnosis, and treatment, as well as a guideline-based cMRI follow-up.
严重急性呼吸综合征冠状病毒 2 型（SARS-CoV-2）改变了临床日常实践。本研究旨在评估大 脑高级别胶质瘤（HGG）患者的大流行影响，并得出最佳实践建议。我们比较了 2020 年 3 月至 5 月（n=119）和 2019 年 3 月至 5 月（n=132）多机构 HGG 患者队列。终点是结局（无进展生存期（PFS）和总生存期（OS））以及治疗模式和治疗步骤之间的时间间隔。2019 年，WHO 4 级胶质瘤的中位 OS 为 12 个月（95%置信区间为 9.7-14.3 个月），而 2020 年未达到（p=0.026）。2019 年和 2020 年队列的 OS 和 PFS 的 Kaplan-Meier 估计值没有其他显著差异，也没有按 WHO 分级分层的 OS、PFS 或治疗模式的显著差异。2020 年队列的颅磁共振成像（cMRI）和活检之间的时间间隔明显延长（11 天比 21 天，p=0.031）。中位随访时间为 10 个月（范围 0-30 个月）。尽管需要采取疾病控制政策，但确保 HGG 患者按照最近的指南和标准治疗方案（SOC）进行治疗至关重要。因此，我们强烈建议不改变 SOC 治疗方案，及时诊断和治疗，从首次症状、初步诊断到治疗之间的时间间隔要短，并进行基于指南的 cMRI 随访。
