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一项比较性多中心队列研究,评估第一波新冠疫情期间严格封锁对肺癌患者的长期影响(蒿属试验)。

A Comparative Multicenter Cohort Study Evaluating the Long-Term Influence of the Strict Lockdown during the First COVID-19 Wave on Lung Cancer Patients (ARTEMISIA Trial).

作者信息

Molinier Olivier, Guguen Camille, Marcq Marie, Chene Anne-Laure, Masson Philippe, Bigot Frédéric, Denis Fabrice, Empereur Fabienne, Saulnier Philippe, Urban Thierry

机构信息

Respiratory Medicine Department, Hospital Center, 194 Avenue Rubillard, CEDEX 9, 72037 Le Mans, France.

Respiratory Medicine Department, Hospital Center, 85925 La Roche-sur-Yon, France.

出版信息

Cancers (Basel). 2023 Dec 6;15(24):5729. doi: 10.3390/cancers15245729.

Abstract

The consequences of the strict health restrictions during the first wave of COVID-19 on lung cancer (LC) patients are not known. This cohort study evaluated the impact of the initial lockdown on management of and long-term outcome in LC patients. This exposed-unexposed-type study included two evaluation periods of 6 months each in non-selected patients; one began on the first day of lockdown in 2020, and the other in 2019 during the same calendar period. Various indicators were compared: clinical profiles, management delays and overall survival beyond 2 years. A total of 816 patients from 7 public or private centers were enrolled. The clinical characteristics of the patients in 2020 did not differ from those in 2019, except that the population was older ( = 0.002) with more non-smokers ( = 0.006). Delays for pre-therapeutic medical management were generally reduced after the first imaging in 2020 (1.28 [1.1-1.49]). In the multivariate analysis, being part of the 2020 cohort was correlated with better prognosis (HR = 0.71 [0.5-0.84], < 0.001). The gain observed in 2020 mainly benefited non-smoking patients, along with ECOG PS 0-2 ( = 0.01), stage 4 ( = 0.003), squamous cell carcinoma ( = 0.03) and receiving systemic therapy ( = 0.03). In conclusion, the first lockdown did not exert any deleterious impact on LC patients.

摘要

新冠疫情第一波期间严格的健康限制措施对肺癌(LC)患者的影响尚不清楚。这项队列研究评估了最初的封锁措施对LC患者管理及长期预后的影响。这项暴露-未暴露类型的研究在未经过筛选的患者中设置了两个各为期6个月的评估期;一个始于2020年封锁首日,另一个在2019年同一日历时间段。比较了各项指标:临床特征、管理延误情况以及2年以上的总生存期。共纳入了来自7家公立或私立中心的816例患者。2020年患者的临床特征与2019年相比并无差异,只是人群年龄更大(P = 0.002),非吸烟者更多(P = 0.006)。2020年首次影像学检查后,治疗前医疗管理的延误时间总体有所缩短(1.28[1.1 - 1.49])。在多变量分析中,属于2020年队列与更好的预后相关(风险比=0.71[0.5 - 0.84],P<0.001)。2020年观察到的获益主要惠及非吸烟患者,以及东部肿瘤协作组体能状态评分为0 - 2分的患者(P = 0.01)、IV期患者(P = 0.003)、鳞状细胞癌患者(P = 0.03)以及接受全身治疗的患者(P = 0.03)。总之,首次封锁对LC患者未产生任何有害影响。

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