Kawaura Ryo, Shibata Hirofumi, Okuda Hiroshi, Terazawa Kosuke, Ogawa Takenori
Otolaryngology - Head and Neck Surgery, Gifu University Graduate School of Medicine, Gifu, JPN.
Cureus. 2024 May 19;16(5):e60578. doi: 10.7759/cureus.60578. eCollection 2024 May.
Objective The after-effects of coronavirus disease 2019 (COVID-19) infection are still unknown; therefore, we investigate the possibility that COVID-19 may interrupt cancer treatment and impact prognosis. Methods We examined the characteristics, prognosis, and changes in treatment options before and after COVID-19 in 11 head and neck cancer patients who were infected with COVID-19 after admission for cancer treatment at Gifu University Hospital. These patients were compared to 110 patients unaffected by COVID-19 during the same period. To identify the effects of COVID-19 on the cancer treatment sequence, we examined the rates of overall survival, progression-free survival, and completion, as well as radiation dosage in radiotherapy and cisplatin dosage in chemoradiotherapy. Results All 11 patients with COVID-19 had their planned cancer treatment postponed or interrupted. There was no significant difference in overall or progression-free survival compared to patients without COVID-19. Notably, only 3/6 of the COVID-19-affected patients completed radiotherapy compared to 42/46 unaffected patients. The ratio of actual radiation dose to planned dose was significantly impaired in COVID-19 affected patients group (98.3% vs. 88.6%). Cisplatin dosage in chemoradiation was not significantly different in either the radical (100 mg/m, every three weeks) or adjuvant (40 mg/m, every one week) treatment groups. Conclusion COVID-19 infection in head and neck cancer patients had no apparent impact on cancer prognosis. However, when restricted to irradiation, the treatment completion rate and the ratio of planned to actual dose decreased significantly, underscoring the impact of COVID-19 infection on cancer treatment. The difference in irradiation may affect the success of patients' treatment going forward, and it should be explored whether irradiation can be continued without delay.
目的 2019 冠状病毒病（COVID-19）感染的后遗症仍不清楚；因此，我们研究 COVID-19 可能中断癌症治疗并影响预后的可能性。方法 我们检查了 11 例在岐阜大学医院因癌症治疗入院后感染 COVID-19 的头颈癌患者在感染 COVID-19 前后的特征、预后及治疗方案变化。将这些患者与同期 110 例未感染 COVID-19 的患者进行比较。为确定 COVID-19 对癌症治疗顺序的影响，我们检查了总生存率、无进展生存率、完成率，以及放疗中的辐射剂量和放化疗中的顺铂剂量。结果 所有 11 例 COVID-19 患者的计划癌症治疗均被推迟或中断。与未感染 COVID-19 的患者相比，总生存率或无进展生存率无显著差异。值得注意的是，感染 COVID-19 的患者中只有 3/6 完成了放疗，而未感染的患者中有 42/46 完成了放疗。COVID-19 感染患者组实际辐射剂量与计划剂量的比值明显受损（98.3%对 88.6%）。在根治性（每三周 100 mg/m）或辅助性（每周 40 mg/m）治疗组中，放化疗中的顺铂剂量均无显著差异。结论 头颈癌患者感染 COVID-19 对癌症预后无明显影响。然而，仅限于放疗时，治疗完成率和计划剂量与实际剂量的比值显著下降突出了 COVID-19 感染对癌症治疗的影响。放疗方面的差异可能会影响患者未来治疗的成功，应探讨放疗是否可以毫不延迟地继续进行。
