RadiOnCOVID：意大利COVID-19对接受放射治疗患者影响的多中心分析
RadiOnCOVID: Multicentric Analysis of the Impact of COVID-19 on Patients Undergoing Radiation Therapy in Italy.
作者信息
Guerini Andrea Emanuele, Marvaso Giulia, Tonoli Sandro, Corrao Giulia, Teriaca Maria Ausilia, Sepulcri Matteo, Scricciolo Melissa, Gava Alessandro, Montrone Sabrina, Giaj-Levra Niccolò, Chiorda Barbara Noris, Mantello Giovanna, Fiorica Francesco, Borghesi Simona, Belgioia Liliana, Caroli Angela, Fiorentino Alba, Jereczek-Fossa Barbara Alicja, Magrini Stefano Maria, Buglione Michela
机构信息
Department of Radiation Oncology, Istituto del Radio O. Alberti, Spedali Civili Hospital, Piazzale Spedali Civili 1, 25121 Brescia, Italy.
Department of Radiation Oncology, Università degli Studi di Brescia, 25123 Brescia, Italy.
出版信息
Cancers (Basel). 2024 Dec 30;17(1):86. doi: 10.3390/cancers17010086.
METHODS AND MATERIALS
Patients with ongoing or planned anticancer treatment at 19 Italian Radiation Oncology centers were included in the study retrospectively from 3 February 2020 to 31 December 2020 and prospectively from 1 January 2021 to 31 May 2021. Anonymized data were processed through a specific website and database. Antineoplastic treatment characteristics and timing and outcomes of COVID-19 and its impact on radiotherapy or systemic therapy were described.
RESULTS
The retrieved cohort included 41,039 patients that received treatment or were planned for therapy in the study period. Overall, 123 patients had a confirmed COVID-19 diagnosis during antineoplastic treatment (group A) and 99 patients before treatment start (group B). The incidence of COVID-19 across the whole cohort in the index period was 0.54% (groups A + B) and 0.30% considering only group A. A total of 60 patients developed severe COVID-19, and a total of 45 patients died as a consequence of the infection (incidence of 0.15% and 0.11%, respectively). Nonetheless, mortality among COVID-19 patients was high, with an attributable death rate after confirmed infection of 20.27%. Among the 123 patients in group A, 37.4% required temporary treatment suspension, 32.5% definitive suspension and 37 patients continued treatment while positive. As for the 99 patients in group B, 53.5% experienced temporary delay, 20.2% experienced definitive treatment suspension and 26.3% had no delay.
CONCLUSIONS
Most of the patients with a COVID-19 diagnosis in our cohort recovered and completed their treatment; nonetheless, the attributable death rate after confirmed infection was 20.27%, and mortality was high among cancer patients with severe COVID-19 presentation. The global incidence of death due to COVID-19 or severe COVID-19 was low and decreased over time. Radiation oncology activity could be safely continued during the COVID-19 pandemic with the adoption of adequate preventive measures.
方法与材料
回顾性纳入2020年2月3日至2020年12月31日期间以及前瞻性纳入2021年1月1日至2021年5月31日期间在意大利19个放射肿瘤中心接受正在进行或计划进行的抗癌治疗的患者。通过一个特定的网站和数据库对匿名数据进行处理。描述了抗肿瘤治疗特征、时间安排以及2019冠状病毒病（COVID-19）的结局及其对放疗或全身治疗的影响。
结果
所检索的队列包括在研究期间接受治疗或计划接受治疗的41,039名患者。总体而言，123名患者在抗肿瘤治疗期间确诊为COVID-19（A组），99名患者在治疗开始前确诊（B组）。在索引期，整个队列中COVID-19的发病率为0.54%（A组+B组），仅考虑A组时为0.30%。共有60名患者发生重症COVID-19，共有45名患者因感染死亡（发病率分别为0.15%和0.11%）。尽管如此，COVID-19患者的死亡率较高，确诊感染后的归因死亡率为20.27%。在A组的123名患者中，37.4%需要暂时中断治疗，32.5%需要永久中断治疗，37名患者在呈阳性时继续治疗。对于B组的99名患者，53.5%经历了暂时延迟，20.2%经历了永久治疗中断，26.3%没有延迟。
结论
我们队列中大多数确诊为COVID-19的患者康复并完成了治疗；尽管如此，确诊感染后的归因死亡率为20.27%，在出现重症COVID-19的癌症患者中死亡率较高。因COVID-19或重症COVID-19导致的全球死亡率较低且随时间下降。在COVID-19大流行期间，通过采取适当的预防措施，可以安全地继续放射肿瘤学活动。
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