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Xavier Bosch Elisabet Montori-Palacin Rosa Martínez-Ferrer Anna Aldea Pedro Moreno Alfonso López-Soto 《International journal of cancer. Journal international du cancer》2023,152(3):384-395
Despite extensive research on cancer care during the COVID-19 pandemic, evidence on the impact on prediagnostic time intervals is lacking. To better understand how COVID-19 changed the pathway to diagnosis of cancer, we examined the length of intervals from symptom onset to diagnosis for 13 common cancer types with known clinical stage over 1-year nonpandemic period (March 2019 to March 2020; N = 844) and three biannual COVID periods (March 2020 to September 2021; N = 1172). We analyzed the patient interval (from first symptoms to presentation to a physician), the primary care/emergency department interval (from presentation with relevant symptoms to a primary care or emergency department physician to referral to a hospital-based diagnosis center) and the hospital interval (from referral to diagnosis). Compared to nonpandemic data, there were significant changes across COVID periods. The pandemic mostly impacted patient intervals for cancers diagnosed over the first 6 months after onset in March 2020. Overall median patient intervals were longest in the early COVID period (39 [IQR 22-64] days) and shortest in the nonpandemic period (20 [IQR 13-30] days; Kruskal-Wallis test [χ2], P < .0001). Differences in clinical stage between periods were relevant, with cancers from the mid-period (September 2020 to March 2021) showing the most advanced stage. A shift to later stage was plausibly a result of delayed intervals in the early COVID period. Since intervals are eventually relevant to prognosis, our results provide a baseline against which the impact of improvement strategies to minimize the negative outcomes of COVID-19-associated cancer delays can be assessed and implemented. 相似文献
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Florence Joly MD PhD Olivier Rigal MD Lydia Guittet MD PhD Sophie Lefèvre-Arbogast PhD Jean-Michel Grellard MSc Giulia Binarelli MSc Marie Lange PhD Chantal Rieux Marie Fernette Laure Tron PhD François Gernier MSc Romain Travers MSc Adeline Morel MD Doriane Richard PhD Bénédicte Griffon PhD Alexandra Leconte MSc Etienne Bastien MSc Florian Quilan MSc Louis-Ferdinand Pépin MD Fabrice Jardin MD PhD Marianne Leheurteur MD Bénédicte Clarisse PharmD PhD Justine Lequesne PhD Audrey Faveyrial MD 《Cancer》2021,127(24):4636-4645
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Elizabeth R. Sniderman MSN APRN Dylan E. Graetz MD MPH Asya Agulnik MD MPH Radhikesh Ranadive MS Yuvanesh Vedaraju MS Yichen Chen PhD Meenakshi Devidas PhD MBA Guillermo L. Chantada MD PhD Laila Hessissen MD Rashmi Dalvi MBBS Kathy Pritchard-Jones MD PhD Carlos Rodriguez-Galindo MD Daniel C. Moreira MD 《Cancer》2022,128(7):1493-1502
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Dylan E. Graetz MD MPH Elizabeth Sniderman MSN APRN Cesar A. Villegas MD Erica C. Kaye MD MPH Iman Ragab MD PhD Aliaksandra Laptsevich MD Biemba Maliti BSN Gita Naidu MD PhD Haiying Huang BSN Pascale Y. Gassant MD Luciana Nunes Silva MD Daniela Arce MD Jacqueline Montoya Vasquez MD Ramandeep Singh Arora MD Ana Patricia Alcasabas MD Desy Rusmawatiningtyas MD Muhammad Rafie Raza MD Pablo Velasco MD Joyce Kambugu MD Anna Vinitsky MD MS Carlos Rodriguez-Galindo MD Asya Agulnik MD MPH Daniel C. Moreira MD for the COVIMPACT Study Group 《Cancer》2022,128(4):797-807
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Raya Saab MD Anas Obeid MD Fatiha Gachi MD Houda Boudiaf MD Lilit Sargsyan MD Khulood Al-Saad MD Tamar Javakhadze MD Azim Mehrvar MD Sawsan Sati Abbas MD Yasir Saadoon Abed Al-Agele MD Salma Al-Haddad MD Mouroge Hashim Al Ani MD Suleiman Al-Sweedan MD Amani Al Kofide MD Wasil Jastaniah MD Nisreen Khalifa MD Elie Bechara MD Malek Baassiri MD Peter Noun MD Jamila El-Houdzi MD Mohammed Khattab MD Krishna Sagar Sharma MD Yasser Wali MD Naureen Mushtaq MD Aliya Batool MD Mahwish Faizan MD Muhammad Rafie Raza MD Mohammad Najajreh MD Mohammed Awad Mohammed Abdallah MD Ghada Sousan MD Khaled M. Ghanem MD Ulker Kocak MD Tezer Kutluk MD Hacı Ahmet Demir MD Hamoud Hodeish MD Samar Muwakkit MD Asim Belgaumi MD Abdul-Hakim Al-Rawas MD Sima Jeha MD 《Cancer》2020,126(18):4235-4245
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Ellis Slotman Feike Weijzen Heidi P. Fransen Jolanda C. van Hoeve Auke M. T. Huijben Evelien J. M. Kuip Agnes Jager Peter W. A. Kunst Hanneke W. M. van Laarhoven Jolien Tol Vivianne C. G. Tjan-Heijnen Natasja J. H. Raijmakers Yvette M. van der Linden Sabine Siesling On-behalf-of-the-COVID-and-Cancer-NL Consortium 《International journal of cancer. Journal international du cancer》2024,154(10):1786-1793
During the COVID-19 pandemic recommendations were made to adapt cancer care. This population-based study aimed to investigate possible differences between the treatment of patients with metastatic cancer before and during the pandemic by comparing the initial treatments in five COVID-19 periods (weeks 1–12 2020: pre-COVID-19, weeks 12–20 2020: 1st peak, weeks 21–41 2020: recovery, weeks 42–53 2020: 2nd peak, weeks 1–20 2021: prolonged 2nd peak) with reference data from 2017 to 2019. The proportion of patients receiving different treatment modalities (chemotherapy, hormonal therapy, immunotherapy or targeted therapy, radiotherapy primary tumor, resection primary tumor, resection metastases) within 6 weeks of diagnosis and the time between diagnosis and first treatment were compared by period. In total, 74,208 patients were included. Overall, patients were more likely to receive treatments in the COVID-19 periods than in previous years. This mainly holds for hormone therapy, immunotherapy or targeted therapy and resection of metastases. Lower odds were observed for resection of the primary tumor during the recovery period (OR 0.87; 95% CI 0.77–0.99) and for radiotherapy on the primary tumor during the prolonged 2nd peak (OR 0.84; 95% CI 0.72–0.98). The time from diagnosis to the start of first treatment was shorter, mainly during the 1st peak (average 5 days, p < .001). These findings show that during the first 1.5 years of the COVID-19 pandemic, there were only minor changes in the initial treatment of metastatic cancer. Remarkably, time from diagnosis to first treatment was shorter. Overall, the results suggest continuity of care for patients with metastatic cancer during the pandemic. 相似文献
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Braga S Miranda A Fonseca R Passos-Coelho JL Fernandes A Costa JD Moreira A 《Psycho-oncology》2007,16(9):863-868
BACKGROUND: There is concern that terminally ill cancer patients are over treated with chemotherapy, even when such treatment is unlikely to palliate symptoms. The study objective was to evaluate the use of chemotherapy in the last three months of life in a cohort of adult patients with advanced solid tumours. METHODS: All adult patients with solid tumours who died in our hospital in 2003 and received chemotherapy for advanced cancer, were included. Detailed data concerning chemotherapy and toxicity, in the last three months of life, were collected from patients' clinical charts. RESULTS: A total of 319 patients were included. Median age was 61 years. Median time from diagnosis of metastatic disease to death was 11 months. The proportion of patients who received chemotherapy in the last three months of life was 66% (n = 211), in the last month 37% and in the last two weeks 21%. Among patients who received chemotherapy in the last three months of life, 50% started a new chemotherapy regimen in this period and 14% in the last month. There was an increased probability of receiving chemotherapy in the last three months of life in younger patients and in patients with breast, ovarian and pancreatic carcinomas. CONCLUSION: There was a large proportion of patients who received chemotherapy in the last three months of life, including initiation of a new regimen within the last 30 days. Thus, further study is needed to evaluate if such aggressive attitude results in better palliation of symptoms at the end of life. 相似文献
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Jung Julie Kang MD PhD Richard J. Wong MD Eric J. Sherman MD Alisa Rybkin BS Sean M. McBride MD MPH Nadeem Riaz MD MSc C. Jillian Tsai MD PhD Yao Yu MD Linda Chen MD Kaveh Zakeri MD MAS Daphna Y. Gelblum MD Erin F. Gillespie MD Marc A. Cohen MD MPH Jennifer R. Cracchiolo MD Ian Ganly MD PhD Snehal Patel MD Bhuvanesh Singh MD PhD Jay O. Boyle MD Benjamin R. Roman MD MSHP Luc G. Morris MD MSc Ashok R. Shaha MD Lara A. Dunn MD Alan L. Ho MD PhD James V. Fetten MD Jatin P. Shah MD David G. Pfister MD Nancy Y. Lee MD 《Cancer》2020,126(18):4092-4104
Because of the national emergency triggered by the coronavirus disease 2019 (COVID-19) pandemic, government-mandated public health directives have drastically changed not only social norms but also the practice of oncologic medicine. Timely head and neck cancer (HNC) treatment must be prioritized, even during emergencies. Because severe acute respiratory syndrome coronavirus 2 predominantly resides in the sinonasal/oral/oropharyngeal tracts, nonessential mucosal procedures are restricted, and HNCs are being triaged toward nonsurgical treatments when cures are comparable. Consequently, radiation utilization will likely increase during this pandemic. Even in radiation oncology, standard in-person and endoscopic evaluations are being restrained to limit exposure risks and preserve personal protective equipment for other frontline workers. The authors have implemented telemedicine and multidisciplinary conferences to continue to offer standard-of-care HNC treatments during this uniquely challenging time. Because of the lack of feasibility data on telemedicine for HNC, they report their early experience at a high-volume cancer center at the domestic epicenter of the COVID-19 crisis. 相似文献