新型冠状病毒病(COVID-19)疫情期间四川省地市级医院肿瘤患者诊治情况调查分析

目的 调查2019新型冠状病毒病(COVID-19)疫情期间四川省各地市级医院肿瘤患者的诊治情况,分析疫情对肿瘤患者住院和治疗的影响,为不同省份的医疗机构开展肿瘤患者的诊治提供参考。方法 对四川省地市级医院通过问卷表的形式进行调查。采用描述性统计方法分析疫情期间四川省地市级医院肿瘤科患者的诊治情况。结果 调查了四川省37家地市级大中型医院,其中三级甲等医院占78.4%。在调查医院中,疫情一级响应后,肿瘤科患者住院指数和放疗指数<1的医院占比分别为83.7%和93.1%。化疗正常进行或推迟时间≤1周的医院占54.1%,放疗在春节假期后正常进行或延迟时间≤1周的医院占89.7%。疫情二级响应后,肿瘤科患者和放疗患者较一级响应后上升的医院占比分别为78.4%和79.3%。结论 在国务院、四川省委省政府、四川省卫健委、各地市级卫健委的指导下,各医疗机构和肿瘤科临床一线医护人员的共同努力下,COVID-19疫情期间大部分肿瘤患者在四川省各地市级医院得到积极有效的治疗。     

2019新型冠状病毒病(COVID-19)疫情期间放疗患者焦虑抑郁状况分析

目的 调查2019新型冠状病毒病(COVID-19)疫情期间肿瘤放疗患者焦虑及抑郁情况。方法 采用焦虑自评量表和抑郁自评量表,对COVID-19疫情期间 101例肿瘤放疗患者进行横断面调查。结果 COVID-19疫情期间肿瘤放疗患者焦虑和抑郁发生率分别为15.8%和27.7%,其中12.9%的患者同时患有焦虑和抑郁。焦虑总分平均值为49.4分(25~76分),抑郁总分平均值为46.4分(25~83分),均高于国内常模。年龄是影响焦虑的因素,居住在城市者更易出现焦虑和抑郁状态。结论 COVID-19疫情期间肿瘤放疗患者存在焦虑和抑郁心理,疫情因素会使上述情况加重,应关注上述患者心理健康,积极疏导,减轻疫情因素对患者产生的心理影响。     

2019新型冠状病毒病(COVID-19)疫情期间妇科恶性肿瘤放疗推荐

随着COVID-19疫情在全球范围内暴发,中国的疫情防控将呈长期化趋势。放疗作为妇科恶性肿瘤的主要治疗手段,在做好疫情防控的同时合理应用,可使患者做到“防疫”、“抗瘤”两不误。本推荐将国内防疫指南、国外防疫及妇科肿瘤治疗文献,与北京协和医院前期疫情期间妇科肿瘤放疗实践相结合,从疫情期间妇科肿瘤放疗原则、临床试验、MDT及学术活动方面,为国内放疗科、妇科放疗组在COVID-19疫情期间的妇科恶性肿瘤放疗工作的开展提供指导建议。     

2020年新疆地区放疗工作基本情况调查

目的 了解新疆地区放疗应用及教学科研开展基本情况。方法 采用统一的调查问卷,通过邮件、即时通讯软件及电话等方式进行问卷的发放与回收,对全区范围内所有放疗单位的基本情况进行统计。结果 问卷覆盖面100%,回收率100%。2020年全区范围内运行放疗单位共计17家,其中直线加速器23台、⁶⁰Co治疗机1台、伽马刀3台、后装治疗机6台,专用模拟定位机13台,治疗计划系统46套,放疗质控设备103套,全区估计百万人口放疗设备保有量约为0.84台。放疗人员共计359人,其中医师220人,物理师49人,技师90人。共计开放病床1270张,日均治疗量约人次。2016—2021年17家单位共承担国家自然科学基金9项,省部级项目49项;授予博士学位19人次、硕士87人次。参与《中华放射肿瘤学杂志》文章的发表共25篇,其中以第一作者和/或通信作者发表18篇。结论 近年来新疆地区放疗工作发展较快,但仍与全国平均水平存在一定差距,同时显示出全区地域差异性大、放疗资源及科研教学资源配置不均衡等问题,需要进一步改善。     

肿瘤专科医院放疗患者新冠疫情期间的防控管理CSCD

新冠肺炎(COVID-19)疫情对肿瘤患者的常规诊疗造成影响。由于肿瘤患者免疫力低,为病毒易感人群,且预后差,特别是放疗患者需每天往返于病房与放疗机房之间,增加了病毒的感染机会,应是疫情防治的重点对象。我院作为肿瘤专科医院,在疫情暴发期间,做到了防控与收治两不误。在医院感控办指导下,成立院级及科级防控小组,采取一系列防控管理措施,如标准化培训及物理空间区域的划分、规范收治及放疗流程、可跟踪式闭环管理及人文关怀等。我院处在中国疫情最为严重的武汉,放疗中心在接诊患者的2月内,做到了患者及工作人员零感染,有效地防范了新冠肺炎,确保了放疗患者的安全及正常治疗。     

“十四五”大型医用设备规划编制基础研究放射治疗组地区调查研究

目的 对中国内地放疗人员及设备现状进行调研,为“十四五”期间放疗设备科学配置和安全有效使用提供数据依据。方法 2020年10月至12月,中国医学装备协会组织专家组以线上问卷的形式开展中国内地放射治疗工作开展情况调研,调研内容包括2020年度全国放疗行业单位、专业人员、设备、技术、设备利用率、未来5年人员及设备增长预估等。数据经过各省级医学会/协会再次确认。结果 中国内地放疗单位1538家,从事放疗专业人员32978人,其中放疗医师18966人、物理师4475人、技术人员9537人;共有直线加速器2139台、⁶⁰Co机57台、近距离治疗机457台、质子重离子机6台、常规模拟机1034台、CT模拟机1208台、MR模拟机89台;能开展三维适形放疗单位1459家、固定野调强1256家、容积调强514家、近距离治疗422家;根据参与调研单位填报的预估数据汇总后,预估未来5年新增放疗医师4868人、物理师2078人、技术人员3796人;预估未来5年新增设备加速器994台、CT定位机896台、MR定位机313台、质子重离子机54台。结论 我国放疗行业发展迅速,在“十四五”期间,放疗行业还有强大的市场需求以及人员与设备增长的需求。增强国产放疗企业的市场竞争力,提高基层医院的设备利用率,提供完善系统的培训,促进标准化、规范化地临床应用等措施,有助于解决放疗资源欠缺、分布不均衡等问题,促进我国放疗事业健康快速发展。     

放疗科信息化管理平台建设及应用研究

目的 开发放疗科信息化管理平台,优化放疗流程,实现放疗流程管理信息化,提高医疗效率。方法 采用多元化数字化模板实现肿瘤治疗信息整合,以服务器配多终端模式组建放疗流程信息化管理平台,按照不同岗位设置工作权限,同时系统与放疗计划系统、医院信息系统以及医学影像的存储和传输系统等连接,实现放疗科信息采集、记录收费、信息传递以及计划评估与审核等操作信息化。结果 放疗科信息化管理平台能够优化放疗流程,解决放疗科内不同系统间缺乏联系、信息散乱的现状,同时实现了放疗科与医院多种信息信息平台的互联互通,规范了放疗流程,提高临床工作效率。结论 放疗科信息化管理平台的应用提高了放疗流程信息化管理水平,建立统一的肿瘤治疗流程规范,为临床医疗提供完善的流程及质控管理方案,在治疗流程管理、信息采集的系统化、质控等方面处于业内领先地位,具有独创性和前瞻性。     

中国六家肿瘤中心与欧美肿瘤中心放疗医师培养工作比较

目的:对比国内外优秀放疗中心肿瘤放疗专科医师培养经验,为中国肿瘤专科医院放疗基地医师培养体制提供改进的依据。方法:通过电子问卷邮件和在线调查,收取中国6家省级肿瘤专科医院和欧美5家肿瘤专科中心的住院医师及教师反馈,描述和比较培养模式。结果:中国26位住院医师和23位教师参与调查。国外20位住院医师和1位教师回答问卷,并...     

食管癌根治性调强放疗大体肿瘤体积因素与靶区内放疗失败的关系

目的 回顾性分析GTV-T因素与肿瘤局部失败的关系。方法 整理并计算133例行根治性调强放疗的食管癌患者GTV-T因素。包括:GTV-T体积,GTV-T最大管壁厚度(GTV-T区域中食管平面最大厚度),GTV-T体积/长度 (GTV-T体积除以GTV-T层面数计算病变长度)。结果 GTV-T区域治疗失败率与GTV-T体积呈正相关线性趋势关系。GTV-T肿瘤体积为36 cm³,最大管壁厚度为2.5 cm,以及体积/长度为5.3 cm²,可作为预估食管癌放疗失败风险的临界值。结论 根治性调强放疗大体肿瘤体积(GTV-T)因素能在一定程度上预示食管癌根治性放疗后局部控制情况,预估食管癌的放疗失败风险。     

早期乳腺癌保乳术后未行放疗原因调查与分析

目的 调查和分析乳腺癌保乳手术患者未进行术后放疗的原因。方法 对2012-2016年在本院保乳手术而未行术后辅助放疗的55例患者未接受放疗的临床病理特征和社会经济原因分析。结果 55例未放疗患者中25例因低的局部复发风险,12例因经济或家庭原因,12例恐惧放疗不良反应,5例基层医师未建议放疗。另外有多发远处转移3例,并发甲状腺癌3例未行放疗。结论 低的局部复发风险是未作术后放疗的主要原因,其次是患者担心放疗不良反应和经济原因。通过患者教育和医保可能提高术后放疗的依从性。     

An investigation report of radiotherapy centers in Beijing during the COVID-19 pandemic

Objective An investigation on the prevention and control measures taken by radiotherapy centers of various hospitals in Beijing during the COVID-19 pandemic was conducted. The experience was summarized to provide reference for further work. Methods Electronic questionnaires were distributed to each radiotherapy center through members of the radiation oncology therapeutics branch of Beijing medical association and members of Society of Radiotherapy Specialists (Technicians) of Beijing Medical Doctors Association. Statistical analysis was performed based on the feedback results of electronic questionnaires. Results All forty radiotherapy centers in Beijing returned the questionnaires by the end of April 10, 2020. Except for the suspension of treatment in one center due to COVID-19 pandemic, all radiotherapy centers have taken corresponding prevention and control measures and continued to carry out radiotherapy. No COVID-19 infection of patients or medical staffs occurred during this pandemic. Conclusions During the COVID-19 pandemic, all radiotherapy centers attach great importance to optimizing the clinical process and adopt reasonable prevention and control measures. On the basis of efficient prevention and control measures, radiotherapy is delivered to fulfill the treatment demands of cancer patients.     

新冠肺炎疫情下癌症早诊早治管理工作探讨

目的 了解新型冠状病毒肺炎疫情对于北京城市癌症早诊早治项目的影响,探索疫情防控常态化下相关工作的管理策略.方法 基于2018—2019年度北京城市癌症早诊早治项目,采用整群抽样方法,在北京市6个城区招募40～74岁北京市户籍居民进行癌症风险评估问卷调查,评估得到的高危人群于定点医院接受相关临床检查.其中,2018年度对...     

Reduced Fractionation in Lung Cancer Patients Treated with Curative-intent Radiotherapy during the COVID-19 Pandemic

Patients treated with curative-intent lung radiotherapy are in the group at highest risk of severe complications and death from COVID-19. There is therefore an urgent need to reduce the risks associated with multiple hospital visits and their anti-cancer treatment. One recommendation is to consider alternative dose-fractionation schedules or radiotherapy techniques. This would also increase radiotherapy service capacity for operable patients with stage I-III lung cancer, who might be unable to have surgery during the pandemic.Here we identify reduced-fractionation for curative-intent radiotherapy regimes in lung cancer, from a literature search carried out between 20/03/2020 and 30/03/2020 as well as published and unpublished audits of hypofractionated regimes from UK centres. Evidence, practical considerations and limitations are discussed for early-stage NSCLC, stage III NSCLC, early-stage and locally advanced SCLC. We recommend discussion of this guidance document with other specialist lung MDT members to disseminate the potential changes to radiotherapy practices that could be made to reduce pressure on other departments such as thoracic surgery. It is also a crucial part of the consent process to ensure that the risks and benefits of undergoing cancer treatment during the COVID-19 pandemic and the uncertainties surrounding toxicity from reduced fractionation have been adequately discussed with patients. Furthermore, centres should document all deviations from standard protocols, and we urge all colleagues, where possible, to join national/international data collection initiatives (such as COVID-RT Lung) aimed at recording the impact of the COVID-19 pandemic on lung cancer treatment and outcomes.     

The Impact of COVID-19 on the Diagnosis and Treatment of Lung Cancer at a Canadian Academic Center: A Retrospective Chart Review

The large burden of COVID-19 on health care systems worldwide has raised concerns among medical oncologists about the impact of COVID-19 on the diagnosis and treatment of lung cancer patients. In this retrospective cohort study, we investigated the impact of COVID-19 on lung cancer diagnosis and treatment before and during the COVID-19 era. New lung cancer diagnoses decreased by 34.7% during the pandemic with slightly more advanced stages of disease, there was a significant increase in the utilization of radiosurgery as the first definitive treatment, and a decrease in both systemic treatment as well as surgery compared to the pre-COVID-19 era. There was no significant delay in starting chemotherapy and radiation treatment during the pandemic compared to pre-COVID-19 time. However, we observed a delay to lung cancer surgery during the pandemic time. COVID-19 seems to have had a major impact at our lung cancer center on the diagnoses and treatment patterns of lung cancer patients. Many oncologists fear that they will see an increase in newly diagnosed lung cancer patients in the coming year. This study is still ongoing and further data will be collected and analyzed to better understand the total impact of the COVID-19 pandemic on our lung cancer patient population.     

头颈部肿瘤大分割放疗的研究进展及在新冠疫情中的临床价值

放疗是头颈部肿瘤综合治疗的重要部分,也是根治性手段之一。2019年新型冠状病毒肺炎疫情暴发持续至今,对肿瘤患者的治疗造成很大影响。由于常规分割放疗(2 Gy/次)往往需要6周以上连续照射,给疫情防控带来巨大挑战。大分割放疗增加单次剂量,从而减少照射次数,缩短治疗时间,可能较常规分割更适用于疫情期间的治疗。早期研究对大分割方案在头颈部肿瘤姑息治疗中的应用已有诸多探索,其安全性和有效性已得到部分确认。近期,以根治性为目的的大分割放疗及联合化疗、免疫治疗的综合治疗方案也有初步的尝试。根据疫情防控需要,国外多个专家共识也对头颈部肿瘤大分割方案进行了推荐。本文就上述进展做一综述,并讨论疫情期间实施大分割放疗的临床价值。     

Cancer diagnosis in Brazil in the COVID-19 era

The comprehensive care and treatment for cancer patients in Brazil, regulated by the National Cancer Prevention and Control Policy, is provided by Brazilian Unified Healthcare System (SUS) in certified health institution. Due the COVID-19 pandemic, several restrictive measures have been implemented by the State federation's governments, and cancer diagnosis reference centers were also impacted by these measures. Thus, this study aimed to compare SUS-oriented cancer diagnosis in Brazil before and during the pandemic so far. The average number of cancer diagnoses has dropped considerably in all Brazilian Regions since the pandemic period started. The number of new cancer cases has plunged in all regions, ranged from −24.3% in the North to −42.7% in Northeast region. The overall Brazilian average deficit reached 35.5%, corresponding to about 15,000 undiagnosed cases of cancer monthly. The pandemic period has dramatically reduced the diagnosis of new cases of cancer in Brazil, since consultations in public health services were compromised by restrictive measures. Therefore, effective measures must be urgently put in action in order to minimize the damage, and consequently, the negative health impacts caused by the COVID-19 pandemic in the care of cancer patients.     

Genitourinary Medical Oncology Expert Opinion Survey Regarding Treatment Management in the COVID-19 Pandemic

BackgroundThe worldwide Coronavirus disease 2019 (COVID-19) public health pandemic has restructured clinical care of patients with cancer throughout the world. The specific changes in the management of genitourinary (GU) cancers in different cancer centers owing to COVID-19 are not known, and some clinical scenarios remain controversial. We conducted an opinion survey to determine what changes in cancer treatment strategies are occurring owing to the COVID-19 pandemic.Materials and MethodsA 20-item online survey was sent on May 25, 2020 to 170 expert GU medical oncologists from Europe and North America. The survey solicited responses to changes in GU cancer management in the setting of the COVID-19 pandemic. Data was collected and managed via a secure REDCap Database.ResultsSurveys were completed by 78 (45.8%) of 170 GU oncologists between May 25, 2020 and June 25, 2020. Clinical practice changes owing to COVID-19 in at least one scenario were reported by 79.1% of responders, most pronounced in prostate cancer (71.8%) and least pronounced in urothelial cancer (23%). Preferences for change in management varied by country, with 78% (37/47) of United States oncologists indicating a change in their practice, 57% (4/7) of Canadian oncologists, and 79% (19/24) of European oncologists.ConclusionsThis study suggests international practice changes are occurring in GU cancer care during the COVID-19 pandemic. The variability in practice changes between countries may reflect differences in COVID-19 case load during the time point of data collection. These results, based on expert opinion during this rapidly changing crisis, may inform the oncologic community regarding the effects of COVID-19 on GU cancer care.