呼吸道传染病——新型冠状病毒肺炎流行期间晚期非小细胞肺癌患者诊疗专家指引(试行)

新型冠状病毒肺炎(COVID-19)仍在蔓延,疫情防控任务任重而道远。结合当前疫情,考虑晚期肺癌患者的特殊性,我们对中华医学会呼吸病学分会肺癌学组、CSCO青委肺癌组、中国呼吸肿瘤协作组委员等进行网络问卷调查,共收到来自全国各地专家有效问卷321份。结合国内外肺癌相关指南与本次问卷结果,制订本指引(试行)。对于目前新冠肺炎疫情期间,晚期非小细胞肺癌(non-small cell lung cancer,NSCLC)患者管理、抗肿瘤药物使用的策略、具体注意事项、药物不良反应与新冠肺炎疑诊患者的鉴别诊断要点等方面给予了建议和推荐。建议就近就医、门诊诊疗为主;因病情需要住院患者,应排除合并新型冠状病毒感染后方能住院进行抗肿瘤治疗;建议重视COVID-19相关症状与肿瘤本身或治疗导致的不良反应的鉴别;重视防护和合并感染者的救治;可根据个人情况适当推迟返院时间;同时需针对不同类型NSCLC患者选择不同的诊疗策略,平衡药物疗效与毒性。

Expert recommendations on the management of patients with advanced non-small cell lung cancer during epidemic of coronavirus disease 2019(Trial version)

The outbreak of coronavirus disease 2019(COVID-19)has become a public health emergency of major international concern.Given the systemic immunosuppressive state caused by malignancy and anticancer treatments,patients with advanced lung cancer may be at a higher risk of COVID-19 infection.During epidemic of COVID-19,a guideline for the optimal management of patients with advanced lung cancer urgently needs to be proposed to distinguish the symptoms of COVID-19 and the side effects of antitumor drugs.This network questionnaire survey was conducted on the lung cancer group of the Chinese Thoracic Society,Chinese Medical Association;the lung cancer group of the Chinese Society of Clinical Oncology Youth Committee;and the Chinese Respiratory Oncology Collaboration.321 valid questionnaires were received.Based on the guidelines on lung cancer and the results of the questionnaires,a consensus was reached.During the epidemic of COVID-19,We recommended that patients with advanced NSCLC should be treated as outpatients as possible at the nearest medical center;Patients who need to be hospitalized for antitumor treatment should be excluded from COVID-19 infection;More intensive attention should be paid to identification of COVID-19-related symptoms and adverse reactions caused by the malignancy or antitumor treatments.Stronger personal protection should be made for advanced NSCLC patients;An intentional postponing of antitumor treatment should be considered according to patient performance status.Treatment strategies should be made according to different types of advanced NSCLC patients and efficacy and toxicity of drugs.