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1.
Cancer Invest ; 39(4): 315-320, 2021 Apr.
Article in English | MEDLINE | ID: covidwho-1132232

ABSTRACT

Outcomes for patients (pts) with sarcoma and COVID-19 are unknown. This is a single institution retrospective study of adults with sarcoma and COVID-19. Ten pts [median age 60 (range 24-69)] were identified. Five were hospitalized; two died from COVID-19 complications; another died from sarcoma. Time between last systemic treatment dose and COVID-19 diagnosis was 6-41 days in pts who died. 5 underwent prior radiation (RT); time between RT and COVID-19 diagnosis was 20-62 days for pts who died. All three pts with WBC differential data (two died) were lymphopenic. Efforts to capture outcomes for a larger cohort are urgently needed.


Subject(s)
COVID-19/prevention & control , SARS-CoV-2/isolation & purification , Sarcoma/therapy , Soft Tissue Neoplasms/therapy , Adult , Aged , COVID-19/complications , COVID-19/virology , COVID-19 Testing/methods , Chemoradiotherapy/methods , Female , Humans , Male , Middle Aged , Outcome Assessment, Health Care/methods , Outcome Assessment, Health Care/statistics & numerical data , Retrospective Studies , Risk Factors , SARS-CoV-2/physiology , Sarcoma/complications , Sarcoma/surgery , Soft Tissue Neoplasms/complications , Soft Tissue Neoplasms/surgery , Survival Analysis , Young Adult
2.
BMJ Case Rep ; 13(12)2020 Dec 17.
Article in English | MEDLINE | ID: covidwho-1020885

ABSTRACT

A 67-year-old man presented to his general practitioner with intermittent episodes of unilateral sciatica over a 2-month period for which he was referred for an outpatient MRI of his spine. This evidenced a significant lumbar vertebral mass that showed tight canal stenosis and compression of the cauda equina. The patient was sent to the emergency department for management by orthopaedic surgeons. He was mobilising independently, pain free on arrival and without neurological deficit on assessment. Clinically, this patient presented with no red flag symptoms of cauda equina syndrome or reason to suspect malignancy. In these circumstances, National Institute for Health and Care Excellence guidelines do not support radiological investigation of the spine outside of specialist services. However, in this case, investigation helped deliver urgent care for cancer that otherwise may have been delayed. This leads to the question, do the current guidelines meet clinical requirements?


Subject(s)
Adenocarcinoma/diagnosis , Cauda Equina Syndrome/diagnosis , Prostatic Neoplasms/diagnosis , Spinal Neoplasms/complications , Spinal Stenosis/diagnosis , Adenocarcinoma/complications , Adenocarcinoma/secondary , Adenocarcinoma/therapy , Aged , Cauda Equina/diagnostic imaging , Cauda Equina Syndrome/blood , Cauda Equina Syndrome/etiology , Cauda Equina Syndrome/therapy , Chemoradiotherapy/methods , Humans , Image-Guided Biopsy , Kallikreins/blood , Lumbar Vertebrae/diagnostic imaging , Lumbar Vertebrae/pathology , Magnetic Resonance Imaging , Male , Palliative Care/methods , Prostate/diagnostic imaging , Prostate/pathology , Prostate-Specific Antigen/blood , Prostatic Neoplasms/blood , Prostatic Neoplasms/pathology , Prostatic Neoplasms/therapy , Spinal Neoplasms/blood , Spinal Neoplasms/diagnosis , Spinal Neoplasms/secondary , Spinal Stenosis/etiology , Spinal Stenosis/therapy , Ultrasonography, Interventional
3.
Oral Oncol ; 113: 105112, 2021 02.
Article in English | MEDLINE | ID: covidwho-971842

ABSTRACT

There has been increased interest in hypofractionated accelerated chemoradiation for head and neck cancer during the recent first peak of the COVID-19 pandemic. Prospective data regarding this approach from randomised trials is lacking. In the PET NECK study, 564 patients with squamous cell carcinoma of the head and neck receiving definitive chemoradiation were randomised to either planned neck dissection or PET CT scan guided surveillance. In this surgical trial, three radiotherapy fractionation schedules delivered over 7, 6 or 4 weeks were permitted with synchronous chemotherapy. The purpose of this study was to determine efficacy and quality of life outcomes associated with the use of these schedules. Primary local control and overall survival in addition to quality of life measures at immediately post treatment and 6, 12 and 24 months post-treatment were compared between the three fractionation cohorts. In the 525 patients where fractionation data was available, 181 (34%), 288 (55%) and 56 (11%) patients received 68-70 Gy in 34-35 fractions (#), 60-66 Gy in 30# and 55 Gy in 20# respectively. At a minimum follow up of two years following treatment there was no significant difference between the three fractionation schemes in local control, overall survival or any quality of life measure. Despite the obvious limitations of this study, some data is provided to support the use of hypofractionated accelerated chemoradiation to avoid delays in cancer treatment and reduce hospital visits during the peak of a pandemic. Data from on-going randomised trials examining hypofractionated chemoradiation may be useful for selecting fractionation schedules during future pandemics.


Subject(s)
COVID-19/epidemiology , Carcinoma, Squamous Cell/therapy , Chemoradiotherapy/methods , Head and Neck Neoplasms/therapy , Pandemics , Radiation Dose Hypofractionation , SARS-CoV-2 , Aged , COVID-19/virology , Female , Follow-Up Studies , Humans , Male , Middle Aged , Neck Dissection , Positron Emission Tomography Computed Tomography , Quality of Life , Treatment Outcome
4.
ESMO Open ; 5(5): e000885, 2020 09.
Article in English | MEDLINE | ID: covidwho-788178

ABSTRACT

BACKGROUND: Immunosuppression induced by anticancer therapy in a COVID-19-positive asymptomatic patient with cancer may have a devastating effect and, eventually, be lethal. To identify asymptomatic cases among patients receiving active cancer treatment, the Federico II University Hospital in Naples performs rapid serological tests in addition to hospital standard clinical triage for COVID-19 infection. METHODS: From 6 to 17 April 2020, all candidates for chemotherapy, radiotherapy or target/immunotherapy, if negative at the standard clinical triage on the day scheduled for anticancer treatment, received a rapid serological test on peripheral blood for COVID-19 IgM and IgG detection. In case of COVID-19 IgM and/or IgG positivity, patients underwent a real-time PCR (RT-PCR) SARS-CoV-2 test to confirm infection, and active cancer treatment was delayed. RESULTS: Overall 466 patients, negative for COVID-19 symptoms, underwent serological testing in addition to standard clinical triage. The average age was 61 years (range 25-88 years). Most patients (190, 40.8%) had breast cancer, and chemotherapy with or without immunotherapy was administered in 323 (69.3%) patients. Overall 433 (92.9%) patients were IgG-negative and IgM-negative, and 33 (7.1%) were IgM-positive and/or IgG-positive. Among the latter patients, 18 (3.9%), 11 (2.4%) and 4 (0.9%) were IgM-negative/IgG-positive, IgM-positive/IgG-negative and IgM-positive/IgG-positive, respectively. All 33 patients with a positive serological test, tested negative for RT-PCR SARS-CoV-2 test. No patient in our cohort developed symptoms suggestive of active COVID-19 infection. CONCLUSION: Rapid serological testing at hospital admission failed to detect active asymptomatic COVID-19 infection. Moreover, it entailed additional economic and human resources, delayed therapy administrationand increased hospital accesses.


Subject(s)
Asymptomatic Infections , Clinical Laboratory Techniques/methods , Coronavirus Infections/diagnosis , Neoplasms/therapy , Pneumonia, Viral/diagnosis , Triage/standards , Adult , Aged , Aged, 80 and over , Antibodies, Viral/blood , Antibodies, Viral/immunology , Antineoplastic Agents, Immunological/adverse effects , Betacoronavirus/genetics , Betacoronavirus/immunology , Betacoronavirus/isolation & purification , COVID-19 , COVID-19 Testing , COVID-19 Vaccines , Chemoradiotherapy/adverse effects , Chemoradiotherapy/methods , Clinical Laboratory Techniques/economics , Clinical Laboratory Techniques/statistics & numerical data , Coronavirus Infections/blood , Coronavirus Infections/economics , Coronavirus Infections/immunology , Coronavirus Infections/virology , Diagnostic Tests, Routine/economics , Diagnostic Tests, Routine/statistics & numerical data , Feasibility Studies , Female , Humans , Male , Middle Aged , Neoplasms/immunology , Pandemics , Patient Admission/economics , Patient Admission/statistics & numerical data , Pneumonia, Viral/blood , Pneumonia, Viral/immunology , Pneumonia, Viral/virology , Practice Guidelines as Topic , RNA, Viral/isolation & purification , Reverse Transcriptase Polymerase Chain Reaction/economics , Reverse Transcriptase Polymerase Chain Reaction/statistics & numerical data , SARS-CoV-2 , Sensitivity and Specificity
8.
Respir Med Res ; 78: 100769, 2020 Nov.
Article in English | MEDLINE | ID: covidwho-343140

ABSTRACT

The objective of this document is to formalize a degraded mode management for patients with thoracic cancers in the context of the COVID-19 pandemic. The proposals are based on those of the French High Council for Public Health, on published data outside the context of COVID-19, and on a concerted analysis of the risk-benefit ratio for our patients by a panel of experts specialized on thoracic oncology under the aegis of the French-Language Society of Pulmonology (SPLF)/French-language oncology group. These proposals are evolving (10 April 2020) according to the situations encountered, which will enrich it, and are to be adapted to our institutional organisations and to the evolution of resources during the COVID-19 epidemic. Patients with symptoms and/or COVID-19+ are not discussed in this document and are managed within the framework of specific channels.


Subject(s)
COVID-19/epidemiology , COVID-19/prevention & control , Pandemics , Thoracic Neoplasms/therapy , Antineoplastic Agents/therapeutic use , COVID-19/complications , Chemoradiotherapy/methods , Chemoradiotherapy/standards , Clinical Trials as Topic/methods , Clinical Trials as Topic/organization & administration , Clinical Trials as Topic/standards , Humans , Mutation , Neoadjuvant Therapy/methods , Neoadjuvant Therapy/standards , Neoplasm Metastasis , Pulmonary Medicine/methods , Pulmonary Medicine/organization & administration , Pulmonary Medicine/standards , Risk Factors , Risk Reduction Behavior , SARS-CoV-2 , Thoracic Neoplasms/epidemiology , Thoracic Neoplasms/genetics , Thoracic Neoplasms/pathology , Thoracic Surgical Procedures/methods , Thoracic Surgical Procedures/standards
9.
J Am Acad Dermatol ; 83(2): 703-704, 2020 Aug.
Article in English | MEDLINE | ID: covidwho-92098
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