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1.
Tuberk Toraks ; 69(4): 499-509, 2021 Dec.
Article in English | MEDLINE | ID: covidwho-1594579

ABSTRACT

Introduction: One of the patient groups adversely affected during the COVID19 pandemic is those suffering with cancer. The aim of this study was to evaluate the clinical characteristics and outcomes of lung cancer (LC) patients with COVID-19. Materials and Methods: Three thousand seven-hundred and fifty hospitalized patients with a presumptive diagnosis of COVID-19 in a tertiary referral hospital between March 2020-February 2021 were retrospectively evaluated. Among them, 36 hospitalized COVID-19 patients with a history of primary LC were included in the study. Univariate and multivariate analyses were carried out to assess the risk factors associated with severe disease. Result: Of the 36 patients included in the study, 28 (77%) were males and 8 (23%) were females. Median age was 67 years (min-max: 53-81 years). Six patients (17%) had a diagnosis of small cell LC, whereas 30 patients (83%) had a diagnosis of non-small cell LC. The most common symptoms were fever (n= 28, 77%), coughing and myalgia (n= 21, 58%) and dyspnea (n= 18, 50%). The most common radiological finding was ground glass opacity (GGO) (n= 30), of which 13 was bilateral and 17 was unilateral in distribution. Nearly 30% (n= 11) of LC patients with COVID-19 developed severe disease, 5% (n= 2) of the 36 patients were admitted to intensive care unit and all of these patients eventually expired. LC patients with COVID-19 and patchy consolidation on computed tomography of thorax (Th CT) on admission had a higher risk of developing severe disease in univariate (HR 2.41, 95%CI: 1.4- 4.4, p= 0.04) and multivariate Cox regression analysis (HR 0.48, 95%CI: 0.24-0.97, p= 0.03). Conclusions: Clinical characteristics, laboratory and radiographic findings were similar in LC patients with COVID-19 when compared with the general population, LC patients have a higher mortality rate than the general population, with a 5% mortality rate in our series. Our findings suggest that LC may be a risk factor associated with the prognosis of COVID-19 patients.


Subject(s)
COVID-19 , Carcinoma, Non-Small-Cell Lung , Lung Neoplasms , Aged , Female , Humans , Lung , Lung Neoplasms/diagnostic imaging , Lung Neoplasms/epidemiology , Male , Retrospective Studies , SARS-CoV-2
3.
Comput Med Imaging Graph ; 92: 101957, 2021 09.
Article in English | MEDLINE | ID: covidwho-1330724

ABSTRACT

Lung cancer is one of the most common and deadly malignant cancers. Accurate lung tumor segmentation from CT is therefore very important for correct diagnosis and treatment planning. The automated lung tumor segmentation is challenging due to the high variance in appearance and shape of the targeting tumors. To overcome the challenge, we present an effective 3D U-Net equipped with ResNet architecture and a two-pathway deep supervision mechanism to increase the network's capacity for learning richer representations of lung tumors from global and local perspectives. Extensive experiments on two real medical datasets: the lung CT dataset from Liaoning Cancer Hospital in China with 220 cases and the public dataset of TCIA with 422 cases. Our experiments demonstrate that our model achieves an average dice score (0.675), sensitivity (0.731) and F1-score (0.682) on the dataset from Liaoning Cancer Hospital, and an average dice score (0.691), sensitivity (0.746) and F1-score (0.724) on the TCIA dataset, respectively. The results demonstrate that the proposed 3D MSDS-UNet outperforms the state-of-the-art segmentation models for segmenting all scales of tumors, especially for small tumors. Moreover, we evaluated our proposed MSDS-UNet on another challenging volumetric medical image segmentation task: COVID-19 lung infection segmentation, which shows consistent improvement in the segmentation performance.


Subject(s)
COVID-19/diagnostic imaging , Imaging, Three-Dimensional , Lung Neoplasms/diagnostic imaging , Pneumonia, Viral/diagnostic imaging , Radiographic Image Interpretation, Computer-Assisted/methods , Supervised Machine Learning , Tomography, X-Ray Computed , China , Humans , Pneumonia, Viral/virology , SARS-CoV-2
5.
J Thorac Oncol ; 16(11): 1946-1951, 2021 11.
Article in English | MEDLINE | ID: covidwho-1316566

ABSTRACT

INTRODUCTION: Screening for coronavirus disease 2019 (COVID-19) exposure, coupled with engaged decision making to prioritize cancer treatment in parallel with reducing risk of exposure and infection, is crucial in the management of COVID-19 during cancer treatment. After two reported case studies of imaging findings during daily computed tomography (CT)-based image-guided radiotherapy (RT) scans, a call for submission of anonymized case reports was published with the objective of rapidly determining if there was a correlation between the onset of new pulmonary infiltrates found during RT and COVID-19. We hereby report the results of the aggregate analysis. METHODS: Data of deidentified case reports for patients who developed biochemically confirmed COVID-19 during RT were submitted through an online portal. Information requested included a patient's sex, age, cancer diagnosis and treatment, and COVID-19 diagnosis and outcome. Coplanar CT-based imaging was requested to reveal the presence or absence of ground-glass opacities or infiltrates. RESULTS: A total of seven reports were submitted from Turkey, Spain, Belgium, Egypt, and the United States. Results and imaging from the patients reported by Suppli et al. and McGinnis et al. were included for a total of nine patients for analysis. All patients were confirmed COVID-19 positive using polymerase chain reaction-based methods or nasopharyngeal swabs. Of the nine patients analyzed, abnormalities consistent with ground-glass opacities or infiltrates were observed in eight patients. CONCLUSIONS: This is the largest case series revealing the potential use of CT-based image guidance during RT as a tool for identifying patients who need further workup for COVID-19. Considerations for reviewing image guidance for new pulmonary infiltrates and immediate COVID-19 testing in patients who develop new infiltrates even without COVID-19 symptoms are strongly encouraged.


Subject(s)
COVID-19 , Lung Neoplasms , COVID-19 Testing , Humans , Lung , Lung Neoplasms/diagnostic imaging , Lung Neoplasms/radiotherapy , SARS-CoV-2 , Tomography, X-Ray Computed
6.
Oncology (Williston Park) ; 34(9): 370-376, 2020 09 15.
Article in English | MEDLINE | ID: covidwho-1231670

ABSTRACT

In an asymptomatic 77-yearold woman, former 55 packyears smoker, a routine X-ray showed a 45-mm superior left lobe lesion. A chest CT scan confirmed a 36-mm superior left lobe lesion and an aortic-pulmonary lymph node enlargement measuring 42 mm, suspicious for neoplasia. A PET-CT scan showed an elevated uptake in the primary lesion, in the aortic-pulmonary lymph node, and in the left hilar lymph node with a standardized uptake value - 40 and 4.3, respectively. CT-guided lung biopsy showed a lung squamous cell carcinoma. An endobronchial ultrasound-guided transbronchial needle aspiration for lymph-node staging was negative for lymph node spread. Brain MRI was negative. Final staging was determined to be a IIIA (T2bN2) squamous cell carcinoma of the lung.


Subject(s)
Antibodies, Monoclonal/therapeutic use , Antineoplastic Agents, Immunological/therapeutic use , Carcinoma, Squamous Cell/therapy , Coronavirus Infections/diagnosis , Lung Neoplasms/therapy , Pneumonia, Viral/diagnosis , Pneumonia/diagnosis , Aged , Antibodies, Monoclonal/adverse effects , Antineoplastic Agents, Immunological/adverse effects , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Betacoronavirus , COVID-19 , Carboplatin/administration & dosage , Carcinoma, Squamous Cell/diagnostic imaging , Chemoradiotherapy , Consolidation Chemotherapy , Diagnosis, Differential , Female , Humans , Lung/diagnostic imaging , Lung Neoplasms/diagnostic imaging , Paclitaxel/administration & dosage , Pandemics , Pneumonia/chemically induced , SARS-CoV-2
8.
Radiol Imaging Cancer ; 2(3): e204013, 2020 05.
Article in English | MEDLINE | ID: covidwho-1155959

ABSTRACT

Background: The risks from potential exposure to coronavirus disease 2019 (COVID-19), and resource reallocation that has occurred to combat the pandemic, have altered the balance of benefits and harms that informed current (pre-COVID-19) guideline recommendations for lung cancer screening and lung nodule evaluation. Consensus statements were developed to guide clinicians managing lung cancer screening programs and patients with lung nodules during the COVID-19 pandemic. Materials and Methods: An expert panel of 24 members, including pulmonologists (n = 17), thoracic radiologists (n = 5), and thoracic surgeons (n = 2), was formed. The panel was provided with an overview of current evidence, summarized by recent guidelines related to lung cancer screening and lung nodule evaluation. The panel was convened by video teleconference to discuss and then vote on statements related to 12 common clinical scenarios. A predefined threshold of 70% of panel members voting agree or strongly agree was used to determine if there was a consensus for each statement. Items that may influence decisions were listed as notes to be considered for each scenario. Results: Twelve statements related to baseline and annual lung cancer screening (n = 2), surveillance of a previously detected lung nodule (n = 5), evaluation of intermediate and high-risk lung nodules (n = 4), and management of clinical stage I non-small cell lung cancer (n = 1) were developed and modified. All 12 statements were confirmed as consensus statements according to the voting results. The consensus statements provide guidance about situations in which it was believed to be appropriate to delay screening, defer surveillance imaging of lung nodules, and minimize nonurgent interventions during the evaluation of lung nodules and stage I non-small cell lung cancer. Conclusion: There was consensus that during the COVID-19 pandemic, it is appropriate to defer enrollment in lung cancer screening and modify the evaluation of lung nodules due to the added risks from potential exposure and the need for resource reallocation. There are multiple local, regional, and patient-related factors that should be considered when applying these statements to individual patient care.© 2020 RSNA; The American College of Chest Physicians, published by Elsevier Inc; and The American College of Radiology, published by Elsevier Inc.


Subject(s)
COVID-19/prevention & control , Diagnostic Imaging/methods , Lung Neoplasms/diagnostic imaging , Humans , Lung/diagnostic imaging , Pandemics , SARS-CoV-2
9.
Comput Biol Med ; 132: 104348, 2021 05.
Article in English | MEDLINE | ID: covidwho-1141688

ABSTRACT

Corona Virus Disease (COVID-19) has been announced as a pandemic and is spreading rapidly throughout the world. Early detection of COVID-19 may protect many infected people. Unfortunately, COVID-19 can be mistakenly diagnosed as pneumonia or lung cancer, which with fast spread in the chest cells, can lead to patient death. The most commonly used diagnosis methods for these three diseases are chest X-ray and computed tomography (CT) images. In this paper, a multi-classification deep learning model for diagnosing COVID-19, pneumonia, and lung cancer from a combination of chest x-ray and CT images is proposed. This combination has been used because chest X-ray is less powerful in the early stages of the disease, while a CT scan of the chest is useful even before symptoms appear, and CT can precisely detect the abnormal features that are identified in images. In addition, using these two types of images will increase the dataset size, which will increase the classification accuracy. To the best of our knowledge, no other deep learning model choosing between these diseases is found in the literature. In the present work, the performance of four architectures are considered, namely: VGG19-CNN, ResNet152V2, ResNet152V2 + Gated Recurrent Unit (GRU), and ResNet152V2 + Bidirectional GRU (Bi-GRU). A comprehensive evaluation of different deep learning architectures is provided using public digital chest x-ray and CT datasets with four classes (i.e., Normal, COVID-19, Pneumonia, and Lung cancer). From the results of the experiments, it was found that the VGG19 +CNN model outperforms the three other proposed models. The VGG19+CNN model achieved 98.05% accuracy (ACC), 98.05% recall, 98.43% precision, 99.5% specificity (SPC), 99.3% negative predictive value (NPV), 98.24% F1 score, 97.7% Matthew's correlation coefficient (MCC), and 99.66% area under the curve (AUC) based on X-ray and CT images.


Subject(s)
COVID-19 , Deep Learning , Lung Neoplasms , Pneumonia , Algorithms , Early Detection of Cancer , Humans , Lung Neoplasms/diagnostic imaging , Pneumonia/diagnostic imaging , SARS-CoV-2
10.
Int J Radiat Oncol Biol Phys ; 110(4): 957-961, 2021 07 15.
Article in English | MEDLINE | ID: covidwho-1116868

ABSTRACT

Radiation recall phenomenon (RRP) is an uncommon, late occurring, acute inflammatory skin reaction that emerges in localized areas coincident with previously irradiated radiation therapy (RT) treatment fields. RRP has been known to be triggered by a number of chemotherapy agents. To the best of our knowledge, this report is the first description of RRP after administration of the Pfizer-BioNTech vaccine for COVID-19, or any other currently available vaccine against COVID-19. Acute skin reactions were observed in 2 RT patients with differing timelines of RT and vaccinations. In both cases however, the RRP presented within days of the patient receiving the second dose of vaccine. For each RT course, the treatment planning dosimetry of the radiation fields was compared with the area of the observable RRP. RRP developed within the borders of treatment fields where prescription dose constraints were prioritized over skin sparing. Our observation is currently limited to 2 patients. The actual incidence of RRP in conjunction with Pfizer-BioNTech vaccine or any other vaccine against COVID-19 is unknown. For patients with cancer being treated with radiation with significant dose to skin, consideration should be given to the probability of RRP side effects from vaccinations against COVID-19.


Subject(s)
COVID-19 Vaccines/adverse effects , Immunization, Secondary/adverse effects , Lung Neoplasms/radiotherapy , Radiodermatitis/etiology , Sarcoma/radiotherapy , Skin Neoplasms/radiotherapy , Aged , COVID-19 Vaccines/administration & dosage , Humans , Immunization Schedule , Lung Neoplasms/diagnostic imaging , Male , Middle Aged , Radiodermatitis/pathology , Radiosurgery/methods , Sarcoma/diagnostic imaging , Skin Neoplasms/diagnostic imaging , Spinal Cord Compression/surgery , Thoracic Wall
11.
Curr Oncol ; 28(1): 940-949, 2021 02 18.
Article in English | MEDLINE | ID: covidwho-1094234

ABSTRACT

BACKGROUND: COVID-19 has invariably changed the way lung cancer surgical care is provided in Canada. Despite relevant management guidelines, the way in which cancer care has been affected has yet to be described for thoracic surgical populations. Routine lung cancer physiologic and staging assessments are unique in that they are droplet producing and aerosolizing procedures. Our objective was to quantify the effect of the COVID-19 pandemic on surgical lung cancer care as perceived by practicing thoracic surgeons during the first wave of the pandemic in Canada. METHODS: An electronic survey was distributed to members of the Canadian Association of Thoracic Surgeons. The survey was designed to determine surgeon perception of lung cancer preoperative care during the Canadian pandemic-instilled period of resource reallocation compared to standard care. Planned analyses were exploratory in nature; with count and frequency distributions of responses quantified. RESULTS: Fifty-three thoracic surgeons completed the survey. Responses were collected from all Canadian provinces. Little change in access to preoperative imaging was noted. However, a significant decrease in access to lung function and bronchoscopy testing occurred. Pulmonary surgery was perceived to be lengthier with reduced operating theater availability. Despite decreased OR access, only 40% of surgeons were aware of respective institutional mitigation strategies. SUMMARY: The COVID-19 pandemic has had an impact on standard lung cancer care preoperative workup. Further inquiry using institutional data is warranted to quantify its impact on cancer patient outcomes. Assessing the extent and effects of newly present barriers to standard lung cancer care is essential in forming appropriate mitigation strategies and planning for future pandemic waves.


Subject(s)
COVID-19 , Lung Neoplasms/surgery , Preoperative Care/methods , Bronchoscopy , Canada , Humans , Lung Neoplasms/diagnostic imaging , Operating Rooms , Operative Time , Surveys and Questionnaires , Thoracic Surgical Procedures
13.
Clin Oncol (R Coll Radiol) ; 33(5): 283-291, 2021 05.
Article in English | MEDLINE | ID: covidwho-978251

ABSTRACT

AIMS: To report long-term outcomes of patients treated with stereotactic ablative radiotherapy (SABR) for early stage, peripherally located non-small cell lung cancer. MATERIALS AND METHODS: Data were collected retrospectively between September 2009 and May 2019. Electronic medical records were reviewed for baseline characteristics, treatment details and outcomes. All patients were treated according to local protocol based on the national UK SABR Consortium guidelines. Risk-adapted treatment schedules were used depending on the size and the location of the tumour (54 Gy in three fractions, 55 Gy in five fractions, 60 Gy in eight fractions or 50 Gy in 10 fractions). Overall survival outcomes were evaluated using the Kaplan-Meier method. RESULTS: In total, 412 patients were included in the analysis. The median age was 76 years (range 48-93 years). Histological confirmation was obtained in 233 cases (56.6%). The median overall survival for all patients was 42.3 months (95% confidence interval 37.3-47.3 months), with 3- and 5-year overall survival of 52.8% and 37.3%, respectively. For biopsy-proven patients (56.6%), 3- and 5-year overall survival was 57.3% and 40.1%, respectively. With respect to overall survival, univariate and multivariate analysis revealed no significant difference in survival by technique (volume-modulated arc therapy versus conformal; three-dimensional computed tomography versus four-dimensional computed tomography), tumour location, smoking status at first contact, pre-treatment tumour stage or pre-treatment standardised uptake value. Survival was poorer for patients who received the 50 Gy in 10 fractions schedule. Treatment was very well tolerated with very low rates of grade 3-4 toxicity (1%). CONCLUSIONS: SABR for peripherally located, medically inoperable non-small cell lung cancer can be safely and effectively implemented in a non-academic institution with appropriate equipment and training. Overall survival outcomes and toxicity rates are comparable with internationally published studies. Patients treated with 50 Gy in 10 fractions had a poorer survival outcome.


Subject(s)
Carcinoma, Non-Small-Cell Lung/mortality , Lung Neoplasms/mortality , Radiosurgery/mortality , Aged , Aged, 80 and over , Cancer Care Facilities , Carcinoma, Non-Small-Cell Lung/diagnostic imaging , Carcinoma, Non-Small-Cell Lung/pathology , Carcinoma, Non-Small-Cell Lung/surgery , Female , Four-Dimensional Computed Tomography , Humans , Lung Neoplasms/diagnostic imaging , Lung Neoplasms/pathology , Lung Neoplasms/surgery , Male , Middle Aged , Neoplasm Staging , Radiosurgery/methods , Retrospective Studies , Survival Rate
16.
Ann Palliat Med ; 9(5): 3373-3378, 2020 Sep.
Article in English | MEDLINE | ID: covidwho-854830

ABSTRACT

BACKGROUND: The coronavirus disease (COVID-19) poses an unprecedented challenge to health and epidemic prevention system, especially the healthcare of patients with cancer. We sought to study the impact of COVID-19 on lung cancer patients in our center. METHODS: We initiated a retrospectively study to analyze the impact of COVID-19 on lung cancer patients in our center, who were accepted for routine anticancer treatment before the epidemic and planned to return to hospital in January and February of 2020. RESULTS: A total of 161 cases of lung cancer were included in the final analysis. As of April 15, 95 patients had delayed their return visit, and 47 cases were finally designated as having delayed admission during the epidemic and having to discontinue or delay their regular anticancer treatments. Of these 47 delayed patients, 33 were evaluated for tumor status using a computed tomography scan, 6 of these 33 cases (18.18%) were diagnosed as progressive disease (PD), and 5 cases did not return for visit. CONCLUSIONS: This is the first study investigating impact of COVID-19 on non-COVID-19 lung cancer patients during the pandemic. The study demonstrates the significant impact of the COVID-19 crisis on oncological care, indicating the need for appropriate change of treatment decisions and continued follow-up and psycho-oncological support during this pandemic.


Subject(s)
Antineoplastic Agents/therapeutic use , Carcinoma, Non-Small-Cell Lung/therapy , Coronavirus Infections , Immunotherapy , Lung Neoplasms/therapy , Pandemics , Pneumonia, Viral , Radiotherapy , Small Cell Lung Carcinoma/therapy , Time-to-Treatment/statistics & numerical data , Adult , Aged , Aged, 80 and over , Betacoronavirus , COVID-19 , Carcinoma, Non-Small-Cell Lung/diagnostic imaging , Chemoradiotherapy , China , Delivery of Health Care , Disease Progression , Female , Humans , Lung Neoplasms/diagnostic imaging , Male , Middle Aged , Neoplasm Staging , Retrospective Studies , SARS-CoV-2 , Small Cell Lung Carcinoma/diagnostic imaging
17.
BMJ Case Rep ; 13(10)2020 Oct 07.
Article in English | MEDLINE | ID: covidwho-840503

ABSTRACT

A 13-year-old boy presented to hospital with 3-day self-limited fever, followed by dry cough, persistent asthenia and impaired general condition of 2 weeks' duration. Blood analyses showed a severe inflammatory status and chest X-ray images were consistent with bilateral COVID-19 pneumonia. He developed an acute respiratory failure that required paediatric intensive care admission and non-invasive ventilation. A targeted COVID-19 treatment was initiated with hydroxicloroquine, corticosteroids, enoxaparine and a single dose of tocilizumab. Repeated serological tests and real-time reverse transcription PCR for SARS-CoV-2 were negative. Other infectious pathogens were also ruled out. Thoracic high resolution CT showed an intense bilateral pulmonary dissemination with lytic vertebral bone lesions. After diagnostic investigations, Ewing's sarcoma with metastatic pulmonary dissemination was diagnosed. Nowadays, in the context of SARS-CoV-2 community pandemic, we cannot forget that COVID-19 clinical presentation is not specific and other entities can mimic its clinical features.


Subject(s)
Coronavirus Infections/diagnosis , Lung Neoplasms , Multiple Pulmonary Nodules , Pneumonia, Viral/diagnosis , Sarcoma, Ewing , Tomography, X-Ray Computed/methods , Adolescent , Antineoplastic Combined Chemotherapy Protocols , Bone Marrow Examination/methods , COVID-19 , COVID-19 Testing , Clinical Laboratory Techniques/methods , Coronavirus Infections/blood , Coronavirus Infections/physiopathology , Diagnosis, Differential , Humans , Lung Neoplasms/diagnostic imaging , Lung Neoplasms/physiopathology , Lung Neoplasms/secondary , Male , Multiple Pulmonary Nodules/diagnostic imaging , Multiple Pulmonary Nodules/pathology , Pandemics , Pneumonia, Viral/blood , Pneumonia, Viral/etiology , Pneumonia, Viral/physiopathology , Sarcoma, Ewing/diagnosis , Sarcoma, Ewing/physiopathology , Tomography, Emission-Computed, Single-Photon/methods
18.
Int J Med Sci ; 17(16): 2561-2569, 2020.
Article in English | MEDLINE | ID: covidwho-833375

ABSTRACT

Background: During the outbreak period of COVID-19 pneumonia, cancer patients have been neglected and in greater danger. Furthermore, the differential diagnosis between COVID-19 pneumonia and radiation pneumonitis in cancer patients remains a challenge. This study determined their clinical presentations and radiological features in order to early diagnose and separate COVID-19 pneumonia from radiation pneumonitis patients promptly. Methods and Findings: From January 21, 2020 to February 18, 2020, 112 patients diagnosed with suspected COVID-19 were selected consecutively. A retrospective analysis including all patients' presenting was performed. Four patients from 112 suspected individals were selected, including 2 males and 2 females with a median age of 54 years (range 39-64 years). After repeated pharyngeal swab nucleic acid tests, 1 case was confirmed and 3 cases were excluded from COVID-19 pneumonia. Despite the comparable morphologic characteristics of lung CT imaging, the location, extent, and distribution of lung lesions between COVID-19 pneumonia and radiation pneumonitis differed significantly. Conclusions: Lung CT imaging combined with clinical and laboratory findings can facilitate early diagnosis and appropriate management of COVID-19 pneumonia with a history of malignancy and radiation therapy.


Subject(s)
Betacoronavirus , Coronavirus Infections/diagnostic imaging , Diagnosis, Differential , Neoplasms/radiotherapy , Pneumonia, Viral/diagnostic imaging , Radiation Pneumonitis/diagnostic imaging , Adult , COVID-19 , COVID-19 Testing , Clinical Laboratory Techniques , Coronavirus Infections/diagnosis , Esophageal Neoplasms/diagnostic imaging , Esophageal Neoplasms/pathology , Esophageal Neoplasms/radiotherapy , Female , Humans , Lung Neoplasms/diagnostic imaging , Lung Neoplasms/radiotherapy , Male , Middle Aged , Nasopharyngeal Neoplasms/diagnostic imaging , Nasopharyngeal Neoplasms/pathology , Nasopharyngeal Neoplasms/radiotherapy , Neoplasms/virology , Pandemics , Retrospective Studies , SARS-CoV-2 , Tomography, X-Ray Computed
19.
J Control Release ; 328: 776-791, 2020 12 10.
Article in English | MEDLINE | ID: covidwho-753326

ABSTRACT

Over the past decade, the growing interest in targeted lung cancer therapy has guided researchers toward the cutting edge of controlled drug delivery, particularly magnetic particle targeting. Targeting of tissues by magnetic particles has tackled several limitations of traditional drug delivery methods for both cancer detection (e.g., using magnetic resonance imaging) and therapy. Delivery of magnetic particles offers the key advantage of high efficiency in the local deposition of drugs in the target tissue with the least harmful effect on other healthy tissues. This review first overviews clinical aspects of lung morphology and pathogenesis as well as clinical features of lung cancer. It is followed by reviewing the advances in using magnetic particles for diagnosis and therapy of lung cancers: (i) a combination of magnetic particle targeting with MRI imaging for diagnosis and screening of lung cancers, (ii) magnetic drug targeting (MDT) through either intravenous injection and pulmonary delivery for lung cancer therapy, and (iii) computational simulations that models new and effective approaches for magnetic particle drug delivery to the lung, all supporting improved lung cancer treatment. The review further discusses future opportunities to improve the clinical performance of MDT for diagnosis and treatment of lung cancer and highlights clinical therapy application of the MDT as a new horizon to cure with minimal side effects a wide variety of lung diseases and possibly other acute respiratory syndromes (COVID-19, MERS, and SARS).


Subject(s)
Antineoplastic Agents/administration & dosage , Drug Carriers/chemistry , Drug Delivery Systems/methods , Lung Neoplasms , Magnets/chemistry , Nanoparticles/chemistry , Antineoplastic Agents/therapeutic use , Drug Carriers/administration & dosage , Humans , Lung Neoplasms/diagnostic imaging , Lung Neoplasms/drug therapy , Lung Neoplasms/pathology , Magnetic Resonance Imaging , Molecular Targeted Therapy , Nanoparticles/administration & dosage
20.
J Surg Oncol ; 122(6): 1020-1026, 2020 Nov.
Article in English | MEDLINE | ID: covidwho-712496

ABSTRACT

BACKGROUND: Globally, coronavirus disease-2019 (COVID-19) is a new, highly contagious, and life-threatening virus. We aimed to demonstrate how we proceeded with bronchoscopic procedures without published guidelines at the inception of the pandemic period. MATERIALS AND METHODS: All bronchoscopic procedures applied from the first case seen in Turkey (11 March-15 May) were evaluated retrospectively. Patient data on indications, diagnosis, types of procedures, and the results of COVID-19 tests were recorded. RESULTS: This study included 126 patients; 36 required interventional bronchoscopic techniques (28.6%), 74 required endobronchial ultrasonography (EBUS; 58.7%), and 16 required flexible fiberoptic bronchoscopy (12.7%). All interventional rigid bronchoscopic techniques were performed for emergent indications: malignant airway obstruction (66.7%), tracheal stenosis (25%), and bronchopleural fistula (8.3%). Malignancy was diagnosed in 59 (79.7%), 12 (50%), and 4 (25%) patients who underwent EBUS, interventional procedures, and fibreoptic bronchoscopy, respectively. All personnel wore personal protective equipment and patients wore a surgical mask, cap, and disposable gown. Of the patients, 31 (24.6%) were tested for COVID-19 and all the results were negative. COVID-19 was not detected in any of the patients after a 14-day follow-up period. CONCLUSION: This study was based on our experiences and demonstrated that EBUS and/or bronchoscopy should not be postponed in patients with known or suspected lung cancer.


Subject(s)
Bronchoscopy/methods , COVID-19/complications , Delivery of Health Care/standards , Lung Neoplasms/pathology , Practice Guidelines as Topic/standards , SARS-CoV-2/isolation & purification , Adult , Aged , Aged, 80 and over , Bronchoscopy/standards , COVID-19/virology , Cross-Sectional Studies , Endoscopic Ultrasound-Guided Fine Needle Aspiration , Female , Follow-Up Studies , Humans , Lung Neoplasms/diagnostic imaging , Lung Neoplasms/surgery , Lung Neoplasms/virology , Male , Middle Aged , Prognosis , Retrospective Studies , Young Adult
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