COVID-19 epidemic: Proposed alternatives in the management of digestive cancers: A French intergroup clinical point of view (SNFGE, FFCD, GERCOR, UNICANCER, SFCD, SFED, SFRO, SFR)
COVID-19 epidemic: Proposed alternatives in the management of digestive cancers: A French intergroup clinical point of view (SNFGE, FFCD, GERCOR, UNICANCER, SFCD, SFED, SFRO, SFR)
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DOI：
10.1016/j.dld.2020.03.031
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发表时间：
2020-06-01
影响因子：
4.5
通讯作者：
Michel, Pierre
中科院分区：
文献类型：
--
作者：
Di Fiore, Frederic;Bouche, Olivier;Michel, Pierre
简介：接受恶性肿瘤治疗的患者被认为面临严重 COVID-19 的风险。这种特殊的大流行病影响到了各个层面的国家，特别是正在经历饱和的卫生系统。与许多国家一样，法国目前面临着巨大的风险，医院的彻底重组正在进行中。我们在此建议对 COVID-19 流行期间接受消化道癌症治疗的患者的诊断程序、治疗和护理策略进行调整。方法：法国胃肠病学和胃肠道 (GI) 肿瘤学学会进行了这项研究，以回答出现的两个主要问题 (i) 我们如何限制胃肠道癌症患者的高风险情况；(ii) 我们如何限制患者和护理中心之间的接触，以降低患者在继续治疗癌症的同时受到污染的风险。根据截至 2020 年 3 月的文献中发现的证据水平，所有建议均被评为专家同意。结果：针对主要胃肠道肿瘤情况提出了调整治疗策略的建议。考虑到证据水平和COVID-19疫情的异质性进展，所有建议都需要由多学科团队考虑并在患者同意的情况下实施。结论：COVID-19疫情可能会显着影响接受消化系统恶性肿瘤治疗的患者。医疗团队需要在可行的情况下根据疫情情况考虑调整治疗顺序。 (C) 2020 Editrice Gastroenterologica Italiana S.r.l.由爱思唯尔有限公司出版。保留所有权利。
Introduction: Patients treated for malignancy are considered at risk of severe COVID-19. This exceptional pandemic has affected countries on every level, particularly health systems which are experiencing saturation. Like many countries, France is currently greatly exposed, and a complete reorganization of hospitals is ongoing. We propose here adaptations of diagnostic procedures, therapies and care strategies for patients treated for digestive cancer during the COVID-19 epidemic.Methods: French societies of gastroenterology and gastrointestinal (GI) oncology carried out this study to answer two main questions that have arisen (i) how can we limit high-risk situations for GI-cancer patients and (ii) how can we limit contact between patients and care centers to decrease patients' risk of contamination while continuing to treat their cancer. All recommendations are graded as experts' agreement according to the level of evidence found in the literature until March 2020.Results: A proposal to adapt treatment strategies was made for the main GI oncology situations. Considering the level of evidence and the heterogeneous progression of the COVID-19 epidemic, all proposals need to be considered by a multidisciplinary team and implemented with patient consent.Conclusion: COVID-19 epidemic may significantly affect patients treated for digestive malignancies. Healthcare teams need to consider adapting treatment sequences when feasible and according to the epidemic situation. (C) 2020 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.