题名

COVID-19疫情期間癌症病人接受放射治療面臨的挑戰及應變

并列篇名

Challenges and Management Strategies of Cancer Patients in Radiotherapy during the COVID-19 Pandemic

DOI

10.6880/TJON.202110/SP_21.03

作者

戴坤耀(Kun-Yao Dai)；吳秀春(Hsiu-Chun Wu)；陳淑芬(Shu-Fen Chen)；李英芬(In-Fun Li)

关键词

COVID-19 ； 放射治療 ； 治療決策 ； COVID-19 ； radiotherapy ； treatment decision making

期刊名称

腫瘤護理雜誌

卷期/出版年月

21卷增訂刊I（2021 / 10 / 01）

页次

19 - 34

内容语文

繁體中文
中文摘要

新型冠狀病毒肺炎自2019年12月爆發後嚴重肆虐全球，台灣當時雖有較佳之防疫成效，但在2021年5月國內爆發社區感染，感染確診與重症個案數大幅上升，全臺防疫警戒提升至第三級，各醫院均快速設立專責隔離病房，同時也為保全醫療量能，進行醫療營運降載，可延遲診療之醫療均先暫緩，對日常醫療作業產生影響，而需要持續數天至數週到醫院接受放射治療的癌症病人，因頻繁出入醫院易暴露於COVID-19感染風險中，但又必須兼顧癌症治療效益之際，要如何進行以病人為中心之治療決策、若接受放射治療病人確診新型冠狀病毒肺炎時的治療要如何處理、放射治療病人接受COVID-19疫苗注射與心理健康等議題，期待經本文之整理分享，幫助臨床人員在COVID-19流行期間或未來類似疫情爆發時，照顧放射治療病人之參考。
英文摘要

Covid-19 raged throughout the globe since December in 2019, nevertheless Taiwan has effectively contained the disease until a community infection outbreak occurred in May 2021. The number of confirmed cases and case-fatality ratio raised rapidly cautioning a level 3 nationwide pandemic alert in Taiwan where the isolation wards were built expeditiously. In order to ensure the medical capacity, healthcare facilities had to reduce the operational load, non-urgent medical services were postponed, which had a huge impact on the daily medical operations. Radiotherapy sessions usually require days or weeks which means the cancer patients had to adhere to the treatment schedule under the risk of increasing COVID-19 exposure related to the frequent hospital visits. Topics such as patient-centered treatment decision making, management of COVID-19 within patients' ongoing radiotherapy, COVID-19 vaccination for patients during radiotherapy and psychological care are discussed herein. Through sharing this article, we look forward to assisting the clinical staffs in patient care while patients receive radiotherapy during the COVID-19 pandemic or with similar epidemics outbreaks in the future.
主题分类 醫藥衛生 > 預防保健與衛生學
醫藥衛生 > 內科
醫藥衛生 > 社會醫學
参考文献
  1. Achard, V.,Tsoutsou, P.,Zilli, T.(2020).Radiotherapy in the time of the Coronavirus pandemic: When less is better.International Journal of Radiation Oncology. Biology. Physics,107(3),600-601.
  2. Balzora, S.,Issaka, R. B.,Anyane-Yeboa, A.,Gray II, D. M.,May, F. P.(2020).Impact of COVID-19 on colorectal cancer disparities and the way forward.Gastrointestinal Endoscopy,92(4),946-950.
  3. Bi, N.,Yi, J.,Dai, J.,Wang, S.,Zhou, Z.,Men, K.,Jin, J.,Gao, S.,Li, Y. X.,He, J.(2020).Managing a radiotherapy center safely and efficiently using risk-adaptive strategies during coronavirus disease pandemic: Experience from national cancer center of China.Radio-therapy and Oncology,148,243-244.
  4. Cannistra, S. A.,Haffty, B. G.,Ballman, K.(2020).Challenges faced by medical journals during the COVID-19 pandemic.Journal of Clinical Oncology,38(19),2206-2207.
  5. Carson, J. L., & Klinman, S. (2021). Indications and hemoglobin thresholds for red blood cell transfusion in the adult. In J. S. Tirnauer (Ed.), Up-ToDate. Retrieved Jun. 23. 2021, from https://www.uptodate.com/contents/indications-and-hemoglobin-thresholds-for-red-blood-cell-transfusion-in-the-adult
  6. Combs, S. E.,Belka, C.,Niyazi, M.,Corradini, S.,Pigorsch, S.,Wilkens, J.,Grosu, A. L.,Guckenberger, M.,Ganswindt, U.,Bernhardt, D.(2020).First statement on preparation for the COVID-19 pandemic in large german speaking university-based radiation oncology departments.Radiation Oncology,15(1),1-12.
  7. Cooksley, T.,Font, C.,Scotte, F.,Escalante, C.,Johnson, L.,Anderson, R.,Rapoport, B.(2020).Emerging challenges in the evaluation of fever in cancer patients at risk of febrile neutropenia in the era of COVID-19: A MASCC position paper.Supportive Care in Cancer,29(2),1129-1138.
  8. Cooperberg, M. R.,Zheng,Y.,Faino, A. V.,New-comb, L. F.,Zhu, K.,Cowan, J. E.,Brooks, J. D.,Dash, A.,Gleave, M. E.,Martin,F.,Morgan, T. M.,Nelson, P. S.,Thompson, I. M.,Wagner, A. A.,Carroll, P. R.,Lin, D. W.(2020).Tailoring intensity of active surveillance for low-risk prostate cancer based on individualized prediction of risk stability.JAMA Oncology,6(10),e203-e203187.
  9. Dee, E. C.,Mahal, B. A.,Arega, M. A.,D’Amico, A. V.,Mouw, K. W.,Nguyen, P. L.,Muralidhar, V.(2020).Relative timing of radio-therapy and androgen deprivation for prostate cancer and implications for treatment during the COVID-19 pandemic.JAMA Oncology,6(10),-1630.
  10. Delaney, G.,Jacob, S.,Featherstone, C.,Barton, M.(2005).The role of radiotherapy in cancer treatment: estimating optimal utilization from a review of evidence-based clinical guidelines.Cancer: Interdisciplinary International Journal of the American Cancer Society,104(6),1129-1137.
  11. Di Franco, R.,Borzillo, V.,D’Ippolito, E,Scipilliti, E.,Petito, A.,Facchini, G.,Berretta, M.,Muto, P.(2020).COVID-19 and radiotherapy: potential new strategies for patients management with hypofractionation and telemedicine.European Review for Medical and Pharmacological Sciences,24(23),12480-12489.
  12. Filippi, A. R.,Russi, E.,Magrini, S. M.,Corvò, R.(2020).Letter from Italy: First practical indications for radiation therapy departments during COVID-19 outbreak.International Journal of Radiation Oncology. Biology. Physics,107(3),597-599.
  13. Grellety, T.,Ravaud, A.,Canivet, A.,Ganem, G.,Giraud, P.,Guimbaud, R.,Kaluzinski, L.,Krekowski, I.,Mayeur, D.,Lotz, J. P.,You, B.(2020).SARS-CoV-2/COVID 19 infection and solid cancers: synthesis of recommendations for health professionals.Bulletin du Cancer,107(4),400-402.
  14. Hanna, T. P.,King, W. D.,Thibodeau, S.,Jalink, M.,Paulin, G. A.,Harvey-Jones, E.,O’Sullivan, D. E,Booth, C. M.,Sullivan, R.,Aggarwal, A.(2020).Mortality due to cancer treatment delay: systematic review and meta-analysis.British Medical Journal,371(4087),1-11.
  15. Horsley, P. J.,Back, M.,Lamoury, G.,Porter, B.,Booth, J.,Eade, T. N.(2021).Radiation on-cology during COVID-19: Strategies to avoid compromised care.Asia-Pacific Journal of Clinical Oncology,17(1),24-28.
  16. Hughes, K. S.,Schnaper, L. A.,Bellon, J. R.,Cirrincione, C. T.,Berry, D. A.,McCormick, B.,Muss, H. B.,Smith, B. L.,Hudis, C. A.,Winer, E. P.,Wood, W. C.(2013).Lumpectomy plus tamoxifen with or without irradiation in women age 70 years or older with early breast cancer: long-term follow-up of CALGB 9343.Journal of Clinical Oncology,31(19),2382-2387.
  17. Hughes, K. S.,Schnaper, L. A.,Berry, D.,Cirrincione, C.,McCormick, B.,Shank, B.,Wheeler, J.,Champion, L. A.,Smith, T. J.,Smith, B. L.,Shapiro, C.,Muss, H. B.,Winer, E.,Hudis, C.,Wood, W.,Sugarbaker, D.,Henderson, I. C.,Norton, L.(2004).Lumpectomy plus tamoxifen with or without irradiation in women 70 years of age or older with early breast cancer.The New England Journal of Medicine,351(10),971-977.
  18. Klotz, L.,Zhang, L.,Lam, A.,Nam, R.,Mamedov, A.,Loblaw, A.(2010).Clinical results of long-term follow-up of a large, active surveillance cohort with localized prostate cancer.Journal of Clinical Oncology,28(1),126-131.
  19. Kong, Y. C.,Sakti, V. V.,Sullivan, R.,Bhoo-Pathy, N.(2020).Cancer and COVID-19: economic impact on households in Southeast Asia.Ecancermedicalscience,14(1334),1-7.
  20. Krengli, M.,Ferrara, E.,Mastroleo, F.,Brambilla, M.,Ricardi, U.(2020).Running a radiation oncology department at the time of coronavirus: an Italian experience.Advances in Radiation Oncology,5,3-6.
  21. Kunkler, I. H.,Williams, L. J.,Jack, W. J.,Cameron, D. A.,Dixon, J. M.(2015).Breast-conserving surgery with or without irradiation in women aged 65 years or older with early breast cancer (PRIME II): A randomised controlled trial.The Lancet Oncology,16(3),266-273.
  22. Kutikov, A.,Weinberg, D. S.,Edelman, M. J.,Horwitz, E. M.,Uzzo, R. G.,Fisher, R. I.(2020).A war on two fronts: cancer care in the time of COVID-19.Annals of Internal Medicine,172(11),756-758.
  23. Liang, W.,Guan, W.,Chenb, R.,Wang, W.,Li, J.,Xu, K.,Li, C.,Ai, Q.,Lu, W.,Liang, H.,Li, S.,He, J.(2020).Cancer patients in SARS-CoV-2 infection: a nationwide analysis in China.The Lancet Oncology,21(3),335-337.
  24. Lutz, S.,Balboni, T.,Jones, J.,Lo, S.,Petit, J.,Rich, S. E.,Wong, R.,Hahn, C.(2017).Palliative radiation therapy for bone metastases: Update of an ASTRO Evidence-Based Guideline.Practical Radiation Oncology,7(1),4-12.
  25. Madan, A.,Siglin, J.,Khan, A.(2020).Comprehensive review of implications of COVID-19 on clinical outcomes of cancer patients and management of solid tumors during the pandemic.Cancer Medicine,9(24),9205-9218.
  26. Mohindra, P.,Buckey, C. R.,Chen, S.,Sio, T. T.,Rong, Y.(2020).Radiation therapy considerations during the COVID-19 Pandemic: Literature review and expert opinions.Journal of Applied Clinical Medical Physics,21(5),6-12.
  27. Momenimovahed, Z.,Salehiniya, H.,Hadavandsiri, F.,Allahqoli, L.,Günther, V.,Alkatout, I.(2021).Psychological distress among cancer patients during COVID-19 pandemic in the world: A systematic review.Frontiers in Psychology,12
  28. Morgan, S. C.,Hoffman, K.,Loblaw, D. A.,Buyyounouski, M. K.,Patton, C.,Barocas, D.,Bentzen, S.,Chang, M.,Efstathiou, J.,Greany, P.,Halvorsen, P.,Koontz, B. F.,Lawton, C.,Leyrer, C. M.,Lin, D.,Ray, M.,Sandler, H.(2018).Hypofractionated radiation therapy for localized prostate cancer: executive summary of an ASTRO, ASCO, and AUA evidence-based guideline.Practical Radiation Oncology,8(6),354-360.
  29. National Comprehensive Cancer Network (2021a). Recommendations of the National Comprehensive Cancer Network® (NCCN®) COVID-19 Vaccination Advisory Committee. NCCN: Cancer and COVID-19 Vaccination Version 4.0. https://www.nccn.org/docs/default-source/covid-19/2021_covid-19_vaccination_guidance_v4-0.pdf?sfvrsn=b483da2b_70
  30. National Comprehensive Cancer Network (2021b). NCCN COVID-19 Vaccination Guide for People With Cancer. https://mail.mmh.org.tw/cgibin/downfile/B/146369120697_tmp7A.pdf/covid-vaccine-and-cancer-05.pdf?fake=covid-vaccine-and-cancer-05.pdf
  31. National Institute for Health and Care Excellence. (2020). COVID-19 rapid guideline: delivery of radiotherapy. (NICE guideline Published: 28 March 2020). https://www.nice.org.uk/guidance/ng162/resources/covid19-rapid-guideline-delivery-of-radiotherapy-pdf-66141897390277
  32. Rajan, S.,Akhtar, N.,Sharma, S.,Chakrabarti, D.,Kumar, V.(2021).COVID-19 vaccination for cancer patients: Evidence, priority, and practice.Vaccine,39(36),5075-5077.
  33. Rocco, N.,Montagna, G.,Di Micco, R.,Benson, J.,Criscitiello, C.,Chen, L.,Bruno, D. P.,Colmenarejo, A. J. E.,Harder, Y.,Karakatsanis, A.,Maglia, A.,Mele, M.,Nafissi, N.,Ferreira, P. S.,Taher, W.,Tejerina, A.,Vinci, A.,Nava, M.,Catanuto, G.(2021).The impact of the COVID-19 pandemic on surgical management of breast cancer: global trends and future perspectives.The Oncologist,26(1),e66-e77.
  34. Shelley, W.,Grimard, L.,Bowen, J.,Lukka, H.,Perera, F.,Fyles, A.,Schneider, K.,Gulavita, S.,Freeman, C.(2010).Long-term results of hypofractionated radiation therapy for breast cancer.New England Journal of Medicine,362(6),513-520.
  35. Tabrizi, S.,Trippa, L.,Cagney, D. Aizer, A. A.,Tanguturi, S.,Ventz, S. Fell, G.,Bellon, J. R.,Mamon, H.,Nguyen, P. L.,D’Amico, A. V.,Haas-Kogan, D.,Alexander, B. M.,Rahman, R.(2021).Assessment of simulated SARS-CoV-2 infection and mortality risk associated with radiation therapy among patients in 8 randomized clinical trials.JAMA Network Open,4(3),e213304-e213304.
  36. Tamari, K.,Nagata, Y.,Nishiki, S.,Nakamura, S.,Ogawa, K.,Uno, T.(2020).Nationwide survey of COVID-19 prevention measures in Japanese radiotherapy departments via online questionnaire for radiation oncologists.Radio-therapy and Oncology,149,219-221.
  37. The START Trialists’ Group(2008).The UK standardisation of breast radiotherapy (START) trial a of radiotherapy hypofractionation for treatment of early breast cancer: a randomised trial.The Lancet Oncology,9(4),331-341.
  38. Thomson, D. J.,Yom, S. S.,Saeed, H.,El Naqa, I.,Ballas, L.,Bentzen, S. M.,Chao, S. T.,Choudhury, A.,Coles, C. E.,Dover, L.,Guadagnolo, B. A.,Guckenberger, M.,Hoskin, P.,Jabbour, S. K.,Katz, M. S.,Mukherjee, S,Rembielak, A.,Sebag-Montefiore D.,Sher, D. J.,Estes, C.(2020).Radiation fractionation schedules published during the COVID-19 pandemic: A sys tematic seview of the quality of evidence and recommendations for future development.International Journal of Radiation Oncology Biology Physics,108(2),379-389.
  39. Uzzo, R. G., Kutikov, A., & Geynisman, D. M., (2021a). COVID-19: Cancer treatment in uninfected patients during the pandemic, issues related to telemedicine, and resource allocation. In D. MF. Savarese. (Ed.), UpToDate. Retrieved Aug. 25. 2021, from https://www.uptodate.com/contents/covid-19-cancer-treatment-in-uninfected-patients-during-the-pandemic-issues-related-to-telemedicine-and-resource-allocation/print
  40. Uzzo, R. G., Kutikov, A., & Geynisman, D. M. (2021b). COVID-19: Cancer treatment in uninfected patients during the pandemic, issues related to telemedicine, and resource allocation. In D. MF. Savarese (Ed.), UpToDate. Retrieved Sep. 13. 2021, from https://www.uptodate.com/contents/covid-19-cancer-treatment-in-uninfected-patients-during-the-pandemic-issues-related-to-telemedicine-and-resource-allocation?source=related_link
  41. World Health Organization. (2020). WHO Director-General’s remarks at the media briefing on 2019-nCoV on 11 February 2020. https://www.who.int/director-general/speeches/detail/who-director-general-s-remarks-at-the-media-briefing-on-2019-ncov-on-11-february-2020
  42. Xia, Y.,Jin, R.,Zhao, J.,Li, W.,Shen, H.(2020).Risk of COVID-19 for cancer patients.The Lancet Oncology,21(4),e180.
  43. 行政院衛生福利部疾病管制署（2021d，7月13日）．因應社區傳播有擴大趨勢，指揮中心自即日起至5月28日提升雙北地區疫情警戒至第三級，加嚴、加大全國相關限制措施，嚴守社區防線。https://www.cdc.gov.tw/Bulletin/Detail/E7bi2j8UYj1Rmz73OPE7Yg?typeid=9
  44. 行政院衛生福利部疾病管制署（2021b，7月13日）．醫療機構因應COVID-19之個人防護裝備使用建議。https://www.cdc.gov.tw/File/Get/3JGfe6t8DazyqI6mNsPOMQ
  45. 行政院衛生福利部疾病管制署(2021)。行政院衛生福利部疾病管制署（2021a，7月13日）．新型冠狀病毒（SARS-CoV-2）感染臨床處置暫行指引第十三版。https://www.cdc.gov.tw/File/Get/GE-cLga52awm9aKR5ni3Ag。https://www.cdc.gov.tw/File/Get/GE-cLga52awm9aKR5ni3Ag
  46. 行政院衛生福利部疾病管制署（2021c，7月13日）．因應國內疫情進入社區流行階段，保全醫療量能，指揮中心宣布四大醫療應變策略。https://www.cdc.gov.tw/Bulletin/Detail/qjLPbiOtHhwprxP5qbl67Q?typeid=48
print cancel