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Salek M, Silverstein A, Tilly A, Gassant PY, Gunasekera S, Hordofa DF, Hesson D, Duffy C, Malik N, McNeil M, Force LM, Bhakta N, Rodin D, Kaye EC. Factors influencing treatment decision-making for cancer patients in low- and middle-income countries: A scoping review. Cancer Med 2023; 12:18133-18152. [PMID: 37526041 PMCID: PMC10524036 DOI: 10.1002/cam4.6375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 07/01/2023] [Accepted: 07/16/2023] [Indexed: 08/02/2023] Open
Abstract
PURPOSE In this scoping review, we evaluated existing literature related to factors influencing treatment decision-making for patients diagnosed with cancer in low- and middle-income countries, noting factors that influence decisions to pursue treatment with curative versus non-curative intent. We identified an existing framework for adult cancer developed in a high-income country (HIC) context and described similar and novel factors relevant to low-and middle-income country settings. METHODS We used scoping review methodology to identify and synthesize existing literature on factors influencing decision-making for pediatric and adult cancer in these settings. Articles were identified through an advanced Boolean search across six databases, inclusive of all article types from inception through July 2022. RESULTS Seventy-nine articles were identified from 22 countries across six regions, primarily reporting the experiences of lower-middle and upper-middle-income countries. Included articles largely represented original research (54%), adult cancer populations (61%), and studied patients as the targeted population (51%). More than a quarter of articles focused exclusively on breast cancer (28%). Approximately 30% described factors that influenced decisions to choose between therapies with curative versus non-curative intent. Of 56 reported factors, 22 novel factors were identified. Socioeconomic status, reimbursement policies/cost of treatment, and treatment and supportive care were the most commonly described factors. CONCLUSIONS This scoping review expanded upon previously described factors that influence cancer treatment decision-making in HICs, broadening knowledge to include perspectives of low- and middle-income countries. While global commonalities exist, certain variables influence treatment choices differently or uniquely in different settings. Treatment regimens should further be tailored to local environments with consideration of contextual factors and accessible resources that often impact decision-making.
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Affiliation(s)
- Marta Salek
- Department of Global Pediatric MedicineSt Jude Children's Research HospitalMemphisTennesseeUSA
| | - Allison Silverstein
- Department of PediatricsUniversity of Colorado School of MedicineAuroraColoradoUSA
| | - Alyssa Tilly
- Division of General Medicine and Clinical EpidemiologyUniversity of North Carolina School of MedicineChapel HillNorth CarolinaUSA
| | | | - Sanjeeva Gunasekera
- Department of Paediatric OncologyNational Cancer InstituteMaharagamaSri Lanka
| | - Diriba Fufa Hordofa
- Department of Pediatrics and Child HealthJimma University Medical CenterJimmaEthiopia
| | - Donna Hesson
- Welch Medical LibraryJohns Hopkins UniversityBaltimoreMarylandUSA
| | - Caitlyn Duffy
- Department of Global Pediatric MedicineSt Jude Children's Research HospitalMemphisTennesseeUSA
| | - Nauman Malik
- Department of Radiation OncologyUniversity of California, San FranciscoSan FranciscoCaliforniaUSA
| | - Michael McNeil
- Department of Global Pediatric MedicineSt Jude Children's Research HospitalMemphisTennesseeUSA
| | - Lisa M. Force
- Department of Health Metrics Sciences and Department of Pediatrics, Division of Pediatric Hematology/OncologyUniversity of WashingtonSeattleWashingtonUSA
| | - Nickhill Bhakta
- Department of Global Pediatric MedicineSt Jude Children's Research HospitalMemphisTennesseeUSA
| | - Danielle Rodin
- Department of Radiation, OncologyUniversity of TorontoTorontoOntarioCanada
- Radiation Medicine ProgramPrincess Margaret Cancer CentreTorontoOntarioCanada
- Canada Global Cancer ProgramPrincess Margaret Cancer CentreTorontoOntarioCanada
| | - Erica C. Kaye
- Department of OncologySt Jude Children's Research HospitalMemphisTennesseeUSA
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Mahdavi A, Mofid B, Taghizadeh-Hesary F. Intra-prostatic gold fiducial marker insertion for image-guided radiotherapy (IGRT): five-year experience on 795 patients. BMC Med Imaging 2023; 23:79. [PMID: 37308834 DOI: 10.1186/s12880-023-01036-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 05/29/2023] [Indexed: 06/14/2023] Open
Abstract
INTRODUCTION Prostate cancer is the second most commonly diagnosed cancer in males. The use of intra-prostatic fiducial markers (FM) for image-guided radiotherapy (IGRT) has become widespread due to their accuracy, relatively safe use, low cost, and reproducibility. FM provides a tool to monitor prostate position and volume changes. Many studies reported low to moderate rates of complications following FM implantation. In the current study, we present our five years' experience regarding the insertion technique, technical success, and rates of complication and migration of intraprostatic insertion of FM gold marker. METHODS From January 2018 to January 2023, 795 patients with prostate cancer candidate for IGRT (with or without a history of radical prostatectomy) enrolled in this study. We used three fiducial markers (3*0.6 mm) inserted through an 18-gauge Chiba needle under transrectal ultrasonography (TRUS) guidance. The patients were observed for complications up to seven days after the procedure. Besides, the rate of marker migration was recorded. RESULTS All procedures were completed successfully, and all patients tolerated the procedure well with minimal discomfort. The rate of sepsis after the procedure was 1%, and transient urinary obstruction was 1.6%. Only two patients experienced marker migration shortly after insertion, and no fiducial migration was reported throughout radiotherapy. No other major complication was recorded. DISCUSSION TRUS-guided intraprostatic FM implantation is technically feasible, safe, and well-tolerated in most patients. The FM migration can seldom occur, with negligible effects. This study can provide convincing evidence that TRUS-guided intra-prostatic FM insertion is an appropriate choice for IGRT.
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Affiliation(s)
- Ali Mahdavi
- Department of Radiology, Imam Hossein Educational Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Bahram Mofid
- Department of Radiation Oncology, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, 1985717443, Iran.
| | - Farzad Taghizadeh-Hesary
- ENT and Head and Neck Research Center and Department, The Five Senses Health Institute, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
- Department of Radiation Oncology, Iran University of Medical Sciences, Tehran, Iran.
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Nazari A, Hong J, Taghizadeh-Hesary F, Taghizadeh-Hesary F. Reducing Virus Transmission from Heating, Ventilation, and Air Conditioning Systems of Urban Subways. TOXICS 2022; 10:796. [PMID: 36548629 PMCID: PMC9784553 DOI: 10.3390/toxics10120796] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 12/13/2022] [Accepted: 12/15/2022] [Indexed: 06/17/2023]
Abstract
Aerosols carrying the virus inside enclosed spaces is an important mode of transmission for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), as supported by growing evidence. Urban subways are one of the most frequented enclosed spaces. The subway is a utilitarian and low-cost transit system in modern society. However, studies are yet to demonstrate patterns of viral transmission in subway heating, ventilation, and air conditioning (HVAC) systems. To fill this gap, we performed a computational investigation of the airflow (and associated aerosol transmission) in an urban subway cabin equipped with an HVAC system. We employed a transport equation for aerosol concentration, which was added to the basic buoyant solver to resolve the aerosol transmission inside the subway cabin. This was achieved by considering the thermal, turbulent, and induced ventilation flow effects. Using the probability of encountering aerosols on sampling surfaces crossing the passenger breathing zones, we detected the highest infection risk zones inside the urban subway under different settings. We proposed a novel HVAC system that can impede aerosol spread, both vertically and horizontally, inside the cabin. In the conventional model, the maximum probability of encountering aerosols from the breathing of infected individuals near the fresh-air ducts was equal to 51.2%. This decreased to 3.5% in the proposed HVAC model. Overall, using the proposed HVAC system for urban subways led to a decrease in the mean value of the probability of encountering the aerosol by approximately 84% compared with that of the conventional system.
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Affiliation(s)
- Ata Nazari
- Department of Mechanical Engineering, University of Tabriz, Tabriz 51666-16471, Iran
| | - Jiarong Hong
- Mechanical Engineering & Saint Anthony Falls Laboratory, University of Minnesota, Minneapolis, MN 55455, USA
| | - Farzad Taghizadeh-Hesary
- ENT and Head and Neck Research Center and Department, The Five Sense Health Institute, School of Medicine, Iran University of Medical Sciences, Tehran 14535, Iran
| | - Farhad Taghizadeh-Hesary
- TOKAI Research Institute for Environment and Sustainability (TRIES), Tokai University, Hiratsuka-shi 259-1292, Kanagawa-ken, Japan
- School of Global Studies, Tokai University, Hiratsuka-shi 259-1292, Kanagawa-ken, Japan
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Fazilat-Panah D, Fallah Tafti H, Rajabzadeh Y, Fatemi MA, Ahmadi N, Jahansouz D, Tabasi M, Javadinia SA, Joudi M, Harati H, Attarian F, Taghizadeh-Hesary F. Clinical Characteristics and Outcomes of COVID-19 in 1290 New Cancer Patients: Single-center, Prospective Cohort Study from Iran. Cancer Invest 2022; 40:505-515. [PMID: 35521692 DOI: 10.1080/07357907.2022.2075376] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To determine the clinical characteristics and outcomes of COVID-19 in a large cohort of new cancer patients referred to an oncology clinic in the north of Iran. METHODS During the 20-months COVID-19 pandemic, new cancer patients were followed-up. Demographic, pathologic, and clinical variables were collected for each patient. COVID-19 was confirmed based on a positive polymerase chain reaction test. Analyses were performed using the STATA version 14.0 at a significance level of 0.05. RESULTS In this study, 1294 new cancer patients were followed for 24 months (mean age: 58.7 years [range 10 to 95]). During the study period, COVID-19 was diagnosed in 9.4% of the patients with hospitalization rate of 3.4%, an ICU admission rate of 0.7%, and COVID-19 mortality rate of 4.9%. Hematological malignancies (ORU= 2.6, CI95% 1.28- 5.34), receiving palliative treatments (ORA=3.03, CI95% 1.6-5.45) and receiving radiotherapy (ORA=2.07, 1.17-3.65) were the most common predictive factors of COVID infection in cancer patients. Also, the COVID mortality was higher in brain cancer patients (P = 0.07), metastatic disease (P = 0.01) and patients receiving palliative treatments (P = 0.02). CONCLUSION In patients suffering from cancer, COVID-19 infection can be predicted by cancer type, palliative care, and radiotherapy in cancer patients. Furthermore, brain cancers, metastasis, and palliative care were all associated with COVID-19 related mortality.
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Affiliation(s)
| | - Hamid Fallah Tafti
- Resident of radiation oncology, Babol University of Medical Sciences, Babol, Iran
| | - Yavar Rajabzadeh
- Babolsar Rajaee Cancer Center, Babol University of Medical Sciences, Babol, Iran
| | | | - Nahid Ahmadi
- Cancer Research Center, Babol University of Medical Sciences, Babol, Iran
| | - Davoud Jahansouz
- Babolsar Rajaee Cancer Center, Babol University of Medical Sciences, Babol, Iran
| | - Mohsen Tabasi
- Department of Molecular Biology, Pasteur Institute of Iran, Pasteur Ave., Tehran, 13164, Iran
| | - Seyed Alireza Javadinia
- Vasei Clinical Research Development Unit, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Maryam Joudi
- Assistant professor of Allergy and clinical immunology, Pediatric Gastroenterology and Hepatology Research Center, Zabol University of Medical Sciences, Zabol, Iran
| | - Hadi Harati
- Assistant professor of Nurology, Pediatric Gastroenterology and Hepatology Research Center, Zabol University of Medical Sciences, Zabol, Iran
| | - Fahimeh Attarian
- Department of Public Health, School of Health, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran
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Salman HM, Syed J, Riaz A, Sarfraz Z, Sarfraz A, Bokhari SHAA, Ojeda IC. An epidemiological, strategic and response analysis of the COVID-19 pandemic in South Asia: a population-based observational study. BMC Public Health 2022; 22:457. [PMID: 35255848 PMCID: PMC8900114 DOI: 10.1186/s12889-022-12811-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 02/07/2022] [Indexed: 11/10/2022] Open
Abstract
Introduction South Asia has had a dynamic response to the ongoing COVID-19 pandemic. The overall burden and response have remained comparable across highly-burdened countries within the South Asian Region. Methodology Using a population-based observational design, all eight South Asian countries were analyzed using a step-wise approach. Data were obtained from government websites and publicly-available repositories for population dynamics and key variables. Results South Asian countries have a younger average age of their population. Inequitable distribution of resources centered in urban metropolitan cities within South Asia is present. Certain densely populated regions in these countries have better testing and healthcare facilities that correlate with lower COVID-19 incidence per million populations. Trends of urban-rural disparities are unclear given the lack of clear reporting of the gaps within these regions. COVID-19 vaccination lag has become apparent in South Asian countries, with the expected time to complete the campaign being unfeasible as the COVID-19 pandemic progresses. Conclusion With a redesigning of governance policies on preventing the rise of COVID-19 promptly, the relief on the healthcare system and healthcare workers will allow for adequate time to roll out vaccination campaigns with equitable distribution. Capacity expansion of public health within the Region is required to ensure a robust healthcare response to the ongoing pandemic and future infectious disease outbreaks.
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Affiliation(s)
| | | | - Atif Riaz
- Fatima Memorial Medical and Dental College, Lahore, Pakistan
| | | | - Azza Sarfraz
- Aga Khan University, P.O. Box: 3500, Stadium Road, 74800, Karachi, Pakistan.
| | | | - Ivan Cherrez Ojeda
- Universidad Espíritu Santo, Samborondón, Ecuador; ii. Respiralab Research Center, Guayaquil, Ecuador
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Impact of COVID-19 on care of older adults with cancer: a narrative synthesis of reviews, guidelines and recommendations. Curr Opin Support Palliat Care 2022; 16:3-13. [DOI: 10.1097/spc.0000000000000584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Leulseged TW, Abebe KG, Hassen IS, Maru EH, Zewde WC, Chamiso NW, Yegele KT, Bayisa AB, Siyoum DF, Edo MG, Mesfin EG, Derejie MN, Shiferaw HK. COVID-19 disease severity and associated factors among Ethiopian patients: A study of the millennium COVID-19 care center. PLoS One 2022; 17:e0262896. [PMID: 35085338 PMCID: PMC8794201 DOI: 10.1371/journal.pone.0262896] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 01/07/2022] [Indexed: 01/04/2023] Open
Abstract
Background The COVID-19 pandemic started a little later in Ethiopia than the rest of the world and most of the initial cases were reported to have a milder disease course and a favorable outcome. This changed as the disease spread into the population and the more vulnerable began to develop severe disease. Understanding the risk factors for severe disease in Ethiopia was needed to provide optimal health care services in a resource limited setting. Objective The study assessed COVID-19 patients admitted to Millennium COVID-19 Care Center in Ethiopia for characteristics associated with COVID-19 disease severity. Methods A cross-sectional study was conducted from June to August 2020 among 686 randomly selected patients. Chi-square test was used to detect the presence of a statistically significant difference in the characteristics of the patients based on disease severity (Mild vs Moderate vs Severe). A multinomial logistic regression model was used to identify factors associated with COVID-19 disease severity where Adjusted Odds ratio (AOR), 95% CIs for AOR and P-values were used for significance testing. Results Having moderate as compared with mild disease was significantly associated with having hypertension (AOR = 2.30, 95%CI = 1.27,4.18), diabetes mellitus (AOR = 2.61, 95%CI = 1.31,5.19for diabetes mellitus), fever (AOR = 6.12, 95%CI = 2.94,12.72) and headache (AOR = 2.69, 95%CI = 1.39,5.22). Similarly, having severe disease as compared with mild disease was associated with age group (AOR = 4.43, 95%CI = 2.49,7.85 for 40–59 years and AOR = 18.07, 95%CI = 9.29,35.14for ≥ 60 years), sex (AOR = 1.84, 95%CI = 1.12,3.03), hypertension (AOR = 1.97, 95%CI = 1.08,3.59), diabetes mellitus (AOR = 3.93, 95%CI = 1.96,7.85), fever (AOR = 13.22, 95%CI = 6.11, 28.60) and headache (AOR = 4.82, 95%CI = 2.32, 9.98). In addition, risk factors of severe disease as compared with moderate disease were found to be significantly associated with age group (AOR = 4.87, 95%CI = 2.85, 8.32 for 40–59 years and AOR = 18.91, 95%CI = 9.84,36.331 for ≥ 60 years), fever (AOR = 2.16, 95%CI = 1.29,3.63) and headache (AOR = 1.79, 95%CI = 1.03, 3.11). Conclusions Significant factors associated with severe COVID-19 in Ethiopia are being older than 60 years old, male, a diagnosis of hypertension, diabetes mellitus, and the presence of fever and headache. This is consistent with severity indicators identified by WHO and suggests the initial finding of milder disease in Ethiopia may have been because the first people to get COVID-19 in the country were the relatively younger with fewer health problems.
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Affiliation(s)
- Tigist W. Leulseged
- Millennium COVID-19 Care Center, St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia
- * E-mail:
| | - Kindalem G. Abebe
- Millennium COVID-19 Care Center, St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Ishmael S. Hassen
- Millennium COVID-19 Care Center, St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Endalkachew H. Maru
- Millennium COVID-19 Care Center, St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Wuletaw C. Zewde
- Millennium COVID-19 Care Center, St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Negat W. Chamiso
- Millennium COVID-19 Care Center, St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Kalkidan T. Yegele
- Millennium COVID-19 Care Center, St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Abdi B. Bayisa
- Millennium COVID-19 Care Center, St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Dagne F. Siyoum
- Millennium COVID-19 Care Center, St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Mesay G. Edo
- Millennium COVID-19 Care Center, St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Edmialem G. Mesfin
- Millennium COVID-19 Care Center, St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Meskerem N. Derejie
- Millennium COVID-19 Care Center, St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Helina K. Shiferaw
- Millennium COVID-19 Care Center, St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia
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Grima S, Rupeika-Apoga R, Kizilkaya M, Romānova I, Dalli Gonzi R, Jakovljevic M. A Proactive Approach to Identify the Exposure Risk to COVID-19: Validation of the Pandemic Risk Exposure Measurement (PREM) Model Using Real-World Data. Risk Manag Healthc Policy 2021; 14:4775-4787. [PMID: 34866947 PMCID: PMC8637761 DOI: 10.2147/rmhp.s341500] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 11/11/2021] [Indexed: 12/12/2022] Open
Abstract
Purpose To statistically validate the PREM (Pandemic Risk Exposure Measurement) model devised in a previous paper by the authors and determine the model’s relationship with the level of current COVID-19 cases (NLCC) and the level of current deaths related to COVID-19 (NLCD) based on the real country data. Methods We used perceived variables proposed in a previous study by the same lead authors and applied the latest available real data values for 154 countries. Two endogenous real data variables (NLCC) and (NLCD) were added. Data were transformed to measurable values using a Likert scale of 1 to 5. The resulting data for each variable were entered into SPSS (Statistical Package for the Social Sciences) version 26 and Amos (Analysis of a Moment Structures) version 21 and subjected to statistical analysis, specifically exploratory factor analysis, Cronbach’s alpha and confirmatory factor analysis. Results The results obtained confirmed a 4-factor structure and that the PREM model using real data is statistically reliable and valid. However, the variable Q14 – hospital beds available per capita (1000 inhabitants) had to be excluded from the analysis because it loaded under more than one factor and the difference between the factor common variance was less than 0.10. Moreover, its Factor 1 and Factor 3 with NLCC and Factor 1 with NLCD showed a statistically significant relationship. Conclusion Therefore, the developed PREM model moves from a perception-based model to reality. By proposing a model that allows governments and policymakers to take a proactive approach, the negative impact of a pandemic on the functioning of a country can be reduced. The PREM model is useful for decision-makers to know what factors make the country more vulnerable to a pandemic and, if possible, to manage or set tolerances as part of a preventive measure. ![]()
Point your SmartPhone at the code above. If you have a QR code reader, the video abstract will appear. Or use: https://youtu.be/3dSPl4ygwdI
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Affiliation(s)
- Simon Grima
- Department of Insurance, Faculty of Economics, Management and Accountancy, University of Malta, Msida, Malta
| | - Ramona Rupeika-Apoga
- Faculty of Business, Management and Economics, University of Latvia, Riga, Latvia
| | - Murat Kizilkaya
- Department of Economics, Faculty of Economics and Administrative Sciences, Ardahan University, Ardahan, Turkey
| | - Inna Romānova
- Faculty of Business, Management and Economics, University of Latvia, Riga, Latvia
| | - Rebecca Dalli Gonzi
- Department of Construction & Property Management, University of Malta, Msida, MSD, 2080, Malta
| | - Mihajlo Jakovljevic
- Institute of Comparative Economic Studies ICES, Faculty of Economics, Hosei University, Tokyo, Japan.,Department of Global Health Economics and Policy, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
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Clinical and Imaging Characteristics of Cancer Patients with COVID-19: A Pilot Study. INTERNATIONAL JOURNAL OF CANCER MANAGEMENT 2021. [DOI: 10.5812/ijcm.115735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Malignancy is a known risk factor of coronavirus disease 2019 (COVID-19) severe involvement. Information about this infection in patients with cancer is limited. Objectives: This study aimed at reporting the clinical and imaging characteristics of COVID-19 infection in patients with cancer. Methods: All the patients were known cases of a solid tumor with COVID-19 infection in one center, between February and May 2020. Clinical presentation and imaging involvement of COVID-19 infection in addition to cancer features were documented from medical records/patient interviews. Results: Thirty-one patients with solid tumors and COVID-19 involvement were included. The most prevalet presentation was fever, cough, and myalgia. Breast and gastrointestinal malignancies were the most common cancer types. The mortality rate was 22.5% and all deceased patients suffered from stage 4 of their underlying cancer disease. Lung computed tomography scan (CT scan) features in these patients were not different from the non-cancer patients with COVID-19. Conclusions: COVID-19 involvement in patients with cancer seems to be more severe with higher mortality rates especially in patients with other comorbidity and in metastatic cases. Treatment modifications during the pandemic era sound to be logical in decreasing the infection rate.
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Siavashpour Z, Goharpey N, Mobasheri M. Radiotherapy based management during Covid-19 pandemic - A systematic review of presented consensus and guidelines. Crit Rev Oncol Hematol 2021; 164:103402. [PMID: 34214608 PMCID: PMC8242203 DOI: 10.1016/j.critrevonc.2021.103402] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 02/17/2021] [Accepted: 06/18/2021] [Indexed: 01/18/2023] Open
Abstract
Treatment management of cancer patients in the radiation oncology departments during the current COVID-19 pandemic is challenging. A systematic review of published consensus/guidelines on the role of radiotherapy prioritization, suggested treatment protocols, and set up management was undertaken based on the PRISMA protocol and through PubMed/PMC, Scopus, Google Scholar, Web of Science databases until 01/20/2021. One hundred and sixty-eight publications or regional consensus were included. Summary of recommendations contained: (1) using hypo-fractionated (Hypo-F) regimens for therapeutic/palliative indications, (2) delaying radiotherapy for several weeks or until pandemic over, (3) omitting radiotherapy by replacement of alternative therapies or active surveillance, (4) applying safer patients' setup and preparation protocols, (5) developing telemedicine/telehealth service. To conclude, it is essential to carefully weigh the risk of exposure to COVID-19 infection and the benefit of treating cancer patients during the pandemic. Trying to have a global guideline facing this or any other probable crisis is crucial for health care service.
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Affiliation(s)
- Zahra Siavashpour
- Radiotherapy Oncology Department, Shohada-e Tajrish Educational Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Neda Goharpey
- Radiotherapy Oncology Department, Shohada-e Tajrish Educational Hospital, Tehran, Iran.
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Shahidsales S, Aledavood SA, Joudi M, Molaie F, Esmaily H, Javadinia SA. COVID-19 in cancer patients may be presented by atypical symptoms and higher mortality rate, a case-controlled study from Iran. Cancer Rep (Hoboken) 2021; 4:e1378. [PMID: 33742793 PMCID: PMC8250318 DOI: 10.1002/cnr2.1378] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 02/12/2021] [Accepted: 03/04/2021] [Indexed: 01/08/2023] Open
Abstract
Background Coronavirus disease 2019 (COVID‐19) pandemic imposes serious problems to health systems around the world and its rapid expansion makes it difficult to serve patients with certain health conditions such as cancer patients which might be at high risk for mortality if they are infected by the severe acute respiratory syndrome coronavirus 2. Aim To compare the outcomes of cancer patients admitted due to COVID‐19 and compare them with data of COVID‐19 infected patients without a history of cancer. Methods In this case‐controlled study, 93 healthy people and 92 patients with malignancy admitted for COVID‐19 were enrolled. The clinical features and laboratory indicators were assessed at the presentation and both groups were followed‐up for treatment options and outcomes prospectively and compared at the level of P ≤ .05. Results COVID‐19 related mortality rate in malignant patients was significantly higher than patients without malignancy (41.3% vs 17.2%, P = .0001). The risk of death increased significantly in patients with malignancy (OR = 8.4, P = .007) and mechanical ventilation (OR = 3.3, P = .034) independent of other variables. Fever (64.5% vs 43.5%, P = .004), chill (35.5% vs 14.1%, P = .001), malaise (49.5% and 30.4%, P = .008), dry cough (51.6% vs 26.1%, P = .0001), and vomiting (17.2% vs 5.4%, P = .012) were reported significantly lower in cancer patients. Conclusion The results suggest that cancer patients who were infected by COVID‐19 may present with atypical symptoms are at higher risk of mortality independent of the demographic data, comorbidities, and treatments.
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Affiliation(s)
| | | | - Mona Joudi
- Cancer Research Centre, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Fatemeh Molaie
- Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Habibollah Esmaily
- Department of Epidemiology and Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Seyed Alireza Javadinia
- Cellular and Molecular Research Center, Sabzevar University of Medical Sciences, Sabzevar, Iran
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Jereczek-Fossa BA, Pepa M, Zaffaroni M, Marvaso G, Bruni A, Buglione di Monale E Bastia M, Catalano G, Filippi AR, Franco P, Gambacorta MA, Genovesi D, Iatì G, Magli A, Marafioti L, Meattini I, Merlotti A, Mignogna M, Musio D, Pacelli R, Pergolizzi S, Tombolini V, Trovo M, Leonardi MC, Ricardi U, Magrini SM, Corvò R, Donato V. COVID-19 safe and fully operational radiotherapy: An AIRO survey depicting the Italian landscape at the dawn of phase 2. Radiother Oncol 2021; 155:120-122. [PMID: 33065185 PMCID: PMC7553860 DOI: 10.1016/j.radonc.2020.09.049] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 09/18/2020] [Accepted: 09/27/2020] [Indexed: 12/12/2022]
Affiliation(s)
- Barbara Alicja Jereczek-Fossa
- Division of Radiation Oncology, IEO, European Institute of Oncology, IRCCS, Milano, Italy; Department of Oncology and Hemato-Oncology, University of Milan, Milano, Italy
| | - Matteo Pepa
- Division of Radiation Oncology, IEO, European Institute of Oncology, IRCCS, Milano, Italy
| | - Mattia Zaffaroni
- Division of Radiation Oncology, IEO, European Institute of Oncology, IRCCS, Milano, Italy.
| | - Giulia Marvaso
- Division of Radiation Oncology, IEO, European Institute of Oncology, IRCCS, Milano, Italy; Department of Oncology and Hemato-Oncology, University of Milan, Milano, Italy
| | - Alessio Bruni
- Radiotherapy Unit, Department of Oncology and Haematology, University Hospital of Modena, Italy
| | | | - Gianpiero Catalano
- Radiation Oncology Centre, IRCCS Ospedale Multimedica, Sesto San Giovanni/Castellanza, Italy
| | - Andrea Riccardo Filippi
- Department of Radiation Oncology, Fondazione IRCCS Policlinico San Matteo and University of Pavia, Italy
| | | | | | - Domenico Genovesi
- Radiation Oncology Unit, "SS Annunziata" Hospital, "G. D'Annunzio" University, Chieti, Italy
| | - Giuseppe Iatì
- Radiation Oncology Unit, Department of Biomedical, Dental Science and Morphological and Functional Images, University of Messina, Italy
| | | | - Luigi Marafioti
- Division of Radiotherapy, Azienda Ospedaliera di Cosenza, Italy
| | - Icro Meattini
- Radiation Oncology Unit, Oncology Department, Azienda Ospedaliero Universitaria Careggi, Firenze, Italy; Department of Experimental and Clinical Biomedical Sciences "M. Serio", University of Florence, Firenze, Italy
| | - Anna Merlotti
- Department of Radiation Oncology, S. Croce and Carle Teaching Hospital, Cuneo, Italy
| | - Marcello Mignogna
- Radiation Oncology Unit, S. Luca Hospital, Healthcare Company Tuscany Nord Ovest, Lucca, Italy
| | - Daniela Musio
- Department of Radiotherapy, Policlinico Umberto I "Sapienza" University of Rome, Roma, Italy
| | - Roberto Pacelli
- Department of Advanced Biomedical Sciences, Federico II University, Napoli, Italy
| | - Stefano Pergolizzi
- Radiation Oncology Unit, Department of Biomedical, Dental Science and Morphological and Functional Images, University of Messina, Italy
| | - Vincenzo Tombolini
- Department of Radiotherapy, Policlinico Umberto I "Sapienza" University of Rome, Roma, Italy
| | - Marco Trovo
- Department of Radiation Oncology, Udine General Hospital, Italy
| | | | | | - Stefano Maria Magrini
- Department of Radiation Oncology, University and Spedali Civili Hospital, Brescia, Italy
| | - Renzo Corvò
- Department of Radiation Oncology, IRCCS Ospedale Policlinico San Martino, Genova, Italy; Health Science Department (DISSAL), University of Genoa, Genova, Italy
| | - Vittorio Donato
- Radiation Oncology Division, Oncology and Specialty Medicine Department, San Camillo-Forlanini Hospital, Roma; President of AIRO (Italian Association of Radiotherapy and Clinical Oncology), Italy
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Fadavi P, Houshyari M, Yousefi Kashi AS, Jarrahi AM, Roshanmehr F, Broomand MA, Sandoughdaran S, Taghizadeh-Hesary F. Review on the Oncology Practice in the Midst of COVID-19 Crisis: The Challenges and Solutions. Asian Pac J Cancer Prev 2021; 22:19-24. [PMID: 33507674 PMCID: PMC8184167 DOI: 10.31557/apjcp.2021.22.1.19] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Indexed: 11/25/2022] Open
Abstract
As of late 2019, the outbreak of novel coronavirus disease (COVID-19) –that started in China– has rapidly afflicted all over the world. The COVID-19 pandemic has challenged health-care facilities to provide optimal care. In this context, cancer care requires special attention because of its peculiar status by including patients who are commonly immunocompromised and treatments that are often highly toxic. In this review article, we have classified the main impacts of the COVID-19 pandemic on oncology practices –followed by their solutions– into ten categories, including impacts on (1) health care providers, (2) medical equipment, (3) access to medications, (4) treatment approaches, (5) patients’ referral, (6) patients’ accommodation, (7) patients’ psychological health, (8) cancer research, (9) tumor board meetings, and (10) economic income of cancer centers. The effective identification and management of all these challenges will improve the standards of cancer care over the viral pandemic and can be a practical paradigm for possible future crises.
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Affiliation(s)
- Pedram Fadavi
- Department of Radiation Oncology, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Houshyari
- Department of Clinical Oncology, Shohada-e Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Amir Shahram Yousefi Kashi
- Department of Clinical Oncology, Shohada-e Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Cancer Research Center, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Alireza Mosavi Jarrahi
- Cancer Research Center, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farnaz Roshanmehr
- Faculty of Science and Engineering, Waseda University, Tokyo, Japan.,Kagawa Nutrition University, Saitama, Japan
| | - Mohammad Ali Broomand
- Department of Clinical Oncology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Saleh Sandoughdaran
- Shohada Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Corrao G, Bergamaschi L, Zaffaroni M, Sarra Fiore M, Bufi G, Leonardi MC, Lazzari R, Alterio D, Cattani F, Pravettoni G, Mastrilli F, Orecchia R, Marvaso G, Jereczek-Fossa BA. COVID-19 impact in radiotherapy practice in an oncology hub: a screenshot from Lombardy, Italy. TUMORI JOURNAL 2020; 107:498-503. [PMID: 33327890 PMCID: PMC7746951 DOI: 10.1177/0300891620980065] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Objective: During 2020, medical clinical activities were dramatically modified by the coronavirus disease 2019 (COVID-19) emergency. We aim to evaluate the impact of COVID-19 on radiotherapy (RT) practice in a hub cancer center. Methods: Retrospective data collection of patients with suspected COVID-19 infection, identified by pathognomonic symptoms feedback at triage realized at the entrance to RT division. Inclusion criteria were diagnosis of oncologic disease, COVID-19–related symptoms, and signed written informed consent. Results: Between 1 March and 30 June 2020, 1,006 patients accessed our RT division for RT simulation or treatment. Forty-four patients matched inclusion criteria (4.4% of all patients): 29 women and 15 men. Seventeen patients had metastatic disease. Twenty-one patients reported fever, 6 presented dyspnea, 4 complained of ageusia and anosmia, and 3 developed conjunctivitis. Thirty-six patients underwent nasal swab, with 7 positive results. From our cohort, 4 cases of pneumonia were diagnosed with computed tomography scan imaging: 3 were related to COVID-19 infection, while the fourth was evaluated as an RT adverse event. From the entire series, 4 patients died: 3 during hospitalization in intensive care unit of complications of COVID-19 and 1 of other causes neither COVID-19 nor cancer-related. Conclusions: Cancer hub allows for safe RT practice continuation while minimizing the spread of contagion in this frail patient population. A challenge for the future will be to understand pandemic consequences in cancer natural history and manage its clinical impact.
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Affiliation(s)
- Giulia Corrao
- Division of Radiation Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy.,Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Luca Bergamaschi
- Division of Radiation Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy.,Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Mattia Zaffaroni
- Division of Radiation Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Massimo Sarra Fiore
- Division of Radiation Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Giammaria Bufi
- Division of Radiation Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | | | - Roberta Lazzari
- Division of Radiation Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Daniela Alterio
- Division of Radiation Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Federica Cattani
- Medical Physics Unit, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Gabriella Pravettoni
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy.,Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology IRCCS, Milan, Italy
| | - Fabrizio Mastrilli
- Medical Administration, CMO, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Roberto Orecchia
- Scientific Direction, IEO, European Institute of Oncology, IRCCS, Milan, Italy
| | - Giulia Marvaso
- Division of Radiation Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy.,Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Barbara Alicja Jereczek-Fossa
- Division of Radiation Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy.,Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
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Rakhsha A, Azghandi S, Taghizadeh-Hesary F. Decision on Chemotherapy Amidst COVID-19 Pandemic: a Review and a Practical Approach from Iran. Infect Chemother 2020; 52:496-502. [PMID: 33263246 PMCID: PMC7779976 DOI: 10.3947/ic.2020.52.4.496] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 11/15/2020] [Indexed: 12/14/2022] Open
Abstract
To provide a step-by-step approach to chemotherapy (CTx) in the novel coronavirus disease 2019 (COVID-19) era. The COVID-19 pandemic is the current global issue resulting in vast health implications. Amid the COVID-19 era, special attention must be paid to at-risk groups, including patients with cancer. To our knowledge, there is a paucity of data on the decision for CTx during the pandemic. We herein provide practical recommendations on the CTx of cancer patients over the pandemic based on our experience in an educational hospital. The decision on CTx should be considered to be individualized based on clinical findings. We hope that our experience provides a practical guide for clinical oncologists to deliver more effective cancer care over the COVID-19 pandemic.
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Affiliation(s)
- Afshin Rakhsha
- Clinical Oncology Department, Shohada-e Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Samira Azghandi
- Clinical Oncology Department, Shohada-e Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farzad Taghizadeh-Hesary
- Clinical Oncology Department, Shohada-e Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Back to (new) normality-A CODRAL/AIRO-L survey on cancer radiotherapy in Lombardy during Italian COVID-19 phase 2. Med Oncol 2020; 37:108. [PMID: 33150476 PMCID: PMC7641253 DOI: 10.1007/s12032-020-01434-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 10/23/2020] [Indexed: 12/22/2022]
Abstract
Background Italy experienced one of the world’s severest COVID-19 outbreak, with Lombardy being the most afflicted region. However, the imposed safety measures allowed to flatten the epidemic curve and hence to ease the restrictions and inaugurate, on the 4th of May 2020, the Italian phase (P) 2 of the pandemic. The present survey study, endorsed by CODRAL and AIRO-L, aimed to assess how radiotherapy (RT) departments in Lombardy have dealt with the recovery. Materials and methods A questionnaire dealing with the management of pandemic was developed online and sent to all CODRAL Directors on the 10th of June 2020. Answers were collected in full anonymity one week after. Results All the 33 contacted RT facilities (100%) responded to the survey. Despite the scale of the pandemic, during P1 14 (42.4%) centres managed to safely continue the activity (≤ 10% reduction). During P2, 10 (30.3%) centres fully recovered and 14 (42.4%) reported an increase. Nonetheless, 6 (18.2%) declared no changes and, interestingly, 3 (9.1%) reduced activities. Overall, 21 centres (63.6%) reported suspected or positive cases within healthcare workforce since the beginning of the pandemic. Staff units were quarantined in 19 (57.6%) and 6 (18.2%) centres throughout P1 and P2, respectively. In the two phases, about two thirds centres registered positive or suspected cases amongst patients. Conclusion The study revealed a particular attention to anti-contagion measures and a return to normal or even higher clinical workload in most RT centres in Lombardy, necessary to carry out current and previously deferred treatments. Electronic supplementary material The online version of this article (10.1007/s12032-020-01434-1) contains supplementary material, which is available to authorized users.
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