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Aden D, Zaheer S, Raj S. Challenges faced in the cancer diagnosis and management-COVID-19 pandemic and beyond-Lessons for future. Heliyon 2022; 8:e12091. [PMID: 36483302 PMCID: PMC9721200 DOI: 10.1016/j.heliyon.2022.e12091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 05/28/2022] [Accepted: 11/25/2022] [Indexed: 12/12/2022] Open
Abstract
The COVID-19 pandemic with multiple waves of infection has caused panic and distress globally. Cancer patients being immuno-compromised are more susceptible to infection leading to increased morbidity and unpredictability of their survival. There has been a halt in the diagnosis and treatment of patients suffering from cancer because of the COVID-19 pandemic. Oncologists have the tedious task of assessing the urgency of managing cancer patients against the risk of Coronavirus infection. Timely diagnostic services along with the treatment strategy are needed for the proper management of cancer patients. Since the laboratories are already overwhelmed with the investigations related to the COVID-19 management, there has been a compromise and delay in the diagnosis, thus leading to an overall lag in the management of cancer patients.
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Affiliation(s)
- Durre Aden
- Department of Pathology, HIMSR and HAHC, New Delhi-62, India
| | - Sufian Zaheer
- Department of Pathology, VMMC, Safdarjang Hospital, New Delhi-29, India,Corresponding author.
| | - Swati Raj
- Department of Pathology, Government Doon Medical College, Dehradun, Uttarakhand, India
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2
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Piras A, Venuti V, D’Aviero A, Cusumano D, Pergolizzi S, Daidone A, Boldrini L. Covid-19 and radiotherapy: a systematic review after 2 years of pandemic. Clin Transl Imaging 2022; 10:611-630. [PMID: 35910079 PMCID: PMC9308500 DOI: 10.1007/s40336-022-00513-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 07/12/2022] [Indexed: 02/08/2023]
Abstract
Introduction Following the Covid-19 pandemic spread, changes in clinical practice were necessary to limit the pandemic diffusion. Also, oncological practice has undergone changes with radiotherapy (RT) treatments playing a key role.Although several experiences have been published, the aim of this review is to summarize the current evidence after 2 years of pandemic to provide useful conclusions for clinicians. Methods A Pubmed/MEDLINE and Embase systematic review was conducted. The search strategy was "Covid AND Radiotherapy" and only original articles in the English language were considered. Results A total of 2.733 papers were obtained using the mentioned search strategy. After the complete selection process, a total of 281 papers were considered eligible for the analysis of the results. Discussion RT has played a key role in Covid-19 pandemic as it has proved more resilient than surgery and chemotherapy. The impact of the accelerated use of hypofractionated RT and telemedicine will make these strategies central also in the post-pandemic period.
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Affiliation(s)
- Antonio Piras
- Radioterapia Oncologica, Villa Santa Teresa, Palermo, Italy
| | - Valeria Venuti
- Radioterapia Oncologica, Università degli Studi di Palermo, Palermo, Italy
| | - Andrea D’Aviero
- Radiation Oncology, Mater Olbia Hospital, Olbia, Sassari Italy
| | | | - Stefano Pergolizzi
- Radiation Oncology Unit, Department of Biomedical, Dental Science and Morphological and Functional Images, University of Messina, Messina, Italy
| | | | - Luca Boldrini
- Dipartimento di Diagnostica per immagini, Radioterapia Oncologica ed Ematologia, UOC Radioterapia Oncologica - Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy
- Università Cattolica del Sacro Cuore, Roma, Italy
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3
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Gadsden T, Downey LE, Vilas VDR, Peiris D, Jan S. The impact of COVID-19 on essential health service provision for noncommunicable diseases in the South-East Asia region: A systematic review. THE LANCET REGIONAL HEALTH. SOUTHEAST ASIA 2022; 1:100010. [PMID: 35769108 PMCID: PMC9069231 DOI: 10.1016/j.lansea.2022.04.006] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Background COVID-19 has had a profound impact on the health systems of the 11 countries of the WHO South East Asia Region. We conducted a systematic review of studies that used quantitative and comparative approaches to assess the impact of the pandemic on the service provision of four noncommunicable diseases (NCDs) (cancer, cardiovascular disease, chronic respiratory diseases, and diabetes) in the region. Methods A systematic search was conducted in PubMed, Embase, MedRxiv, and WHO COVID-19 databases in December 2021. The quality of studies was evaluated using the Joanna Briggs Institute Critical Appraisal Checklist and the ROBINS-I risk of bias tool. A narrative synthesis was conducted following the 'synthesis without meta-analysis' reporting guidelines. Findings Two review authors independently screened 5,397 records with 31 studies included, 26 which were cross-sectional studies. Most studies (n=24, 77%) were conducted in India and 19 (61%) were single-site studies. Compared to a pre-pandemic period, 10/17 cancer studies found a >40% reduction in outpatient services, 9/14 cardiovascular disease found a reduction of 30% or greater in inpatient admissions and 2 studies found diagnoses and interventions for respiratory diseases reduced up to 78.9% and 83.0%, respectively. No eligible studies on the impact of COVID-19 on diabetes services were found. Interpretation COVID-19 has substantially disrupted the provision of essential health services for NCDs in the WHO South East Asia Region, particularly cancer and cardiovascular disease. This is likely to have serious and potentially long-term downstream impacts on health and mortality of those living with or at risk of NCDs in the region. Funding This work was supported by the WHO Sri Lanka Country Office.
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Affiliation(s)
- Thomas Gadsden
- The George Institute for Global Health, University of New South Wales, Sydney, Australia
| | - Laura E Downey
- The George Institute for Global Health, University of New South Wales, Sydney, Australia
- School of Public Health, Imperial College London, London, United Kingdom
| | - Victor Del Rio Vilas
- World Health Organization (WHO) South East Asia Regional Office (SEARO), New Delhi, India
| | - David Peiris
- The George Institute for Global Health, University of New South Wales, Sydney, Australia
- Faculty of Medicine and Health, The University of Sydney School of Public Health, Sydney, Australia
| | - Stephen Jan
- The George Institute for Global Health, University of New South Wales, Sydney, Australia
- Faculty of Medicine and Health, The University of Sydney School of Public Health, Sydney, Australia
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Basu Achari R, Chakraborty S, Goyal L, Saha S, Roy P, Zameer L, Mishra D, Parihar M, Das A, Chandra A, Biswas B, Mallick I, Arunsingh MA, Chatterjee S, Bhattacharyya T. Evaluating Quality Indicators of Glioblastoma Care: Audit Results From an Indian Tertiary Care Cancer Center. JCO Glob Oncol 2022; 8:e2100405. [PMID: 35298293 PMCID: PMC8955054 DOI: 10.1200/go.21.00405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE There are limited reports of quality metrics in glioblastoma. We audited our adherence to quality indicators as proposed in the PRIME Quality Improvement study. METHODS This is a retrospective audit of patients treated between 2017 and 2020. After postsurgical integrated diagnosis, patients received radiotherapy (RT) with concurrent and adjuvant temozolomide (TMZ). Multiparametric magnetic resonance imaging at predefined times guided management. Numbers with proportions for indices were calculated. Survival was estimated using the Kaplan-Meier method. RESULTS One hundred six patients were consecutively treated. The median age was 55 years (interquartile range of 47-61 years) with a male preponderance (68%). Ninety-six (90.6%) patients underwent subtotal resection, and 10 (9.4%) biopsy alone. Isocitrate dehydrogenase was wild-type in 96 (91%), and O6-methylguanine-DNA methyltransferase was unmethylated in 70 (66.0%) patients. Telomerase reverse transcriptase promoter was mutated in 64 (60.4%), and TP53 was mutated in 22 (20.8%). Concurrent radiation and TMZ were planned for 104 (98.1%), and radiation alone for 2 (1.9%). The median time to concurrent RT-TMZ was 36 days (interquartile range 30-44 days). All patients planned for RT-TMZ completed treatment, but only 81 (76%) completed adjuvant TMZ. Sixty-three (59%) completed six cycles, 18 (17%) received less than six cycles, and 25 (24%) did not receive adjuvant TMZ. At a median follow-up of 24 months (range 21-31 months), the median (95% CI) progression-free survival and overall survival were 11 (95% CI, 9.4 to 13.0) and 20.0 (95% CI, 15 to 26) months, respectively. CONCLUSION Our patients met quality indices in most domains; outcomes are comparable with global results. Metrics will be periodically evaluated to include new standards and assess continuous service appropriateness.
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Affiliation(s)
- Rimpa Basu Achari
- Department of Radiation Oncology, Tata Medical Center, Kolkata, India
| | | | - Love Goyal
- Department of Radiation Oncology, Tata Medical Center, Kolkata, India
| | - Saheli Saha
- Department of Radiation Oncology, Tata Medical Center, Kolkata, India
| | - Paromita Roy
- Department of Oncopathology, Tata Medical Center, Kolkata, India
| | - Lateef Zameer
- Department of Oncopathology, Tata Medical Center, Kolkata, India
| | - Deepak Mishra
- Department of Laboratory Hematology, Molecular Genetics and Cytogenetics, Tata Medical Center, Kolkata, India
| | - Mayur Parihar
- Department of Laboratory Hematology, Molecular Genetics and Cytogenetics, Tata Medical Center, Kolkata, India
| | - Anirban Das
- Department of Pediatric Oncology, Tata Medical Center, Kolkata, India
| | - Aditi Chandra
- Department of Radiology, Tata Medical Center, Kolkata, India
| | - Bivas Biswas
- Department of Medical Oncology, Tata Medical Center, Kolkata, India
| | - Indranil Mallick
- Department of Radiation Oncology, Tata Medical Center, Kolkata, India
| | - Moses A Arunsingh
- Department of Radiation Oncology, Tata Medical Center, Kolkata, India
| | - Sanjoy Chatterjee
- Department of Radiation Oncology, Tata Medical Center, Kolkata, India
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Tang A, Neeman E, Vuong B, Arasu VA, Liu R, Kuehner GE, Savitz AC, Lyon LL, Anshu P, Seaward SA, Patel MD, Habel LA, Kushi LH, Mentakis M, Thomas ES, Kolevska T, Chang SB. Care in the time of COVID-19: impact on the diagnosis and treatment of breast cancer in a large, integrated health care system. Breast Cancer Res Treat 2022; 191:665-675. [PMID: 34988767 PMCID: PMC8731186 DOI: 10.1007/s10549-021-06468-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 11/28/2021] [Indexed: 12/19/2022]
Abstract
PURPOSES To delineate operational changes in Kaiser Permanente Northern California breast care and evaluate the impact of these changes during the initial COVID-19 Shelter-in-Place period (SiP, 3/17/20-5/17/20). METHODS By extracting data from institutional databases and reviewing electronic medical charts, we compared clinical and treatment characteristics of breast cancer patients diagnosed 3/17/20-5/17/20 to those diagnosed 3/17/19-5/17/2019. Outcomes included time from biopsy to consultation and treatment. Comparisons were made using Chi-square or Wilcoxon rank-sum tests. RESULTS Fewer new breast cancers were diagnosed in 2020 during the SiP period than during a similar period in 2019 (n = 247 vs n = 703). A higher percentage presented with symptomatic disease in 2020 than 2019 (78% vs 37%, p < 0.001). Higher percentages of 2020 patients presented with grade 3 (37% vs 25%, p = 0.004) and triple-negative tumors (16% vs 10%, p = 0.04). A smaller percentage underwent surgery first in 2020 (71% vs 83%, p < 0.001) and a larger percentage had neoadjuvant chemotherapy (16% vs 11%, p < 0.001). Telehealth utilization increased from 0.8% in 2019 to 70.0% in 2020. Times to surgery and neoadjuvant chemotherapy were shorter in 2020 than 2019 (19 vs 26 days, p < 0.001, and 23 vs 28 days, p = 0.03, respectively). CONCLUSIONS During SiP, fewer breast cancers were diagnosed than during a similar period in 2019, and a higher proportion presented with symptomatic disease. Early-stage breast cancer diagnoses decreased, while metastatic cancer diagnoses remained similar. Telehealth increased significantly, and times to treatment were shorter in 2020 than 2019. Our system continued to provide timely breast cancer treatment despite significant pandemic-driven disruption.
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Affiliation(s)
- Annie Tang
- Department of Surgery, University of California San Francisco, San Francisco, USA
| | - Elad Neeman
- Department of Medical Oncology, San Francisco Medical Center, Kaiser Permanente, San Francisco, USA
| | - Brooke Vuong
- Department of Surgery, South Sacramento Medical Center, Kaiser Permanente, Sacramento, USA
| | - Vignesh A Arasu
- Department of Radiology, Kaiser Permanente Vallejo Medical Center, Vallejo, USA
| | - Raymond Liu
- Department of Medical Oncology, San Francisco Medical Center, Kaiser Permanente, San Francisco, USA
- Division of Research, Kaiser Permanente Northern California, Oakland, USA
| | - Gillian E Kuehner
- Department of Surgery, Kaiser Permanente Vallejo Medical Center, Vallejo, USA
| | - Alison C Savitz
- Department of Surgery, Kaiser Permanente Walnut Creek Medical Center, Walnut Creek, USA
| | - Liisa L Lyon
- Division of Research, Kaiser Permanente Northern California, Oakland, USA
| | - Prachi Anshu
- Department of Surgery, Fremont Medical Center, Kaiser Permanente, Fremont Medical Center - 39400 Paseo Padre Pkwy, Fremont, CA, 94538, USA
| | - Samantha A Seaward
- Department of Radiation Oncology, Kaiser Permanente Oakland Medical Center, Oakland, USA
| | - Milan D Patel
- Department of Radiation Oncology, Kaiser Permanente South San Francisco Medical Center, South San Francisco, USA
| | - Laurel A Habel
- Division of Research, Kaiser Permanente Northern California, Oakland, USA
| | - Lawrence H Kushi
- Division of Research, Kaiser Permanente Northern California, Oakland, USA
| | - Margaret Mentakis
- Department of Surgery, South Sacramento Medical Center, Kaiser Permanente, Sacramento, USA
| | - Eva S Thomas
- Department of Medical Oncology, Kaiser Permanente Oakland Medical Center, Oakland, USA
| | - Tatjana Kolevska
- Department of Medical Oncology, Kaiser Permanente Vallejo Medical Center, Vallejo, USA
| | - Sharon B Chang
- Department of Surgery, Fremont Medical Center, Kaiser Permanente, Fremont Medical Center - 39400 Paseo Padre Pkwy, Fremont, CA, 94538, USA.
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Goenka L, Anandaradje A, Nakka T, Kayal S, Dubashi B, Chaturvedula L, Veena P, Durairaj J, Penumadu P, Ganesan P. The "collateral damage" of the war on COVID-19: impact of the pandemic on the care of epithelial ovarian cancer. Med Oncol 2021; 38:137. [PMID: 34581889 PMCID: PMC8476977 DOI: 10.1007/s12032-021-01588-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 09/19/2021] [Indexed: 12/23/2022]
Abstract
The covid-19 pandemic has impacted the management of non-covid-19 illnesses. Epithelial ovarian cancer (EOC) requires long-duration multidisciplinary treatment. Teleconsultation and shared care are suggested solutions to mitigate the consequences of the pandemic. However, these may be challenging to implement among patients who come from the lower economic strata. We report the disastrous impact of the pandemic on the care of EOC by comparing patients who were treated during the pandemic with those treated in the previous year. We collected the following data from newly diagnosed patients with EOC: time from diagnosis to treatment, time for completion of planned chemotherapy, and proportion of patients completing various components of therapy (surgery and chemotherapy). Patients treated between January 2019 and September 2019 (Group 1: Pre-covid) were compared with those treated between January 2020 and December 2020 (Group 2: During covid pandemic). A total of 82 patients were registered [Group 1: 43(51%) Group 2: 39(49)]. The median time from diagnosis to start of treatment was longer in group 2 when compared to group 1 [31(23–58) days versus 17(11–30) days (p = 0.03)]. The proportion of patients who had surgery in group 2 was lower in comparison to group 1 [33(77%) versus 21(54%) (p = 0.02)]. Proportion of patients who underwent neoadjuvant (NACT) and surgery were fewer in group 2 in comparison to group 1 [9(33%) versus 18(64%) p = 0.002]. Among patients planned for adjuvant chemotherapy, the median time from diagnosis to treatment was longer in group 2 [28(17–45) days, group 1 versus 49(26–78) days, group 2 (p = 0.04)]. The treatment of patients with EOC was adversely impacted due to the COVID-19 pandemic. There was a compromise in the proportion of patients completing planned therapy. Even among those who completed the treatment, there were considerable delays when compared with the pre-covid period. The impact of these compromises on the outcomes will be known with longer follow-up.
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Affiliation(s)
- Luxitaa Goenka
- Department of Medical Oncology, JIPMER, Dhanvantri Nagar, Puducherry, 605006, India
| | | | - Tejaeswar Nakka
- Department of Medical Oncology, JIPMER, Dhanvantri Nagar, Puducherry, 605006, India
| | - Smita Kayal
- Department of Medical Oncology, JIPMER, Dhanvantri Nagar, Puducherry, 605006, India
| | - Biswajit Dubashi
- Department of Medical Oncology, JIPMER, Dhanvantri Nagar, Puducherry, 605006, India
| | | | - Pampapati Veena
- Department of Obstetrics & Gynecology, JIPMER, Puducherry, India
| | | | | | - Prasanth Ganesan
- Department of Medical Oncology, JIPMER, Dhanvantri Nagar, Puducherry, 605006, India.
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