国际肿瘤学杂志››2023,Vol. 50››Issue (10): 577-584.doi:10.3760/cma.j.cn371439-20230706-00111
中国医师协会放射肿瘤治疗医师分会, 中华医学会放射肿瘤治疗学分会, 中国抗癌协会肿瘤放射治疗专业委员会
收稿日期:
2023-07-06修回日期:
2023-07-31出版日期:
2023-10-08发布日期:
2023-11-08Radiation Oncology Treatment Physician Branch, Chinese Medical Doctor Association; Radiation Oncology Therapy Branch, Chinese Medical Association; Chinese Association of Radiation Therapy, China Anti-Cancer Association
Received:
2023-07-06Revised:
2023-07-31Online:
2023-10-08Published:
2023-11-08摘要:
新型冠状病毒感染(COVID-19)疫情的持续大流行给全球卫生健康系统带来了前所未有的挑战,并在世界范围内对恶性肿瘤患者的标准治疗产生了一定影响,包括放疗。资源的限制会导致治疗能力下降,若要降低肿瘤患者暴露于新型冠状病毒的风险,则需要限制放疗的就诊次数,放疗科医生有必要根据现有的临床证据,在不降低疗效的基础上,做出有利于减少感染风险的放疗决策。目前,COVID-19疫情已接近尾声,但更具传染性的变种或其他病毒还可能会出现并传播。为此,中国医师协会放射肿瘤治疗医师分会、中华医学会放射肿瘤治疗学分会、中国抗癌协会肿瘤放射治疗专业委员会参考国内外多项关于恶性肿瘤患者在COVID-19疫情期间的相关指南及最新循证证据,根据中国的国情、医疗体系以及COVID-19流行特征制定了《新型冠状病毒感染疫情背景下肿瘤患者放射治疗管理相关问题中国专家共识(2023版)》。
中国医师协会放射肿瘤治疗医师分会, 中华医学会放射肿瘤治疗学分会, 中国抗癌协会肿瘤放射治疗专业委员会. 新型冠状病毒感染疫情背景下肿瘤患者放射治疗管理相关问题中国专家共识(2023版)[J]. 国际肿瘤学杂志, 2023, 50(10): 577-584.
Radiation Oncology Treatment Physician Branch, Chinese Medical Doctor Association; Radiation Oncology Therapy Branch, Chinese Medical Association; Chinese Association of Radiation Therapy, China Anti-Cancer Association. Chinese expert consensus on issues related to radiotherapy management of cancer patients under the back ground of COVID-19 (2023 Edition)[J]. Journal of International Oncology, 2023, 50(10): 577-584.
[1] | Zaorsky NG, Yu JB, McBride SM, et al. Prostate cancer radiation therapy recommendations in response to COVID-19[J].Adv Radiat Oncol,2020,5(4): 659-665. DOI:10.1016/j.adro.2020.03.010. pmid:32292839 |
[2] | NICE.COVID-19 rapid guideline: delivery of radiotherapy[M]//National Institute for Health and Care Excellence: Clinical Guidelines. London: National Institute for Health and Care Excellence (NICE),2021. |
[3] | Ontario Health.Pandemic Planning Clinical Guideline for Patients with Cancer[Z]. (2020-03-10)[2023-06-25]. https://obgyn.utoronto.ca/sites/default/files/oh-cco_pandemic_planning_clinical_guideline_final_2020-03-10_002.pdf. |
[4] | Rathod S, Dubey A, Bashir B, et al. Bracing for impact with new 4R's in the COVID-19 pandemic—a provincial thoracic radiation oncology consensus[J].Radiother Oncol,2020,149: 124-127. DOI:10.1016/j.radonc.2020.03.045. |
[5] | Dietz JR, Moran MS, Isakoff SJ, et al. Recommendations for prioritization, treatment, and triage of breast cancer patients during the COVID-19 pandemic. The COVID-19 pandemic breast cancer consortium[J].Breast Cancer Res Treat,2020,181(3): 487-497. DOI:10.1007/s10549-020-05644-z. |
[6] | de Azambuja E, Trapani D, Loibl S, et al. ESMO management and treatment adapted recommendations in the COVID-19 era: breast cancer[J].ESMO Open,2020,5(Suppl 3): e000793. DOI:10.1136/esmoopen-2020-000793. |
[7] | Curigliano G, Cardoso MJ, Poortmans P, et al. Recommendations for triage, prioritization and treatment of breast cancer patients during the COVID-19 pandemic[J].Breast,2020,52: 8-16. DOI:10.1016/j.breast.2020.04.006. pmid:32334323 |
[8] | Rathod S, Jeremic B, Dubey A, et al. Role of thoracic consolidation radiation in extensive stage small cell lung cancer: a systematic review and meta-analysis of randomised controlled trials[J].Eur J Cancer,2019,110: 110-119. DOI:10.1016/j.ejca.2019.01.003. pmid:30785014 |
[9] | Slotman BJ, van Tinteren H, Praag JO, et al. Use of thoracic radiotherapy for extensive stage small-cell lung cancer: a phase 3 randomised controlled trial[J].Lancet,2015,385(9962): 36-42. DOI:10.1016/S0140-6736(14)61085-0. pmid:25230595 |
[10] | Slotman B, Faivre-Finn C, Kramer G, et al. Prophylactic cranial irradiation in extensive small-cell lung cancer[J].N Engl J Med,2007,357(7): 664-672. DOI:10.1056/NEJMoa071780. |
[11] | Takahashi T, Yamanaka T, Seto T, et al. Prophylactic cranial irradiation versus observation in patients with extensive-disease small-cell lung cancer: a multicentre, randomised, open-label, phase 3 trial[J].Lancet Oncol,2017, 18(5): 663-671. DOI:10.1016/S1470-2045(17)30230-9. |
[12] | Hughes KS, Schnaper LA, Bellon JR, et al. 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[J].J Clin Oncol,2013,31(19): 2382-2387. DOI:10.1200/JCO.2012.45.2615. pmid:23690420 |
[13] | Kunkler IH, Williams LJ, Jack WJ, et al. Breast-conserving surgery with or without irradiation in women aged 65 years or older with early breast cancer (PRIME Ⅱ): a randomised controlled trial[J].Lancet Oncol,2015, 16(3): 266-273. DOI:10.1016/S1470-2045(14)71221-5. |
[14] | Braunstein LZ, Gillespie EF, Hong L, et al. Breast radiation therapy under COVID-19 pandemic resource constraints—approaches to defer or shorten treatment from a comprehensive cancer center in the United States[J].Adv Radiat Oncol,2020,5(4): 582-588. DOI:10.1016/j.adro.2020.03.013. pmid:32292842 |
[15] | Thomson DJ, Palma D, Guckenberger M, et al. Practice recommendations for risk-adapted head and neck cancer radiation therapy during the COVID-19 pandemic: an ASTRO-ESTRO consensus statement[J].Int J Radiat Oncol Biol Phys,2020,107(4): 618-627. DOI:10.1016/j.ijrobp.2020.04.016. |
[16] | Boettler T, Newsome PN, Mondelli MU, et al. Care of patients with liver disease during the COVID-19 pandemic: EASL-ESCMID position paper[J].JHEP Rep,2020,2(3): 100113. DOI:10.1016/j.jhepr.2020.100113. |
[17] | Lin YK, Hsu HL, Lin WC, et al. Efficacy of postoperative radiotherapy in patients with pathological stage N2epidermal growth factor receptor wild type adenocarcinoma and squamous cell carcinoma lung cancer[J].Oncotarget,2017,8(21): 35280-35288. DOI:10.18632/oncotarget.13257. |
[18] | Kim BH, Kim HJ, Wu HG, et al. Role of postoperative radiotherapy after curative resection and adjuvant chemotherapy for patients with pathological stage N2non-small-cell lung cancer: a propensity score matching analysis[J].Clin Lung Cancer,2014,15(5): 356-364. DOI:10.1016/j.cllc.2014.05.005. |
[19] | Drake JA, Portnoy DC, Tauer K, et al. Adding radiotherapy to adjuvant chemotherapy does not improve survival of patients with N2lung cancer[J].Ann Thorac Surg,2018,106(4): 959-965. DOI:10.1016/j.athoracsur.2018.04.074. |
[20] | Arrieta O, Cardona AF, Lara-Mejía L, et al. Recommendations for detection, prioritization, and treatment of thoracic oncology patients during the COVID-19 pandemic: the THOCOoP cooperative group[J].Crit Rev Oncol Hematol,2020,153: 103033. DOI:10.1016/j.critrevonc.2020.103033. |
[21] | Aupérin A, Arriagada R, Pignon JP, et al. Prophylactic cranial irradiation for patients with small-cell lung cancer in complete remission. Prophylactic Cranial Irradiation Overview Collaborative Group[J].N Engl J Med,1999,341(7): 476-484. DOI:10.1056/NEJM199908123410703. |
[22] | Takada M, Fukuoka M, Kawahara M, et al. Phase Ⅲ study of concurrent versus sequential thoracic radiotherapy in combination with cisplatin and etoposide for limited-stage small-cell lung cancer: results of the Japan Clinical Oncology Group Study 9104[J].J Clin Oncol,2002,20(14): 3054-3060. DOI:10.1200/JCO.2002.12.071. |
[23] | Murray N, Coy P, Pater JL, et al. Importance of timing for thoracic irradiation in the combined modality treatment of limited-stage small-cell lung cancer. The National Cancer Institute of Canada Clinical Trials Group[J].J Clin Oncol,1993,11(2): 336-344. DOI:10.1200/JCO.1993.11.2.336. pmid:8381164 |
[24] | Fried DB, Morris DE, Poole C, et al. Systematic review evaluating the timing of thoracic radiation therapy in combined modality therapy for limited-stage small-cell lung cancer[J].J Clin Oncol,2004,22(23): 4837-4845. DOI:10.1200/JCO.2004.01.178. pmid:15570087 |
[25] | Stinchcombe TE, Gore EM. Limited-stage small cell lung cancer: current chemoradiotherapy treatment paradigms[J].Oncologist,2010,15(2): 187-195. DOI:10.1634/theoncologist.2009-0298. pmid:20145192 |
[26] | Guckenberger M, Belka C, Bezjak A, et al. Practice recommendations for lung cancer radiotherapy during the COVID-19 pandemic: an ESTRO-ASTRO consensus statement[J].Int J Radiat Oncol Biol Phys,2020,107(4): 631-640. DOI:10.1016/j.ijrobp.2020.05.012. |
[27] | Olivotto IA, Lesperance ML, Truong PT, et al. Intervals longer than 20 weeks from breast-conserving surgery to radiation therapy are associated with inferior outcome for women with early-stage breast cancer who are not receiving chemotherapy[J].J Clin Oncol,2009,27(1): 16-23. DOI:10.1200/JCO.2008.18.1891. pmid:19018080 |
[28] | Karlsson P, Cole BF, Colleoni M, et al. Timing of radiotherapy and outcome in patients receiving adjuvant endocrine therapy[J].Int J Radiat Oncol Biol Phys,2011,80(2): 398-402. DOI:10.1016/j.ijrobp.2010.02.042. |
[29] | Vujovic O, Yu E, Cherian A, et al. Time interval from breast-conserving surgery to breast irradiation in early stage node-negative breast cancer: 17-year follow-up results and patterns of recurrence[J].Int J Radiat Oncol Biol Phys,2015,91(2): 319-324. DOI:10.1016/j.ijrobp.2014.10.006. |
[30] | National Comprehensive Cancer Network NCCN. NCCN Guidelines®Insights—Myelodysplastic Syndromes, version 3.2022[EB/OL]. [2023-06-25]. https://education.nccn.org/node/91068. |
[31] | 中国抗癌协会肿瘤支持治疗专业委员会, 中国抗癌协会肿瘤临床化疗专业委员会. 新型冠状病毒肺炎疫情期间实体肿瘤患者防护和诊治管理相关问题中国专家共识(2022版)[J].中华肿瘤杂志,2022,44(10): 1083-1090. DOI:10.3760/cma.j.cn112152-20220505-00309. |
[32] | Achard V, Tsoutsou P, Zilli T. Letter from Switzerland[J].Int J Radiat Oncol Biol Phys,2020,107(3): 600-601. DOI:10.1016/j.ijrobp.2020.03.008. |
[33] | Thomson DJ, Yom SS, Saeed H, et al. Radiation fractionation schedules published during the COVID-19 pandemic: a systematic review of the quality of evidence and recommendations for future development[J].Int J Radiat Oncol Biol Phys,2020,108(2): 379-389. DOI:10.1016/j.ijrobp.2020.06.054. |
[34] | Alterio D, Volpe S, Bacigalupo A, et al. Head and neck radiotherapy amid the COVID-19 pandemic: practice recommendations of the Italian Association of Radiotherapy and Clinical Oncology (AIRO)[J].Med Oncol,2020,37(10): 85. DOI:10.1007/s12032-020-01409-2. pmid:32808089 |
[35] | Combs SE, Belka C, Niyazi M, et al. First statement on preparation for the COVID-19 pandemic in large German Speaking University-based radiation oncology departments[J].Radiat Oncol,2020,15(1): 74. DOI:10.1186/s13014-020-01527-1. pmid:32264908 |
[36] | Gupta T, Ghosh-Laskar S, Agarwal JP. Resource-sparing curative-intent hypofractionated-accelerated radiotherapy in head and neck cancer: more relevant than ever before in the COVID era[J].Oral Oncol,2020,111: 105045. DOI:10.1016/j.oraloncology.2020.105045. |
[37] | Smith BD, Bellon JR, Blitzblau R, et al. Radiation therapy for the whole breast: executive summary of an American Society for Radiation Oncology (ASTRO) evidence-based guideline[J].Pract Radiat Oncol,2018,8(3): 145-152. DOI:10.1016/j.prro.2018.01.012. pmid:29545124 |
[38] | Wang SL, Fang H, Song YW, et al. Hypofractionated versus conventional fractionated postmastectomy radiotherapy for patients with high-risk breast cancer: a randomised, non-inferiority, open-label, phase 3 trial[J].Lancet Oncol,2019, 20(3): 352-360. DOI:10.1016/S1470-2045(18)30813-1. |
[39] | Tchelebi LT, Haustermans K, Scorsetti M, et al. Recommendations for the use of radiation therapy in managing patients with gastrointestinal malignancies in the era of COVID-19[J].Radiother Oncol,2020,148: 194-200. DOI:10.1016/j.radonc.2020.04.010. pmid:32342878 |
[40] | van Hagen P, Hulshof MC, van Lanschot JJ, et al. Preoperative chemoradiotherapy for esophageal or junctional cancer[J].N Engl J Med,2012,366(22): 2074-2084. DOI:10.1056/NEJMoa1112088. |
[41] | Walsh TN, Noonan N, Hollywood D, et al. A comparison of multimodal therapy and surgery for esophageal adenocarcinoma[J].N Engl J Med,1996,335(7): 462-467. DOI:10.1056/NEJM199608153350702. |
[42] | Curran WJ Jr, Paulus R, Langer CJ, et al. Sequential vs. concurrent chemoradiation for stage Ⅲ non-small cell lung cancer: randomized phase Ⅲ trial RTOG 9410[J].J Natl Cancer Inst,2011,103(19): 1452-1460. DOI:10.1093/jnci/djr325. |
[43] | Goodman KA, Ou FS, Hall NC, et al. Randomized phase Ⅱ study of PET response-adapted combined modality therapy for esophageal cancer: mature results of the CALGB 80803 (alliance) trial[J].J Clin Oncol,2021,39(25): 2803-2815. DOI:10.1200/JCO.20.03611. |
[44] | Hwang JK, Zhang T, Wang AZ, et al. COVID-19 vaccines for patients with cancer: benefits likely outweigh risks[J].J Hematol Oncol,2021,14(1): 38. DOI:10.1186/s13045-021-01046-w. |
[45] | 王珞, 徐燕, 张路, 等. 肿瘤患者新冠疫苗接种: 临床研究进展与初步临床推荐[J].中国肺癌杂志,2021,24(6): 377-383. DOI:10.3779/j.issn.1009-3419.2021.101.18. |
[46] | 徐若男, 聂建云, 王涛, 等. 乳腺癌患者新冠疫苗接种中国专家共识[J].传染病信息,2021,34(6): 481-484. DOI:10.3969/j.issn.1007-8134.2021.06.001. |
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