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Is the neutrophil-to-lymphocyte ratio a prognostic factor in non-small cell lung cancer patients who receive adjuvant chemotherapy? 中性粒细胞与淋巴细胞比值是接受辅助化疗的非小细胞肺癌患者的预后因素吗?
IF 4 3区 医学 Q1 Medicine Pub Date : 2022-12-01 DOI: 10.1053/j.seminoncol.2023.01.006
David Smith , Micaela Raices , Federico Cayol , Franco Corvatta , Lucas Caram , Agustín Dietrich

Inflammation plays a key role in malignant tumor progression. Neutrophil-to-lymphocyte ratio (NLR) is a marker of systemic inflammation and, as such, high isolated pretreatment NLR has been shown in some studies to be associated with worse long-term outcomes. We summarize the data regarding the utility of NLR as a prognosis factor and present results of a single institution study assessing the usefulness of high preoperative NLR as a prognosis factor for patients with successfully resected NSCLC who receive adjuvant cisplatin-based chemotherapy. While largely supportive of the value of NLR as a prognostic factor, the literature is not consistent and suggest a more nuanced association. Our single institution study adds to the exiting literature. We conclude preoperative NLR can be used as a reliable, cost-effective biomarker to estimate prognosis in NSCLC patients who have undergone lung lobectomy with curative intent followed by cisplatin-based adjuvant chemotherapy.

炎症在恶性肿瘤的发展中起着关键作用。中性粒细胞与淋巴细胞比率(NLR)是全身性炎症的标志,因此,一些研究表明,高分离预处理NLR与较差的长期预后相关。我们总结了关于NLR作为预后因素的效用的数据,并介绍了一项单机构研究的结果,该研究评估了术前高NLR作为成功切除非小细胞肺癌患者接受辅助顺铂化疗的预后因素的有效性。虽然在很大程度上支持NLR作为预后因素的价值,但文献并不一致,并提出了更微妙的关联。我们的单一机构研究补充了现有的文献。我们得出结论,术前NLR可作为一种可靠的、具有成本效益的生物标志物,用于评估接受肺肺叶切除术并以顺铂为基础的辅助化疗的非小细胞肺癌患者的预后。
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引用次数: 2
The challenges of selecting cancer medicines for the WHO Essential Medicines List with the elephant in the room: A path forward 为《世卫组织基本药物清单》选择癌症药物所面临的挑战:前进的道路
IF 4 3区 医学 Q1 Medicine Pub Date : 2022-12-01 DOI: 10.1053/j.seminoncol.2023.01.005
Tito Fojo
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引用次数: 0
Predictors of treatment refusal in patients with colorectal cancer: A systematic review 结直肠癌患者拒绝治疗的预测因素:系统综述
IF 4 3区 医学 Q1 Medicine Pub Date : 2022-12-01 DOI: 10.1053/j.seminoncol.2023.01.002
Yoshan Moodley , Kumeren Govender , Jacqueline van Wyk , Seren Reddy , Yuming Ning , Steven Wexner , Laura Stopforth , Shona Bhadree , Vasudevan Naidoo , Shakeel Kader , Shalen Cheddie , Alfred I. Neugut , Ravi P. Kiran

This systematic review was conducted to investigate predictors of treatment refusal in colorectal cancer (CRC) patients. An understanding of these predictors would inform statistical models for the identification of high-risk patients who might benefit from interventions that seek to improve treatment compliance. We performed a search of PubMed and Scopus to identify potentially relevant studies on predictors of treatment refusal in CRC patients that were published between January 1, 2000 and December 31, 2021. We screened manuscripts using predefined eligibility criteria. Information on study design, study location, patient characteristics, treatments, rates and predictors of treatment refusal, and the impact of treatment refusal on mortality or survival were collected from eligible studies. Study quality was assessed using the Newcastle-Ottawa score. The overall findings of the review process were summarized using descriptive statistics and a narrative synthesis. A total of 13 studies were included in this review. Ten studies reported on refusal of CRC surgery, refusal rate: 0.25%–3.26%; three studies reported on chemotherapy refusal (one of which reported on both surgery and chemotherapy refusal), refusal rate: 7.8%–41.5%; and one study reported on refusal of any cancer treatment, refusal rate: 8.7%. The bulk of the published literature confirmed the harmful association between treatment refusal and poor survival outcomes in CRC patients. Frequently cited predictors of treatment refusal included patient demographic characteristics (age, race, gender), clinical characteristics (disease stage, comorbidity), and factors that impact access to cancer care services (healthcare insurance, facility level). Potentially high rates of treatment refusal pose a challenge to CRC control. This review has identified several factors which must be considered when attempting to reduce treatment refusal in CRC patients. Furthermore, these factors should be tested as components of predictive risk models for this important outcome.

本系统综述旨在探讨结直肠癌(CRC)患者拒绝治疗的预测因素。对这些预测因素的理解将为识别高风险患者的统计模型提供信息,这些患者可能受益于寻求提高治疗依从性的干预措施。我们对PubMed和Scopus进行了检索,以确定2000年1月1日至2021年12月31日之间发表的关于CRC患者拒绝治疗预测因素的潜在相关研究。我们使用预先确定的资格标准筛选稿件。从符合条件的研究中收集有关研究设计、研究地点、患者特征、治疗、拒绝治疗率和预测因素以及拒绝治疗对死亡率或生存率的影响的信息。使用纽卡斯尔-渥太华评分评估研究质量。使用描述性统计和叙述综合方法总结了审查过程的总体结果。本综述共纳入13项研究。CRC手术拒绝率10例,拒绝率0.25% ~ 3.26%;3项研究报道了化疗拒绝(其中1项研究同时报道了手术和化疗拒绝),拒绝率:7.8%-41.5%;一项研究报告了拒绝任何癌症治疗的比例:8.7%。大部分已发表的文献证实了CRC患者拒绝治疗与不良生存结果之间的有害关联。经常被引用的拒绝治疗的预测因素包括患者人口统计学特征(年龄、种族、性别)、临床特征(疾病阶段、合并症)以及影响获得癌症护理服务的因素(医疗保险、设施水平)。潜在的高拒绝治疗率对结直肠癌的控制提出了挑战。本综述确定了几个必须考虑的因素,当试图减少CRC患者的治疗拒绝。此外,这些因素应该作为预测这一重要结果的风险模型的组成部分进行测试。
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引用次数: 1
Airway disorders associated with immune checkpoint inhibitor therapy: Two case reports and a systematic review 与免疫检查点抑制剂治疗相关的气道疾病:两例报告和一项系统综述
IF 4 3区 医学 Q1 Medicine Pub Date : 2022-12-01 DOI: 10.1053/j.seminoncol.2023.01.003
Naoki Kawakami , Hiroaki Saito , Susumu Takahashi , Shinpei Kajie , Rina Kato , Kazuhiro Shimaya , Yoko Wakai , Kazuhito Saito , Mai Sakashita

Immune checkpoint inhibitors (ICI) are widely used for the treatment of various malignant neoplasms. Interstitial lung disease is a well-known immune-related adverse event, however, ICI-induced airway disease remains under-recognized. Herein, we report two similar cases of pembrolizumab-induced tracheobronchitis presenting as persistent chronic cough and dyspnea. Blood tests revealed elevated C-reactive protein levels without eosinophilia. Spirometry demonstrated mild airflow obstruction. Computed tomography revealed diffuse thickening of the tracheobronchial walls and bronchiectasis predominantly in the lower lobes. Bronchoscopy revealed edematous and erythematous tracheobronchial mucosa, and bronchial biopsy tissue exhibited marked inflammation with predominant infiltration of CD8+ lymphocytes. Subsequently, pembrolizumab-induced tracheobronchitis was diagnosed in both cases. Cessation of pembrolizumab and initiation of erythromycin, inhaled corticosteroids, and long-acting beta-agonists gradually improved the symptoms, airflow obstruction, and radiographic findings. These were completely resolved in one case. The other case initially showed a poor response to systemic corticosteroids combined with the aforementioned drugs, but improved gradually and almost completely. These cases exemplify ICI-induced airway disease that is, an under-recognized manifestation of immune-related adverse events. In addition, we have systematically searched the PubMed database for articles on ICI-induced airway disease, categorized the retrieved articles as eosinophilic and non-eosinophilic airway diseases, and reviewed the differences in treatment and prognoses between these two categories.

免疫检查点抑制剂(ICI)广泛用于各种恶性肿瘤的治疗。间质性肺疾病是一种众所周知的免疫相关不良事件,然而,ici诱导的气道疾病仍未得到充分认识。在此,我们报告了两例类似的派姆单抗诱导的气管支气管炎,表现为持续的慢性咳嗽和呼吸困难。血液检查显示c反应蛋白水平升高,但无嗜酸性粒细胞增多。肺活量测定显示轻度气流阻塞。计算机断层扫描显示气管支气管壁弥漫性增厚,支气管扩张主要在下叶。支气管镜检查示气管支气管黏膜水肿、红斑,支气管活检组织可见明显炎症,以CD8+淋巴细胞浸润为主。随后,两例患者均被诊断为派姆单抗诱导的气管支气管炎。停用派姆单抗并开始使用红霉素、吸入性皮质类固醇和长效β受体激动剂,可逐渐改善症状、气流阻塞和影像学表现。这些问题在一个案例中完全解决了。另一个病例最初对全身性皮质类固醇联合上述药物反应不佳,但逐渐改善,几乎完全改善。这些病例例证了ici诱导的气道疾病,即免疫相关不良事件的一种未被充分认识的表现。此外,我们系统地检索了PubMed数据库中关于ici诱导气道疾病的文章,将检索到的文章分类为嗜酸性和非嗜酸性气道疾病,并回顾了这两类疾病在治疗和预后方面的差异。
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引用次数: 1
TOC 技术选择委员会
IF 4 3区 医学 Q1 Medicine Pub Date : 2022-12-01 DOI: 10.1053/S0093-7754(23)00020-9
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引用次数: 0
Torticollis as a presenting symptom of pediatric CNS tumors: A systematic review 斜颈是儿童中枢神经系统肿瘤的主要症状:一项系统综述
IF 4 3区 医学 Q1 Medicine Pub Date : 2022-10-01 DOI: 10.1053/j.seminoncol.2022.09.003
Nadejda Baklizi, Musthafa Raswoli, Michala Burges, Daniel C. Moreira, Ibrahim Qaddoumi

To assess the frequency of torticollis as a presenting symptom of pediatric CNS tumors and its impact on pre-diagnostic symptom intervals (PSIs) and patient outcomes. We performed a systematic review of studies reporting torticollis in children with various CNS tumors. We searched PubMed for studies published from January 1972 to March 2021 in English. Case reports were included in the analysis if the following criteria were met (1) torticollis was the presenting symptom secondary to a CNS tumor (2) children <18 years of age, (3) underwent imaging intervention and (4) outcome data provided. Of 1,365 relevant articles, 45 were eligible for analysis according to our inclusion criteria representing 95 patients. Two independent investigators extracted the data, and a third investigator arbitrated discrepancies. We found that 38.9% of CNS tumors exhibited torticollis as the only presenting symptom. PSI lengths ranged from 0 to 4 years (median, 5 months) for low-grade tumors, and patient age and PSI length were inversely associated. Of patients with low-grade tumors, 23.8% received physiotherapy, in contrast with 0% of patients with high-grade tumors. PSI length also increased for patients who received rehabilitation, and 39.3% and 7.1% of patients with high-grade and low-grade tumors, respectively, died of their disease. Patients with low-grade tumors and torticollis as a primary presenting symptom were more likely to have a prolonged PSI. Therefore, CNS tumors should be considered in the differential diagnosis of acquired torticollis in children.

评估斜颈作为小儿中枢神经系统肿瘤的主诉症状的频率及其对诊断前症状间隔(PSIs)和患者预后的影响。我们对报道患有各种中枢神经系统肿瘤的儿童斜颈的研究进行了系统回顾。我们在PubMed检索1972年1月至2021年3月发表的英文研究。如果符合以下标准,病例报告将被纳入分析(1)斜颈是继发于中枢神经系统肿瘤的表现症状(2)儿童及18岁,(3)接受影像学干预,(4)提供结局数据。在1365篇相关文章中,45篇符合纳入标准,代表95名患者。两名独立调查人员提取了数据,第三名调查人员对差异进行了仲裁。我们发现38.9%的中枢神经系统肿瘤以斜颈为唯一的表现。低级别肿瘤的PSI长度为0 - 4年(中位5个月),患者年龄与PSI长度呈负相关。在低级别肿瘤患者中,23.8%的患者接受了物理治疗,而在高级别肿瘤患者中,这一比例为0%。接受康复治疗的患者的PSI长度也有所增加,高级别和低级别肿瘤患者分别有39.3%和7.1%死于疾病。以低度肿瘤和斜颈为主要表现症状的患者更有可能延长PSI。因此,小儿获得性斜颈的鉴别诊断应考虑中枢神经系统肿瘤。
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引用次数: 1
Impact of the COVID-19 Pandemic on the Wellbeing of International Oncology and Hematology Fellows at the Princess Margaret Cancer Center (PMCC) COVID-19大流行对玛格丽特公主癌症中心(PMCC)国际肿瘤学和血液学研究员福祉的影响
IF 4 3区 医学 Q1 Medicine Pub Date : 2022-10-01 DOI: 10.1053/j.seminoncol.2022.09.002
Carlos E. Stecca , Marie Alt , Di Maria Jiang , Glaucia Michelis , Nazanin Fallah-Rad , Sharlene Gill , Mary Elliot , Srikala S Sridhar

Background

The COVID-19 pandemic has led to significant disruptions across all levels of medical training. International fellows in subspecialty training programs are essential members of the frontline physician workforce, but may face additional and unique challenges as a result of being away from their home country. In this study, we aimed to understand the impact of the COVID-19 pandemic on the wellbeing of international fellows in the Hematology and/or Oncology fellowship program at the PMCC.

Methods

In collaboration with our staff psychiatrist, we conducted an online survey of hematology and/or oncology fellows at the PMCC from July 6 to August 10, 2020. The survey consisted of 60 questions divided into 4 sections: demographics, wellbeing assessment using the validated Short Warwick Edinburgh Mental Wellbeing Scale (SWEMWBS), fellowship specific questions (personal and professional) and coping strategies using the validated brief COPE scale.

Results

Overall 24/52 (46%) fellows completed the survey: 21/24 were international fellows with 48% from Asia, 3/24 were Canadian fellows but away from home; 54% were male; 48% were aged 31–35 years; 65% were married, 48% had children. Mean SWEMWBS score was 21, indicating lower overall wellbeing than the general population who had a score of 23.6. Compared to their pre-COVID status, many reported a decline in their wellbeing (63%), sense of guilt for not being with their family (45%) or helping their country (41%), stress in personal relationships (26%), fatigue (50%), sleep disorders (38%) and loss of interest in daily activities (38%). Personal events were altered by almost 80%; and 20% planned to extend their fellowship. According to the Brief-COPE scale, during the pandemic, most fellows used more adaptive coping mechanisms (mean score 39.2) as opposed to maladaptive ones (mean score 21.8).

Conclusions

The ongoing COVID-19 pandemic has negatively affected the overall wellbeing of international fellows. Understanding the specific challenges and coping mechanisms used by international fellows may help institutions develop better targeted strategies to promote wellbeing, professional development and ensure high-quality patient care during unprecedented times like the COVID pandemic.

2019冠状病毒病大流行导致各级医疗培训严重中断。亚专科培训项目的国际研究员是一线医师队伍的重要成员,但由于远离祖国,他们可能面临额外和独特的挑战。在本研究中,我们旨在了解COVID-19大流行对PMCC血液学和/或肿瘤学奖学金项目国际研究员福祉的影响。方法2020年7月6日至8月10日,我们与我们的工作人员精神科医生合作,对PMCC血液学和/或肿瘤学研究员进行了在线调查。该调查包括60个问题,分为4个部分:人口统计数据、使用经过验证的短华威爱丁堡心理健康量表(SWEMWBS)的健康评估、奖学金特定问题(个人和专业)以及使用经过验证的简短COPE量表的应对策略。结果共有24/52名(46%)研究员完成了调查,其中21/24为国际研究员,其中48%来自亚洲,3/24为加拿大研究员,但远离家乡;54%为男性;年龄在31-35岁之间的占48%;65%已婚,48%有孩子。SWEMWBS的平均得分为21,表明整体幸福感低于得分为23.6的普通人群。与新冠肺炎前的状况相比,许多人表示幸福感下降(63%),因不能与家人在一起(45%)或不能帮助国家(41%)而感到内疚,人际关系压力(26%),疲劳(50%),睡眠障碍(38%)和对日常活动失去兴趣(38%)。个人事件几乎改变了80%;20%的人计划延长他们的奖学金。根据Brief-COPE量表,在大流行期间,大多数受试者使用更适应性的应对机制(平均得分39.2),而不是不适应的应对机制(平均得分21.8)。持续的COVID-19大流行对国际研究员的整体福祉产生了负面影响。了解国际研究员面临的具体挑战和应对机制,可以帮助机构制定更有针对性的战略,以促进福祉、专业发展,并确保在COVID大流行等前所未有的时期为患者提供高质量的护理。
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引用次数: 1
Maintenance or consolidation therapy in small-cell lung cancer: an updated systematic review and meta-analysis. 小细胞肺癌的维持或巩固治疗:最新的系统综述和荟萃分析。
IF 4 3区 医学 Q1 Medicine Pub Date : 2022-10-01 DOI: 10.1053/j.seminoncol.2022.09.001
Lorenzo Belluomini , Sara Pilotto , Alice Avancini , Jessica Insolda , Marco Sposito , Jessica Menis , Chiara Ciccarese , Roberto Iacovelli , Miriam Grazia Ferrara , Michele Milella , Emilio Bria , Antonio Rossi

We performed an updated meta-analysis to explore the role of maintenance therapy in SCLC. Clinical trials with randomization to maintenance/consolidation (V) placebo or observation or best supportive care in SCLC, both extended and limited disease were searched from January 2009 to March 2022. The hazard ratios (HR) for progression-free survival (PFS) and overall survival (OS) with the relative 95% confidence interval (CI) were extracted from each study. Summary HR was calculated using random- or fixed-effects models, depending on the heterogeneity of the included studies. A total of 9 studies were identified. Neither PFS nor OS were improved with maintenance/consolidation (PFS: random-effect; HR 0.93; 95% CI 0.71–1.21; P=0.10; OS: fixed-effect; HR 0.98; 95% CI 0.89–1.08; P=0.14). Among the different strategies, immunotherapy maintenance showed a significantly decreased risk of progression (V)standard of care (random-effect; HR 0.80; 95% CI 0.66–0.97; P=0.03). The current updated meta-analysis did not demonstrate a benefit of maintenance/consolidation therapy in SCLC, with only a PFS benefit for immunotherapy approach.

我们进行了一项最新的荟萃分析,以探讨维持治疗在SCLC中的作用。从2009年1月到2022年3月,研究人员检索了SCLC中随机分配到维持/巩固(V)安慰剂或观察或最佳支持治疗的临床试验,包括扩展和有限疾病。从每项研究中提取无进展生存期(PFS)和总生存期(OS)的风险比(HR)和相对95%置信区间(CI)。根据纳入研究的异质性,采用随机或固定效应模型计算HR。总共确定了9项研究。PFS和OS均未因维持/巩固而改善(PFS:随机效应;人力资源0.93;95% ci 0.71-1.21;P = 0.10;操作系统:固定效果;人力资源0.98;95% ci 0.89-1.08;P = 0.14)。在不同的策略中,免疫治疗维持显示出进展风险显著降低(V)标准护理(随机效应;人力资源0.80;95% ci 0.66-0.97;P = 0.03)。当前更新的荟萃分析没有证明维持/巩固治疗对SCLC的益处,只有免疫治疗方法的PFS益处。
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引用次数: 2
A systematic review and meta-analysis on non-metastatic castration resistant prostate cancer: The radiation oncologist's perspective 非转移性去势抵抗性前列腺癌的系统回顾和荟萃分析:放射肿瘤学家的观点
IF 4 3区 医学 Q1 Medicine Pub Date : 2022-10-01 DOI: 10.1053/j.seminoncol.2022.09.005
Gianluca Ingrosso , Marta Bottero , Carlotta Becherini , Saverio Caini , Emanuele Alì , Andrea Lancia , Piet Ost , Giuseppe Sanguineti , Shankar Siva , Thomas Zilli , Giulio Francolini , Rita Bellavita , Cynthia Aristei , Lorenzo Livi , Beatrice Detti

Prostate cancer is the second most common cause of cancer-related mortality in men. In patients undergoing a failure after radical treatment, one of the therapeutic option is androgen deprivation: despite initial response rates, a progression to a state of castration resistance is observed in most of the patients. In the present article, we conducted a systematic review and meta-analysis of all clinical trials assessing treatment for nmCRPC with next-generation androgen receptor inhibitors. We performed a review and meta-analysis of phase III randomized controlled trials comparing new agents (apalutamide, enzalutamide, darolutamide) with placebo as control arm, in the setting of nmCRPC. Patients treated with next-generation ARIs had a 26% reduction in the risk of death compared with placebo; compared with other ARIs, darolutamide had the lowest rate of grade 3 and 4 AEs and the lowest therapy discontinuation rate due to any grade AEs. This meta-analysis shows that treatment with new ARIs is safe and significantly reduces the risk of death and of metastasis onset in nmCRPC patients. Under way studies on new biomarkers such as genomic classifiers will probably allow the stratification in more specific subsets of disease. New imaging modalities such as PSMA-PET have shown greater sensibility and specificity than conventional imaging in metastases detection. All patients were randomized in a 2:1 fashion, with a total of 2,694 who underwent next-generation ARIs (806 apalutamide, 955 darolutamide, 933 enzalutamide) and 1,423 in the placebo arm.

前列腺癌是男性癌症相关死亡的第二大常见原因。在根治失败的患者中,一种治疗选择是雄激素剥夺:尽管最初的反应率,但在大多数患者中观察到进展到去势抵抗状态。在本文中,我们对所有评估使用下一代雄激素受体抑制剂治疗nmCRPC的临床试验进行了系统回顾和荟萃分析。在nmCRPC的背景下,我们对比较新药(阿帕鲁胺、恩杂鲁胺、darolutamide)和安慰剂作为对照组的III期随机对照试验进行了回顾和荟萃分析。与安慰剂相比,接受新一代ARIs治疗的患者死亡风险降低26%;与其他ARIs相比,达洛鲁胺的3级和4级不良事件发生率最低,任何级别不良事件导致的停药率最低。这项荟萃分析显示,在nmCRPC患者中,新的ARIs治疗是安全的,并显著降低了死亡和转移发生的风险。正在进行的诸如基因组分类器等新的生物标记物的研究可能会使疾病的更具体亚群分层。新的成像方式,如PSMA-PET在转移检测中显示出比传统成像更高的敏感性和特异性。所有患者以2:1的方式随机分组,共有2694名患者接受了下一代ARIs(806名阿帕鲁胺,955名达罗卢胺,933名恩杂鲁胺),1423名患者接受了安慰剂组。
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引用次数: 2
The psychosocial and emotional experiences of cancer patients during the COVID-19 pandemic: A systematic review 2019冠状病毒病大流行期间癌症患者的心理社会和情感经历:一项系统综述
IF 4 3区 医学 Q1 Medicine Pub Date : 2022-10-01 DOI: 10.1053/j.seminoncol.2022.08.001
A. Muls, S. Georgopoulou, E. Hainsworth, B. Hartley, G. O'Gara, S. Stapleton, S. Cruickshank

Background

COVID-19 was declared a pandemic by the World Health Organization on March 11th, 2020. Global social lockdowns were instigated to reduce spread and prevent health-services from becoming overwhelmed. People having treatment for cancer are known to have heightened psychological/emotional burden. The combined impact of managing pandemic regulations alongside this may present additional burden. The purpose of this systematic review is to examine current evidence of the psychological and emotional impact of COVID-19 on people with cancer, early in the pandemic.

Methods

Five electronic databases were searched (Embase, Global Health, HMIC, PsychINFO, CINAHL) from September 2019 to October 2021. Qualitative, quantitative and mixed-method primary research studies exploring emotional and psychological impacts of COVID-19 on cancer patients, limited to English language, were included. Quality appraisal was conducted using the MMAT.

Results

Fifty-one papers, with 27,356 people from 21 countries treated for cancer, were included. 43 studies were quantitative with a survey method approach, six studies qualitative and four used a mixed methods design. MMAT score was mostly two or three. Four themes were identified: Emotional aspects and Quality of Life; Psychosocial aspects; Impact of COVID-19 on self; Impact of COVID-19 on cancer, with themes overlapping.

Conclusion

Whilst emotional/psychological impacts such as anxiety, isolation, employment fears, and uncertainty about the future were potentially universal concerns early in the pandemic, they may have been particularly acute for people living with cancer and represent complex, overlapping factors. As COVID-19 continues to impact health-services and society, it is important to focus on any ongoing impact to the experience of cancer patients. Most of the studies reviewed used tools that do not provide deeper understanding of how and why emotional states of people with cancer were affected. Further qualitative work may reveal patterns of what was unique to cancer patients during the pandemic, compared to general populations.

2020年3月11日,世界卫生组织宣布covid -19为大流行。全球社会封锁是为了减少传播,防止卫生服务不堪重负。众所周知,接受癌症治疗的人有更高的心理/情感负担。与此同时,管理大流行法规的综合影响可能带来额外负担。本系统综述的目的是在大流行早期检查COVID-19对癌症患者心理和情感影响的现有证据。方法于2019年9月至2021年10月检索Embase、Global Health、HMIC、PsychINFO、CINAHL 5个电子数据库。包括定性、定量和混合方法的初步研究,探讨COVID-19对癌症患者的情绪和心理影响,仅限于英语语言。采用MMAT进行质量评价。结果共纳入51篇论文,涉及来自21个国家的27356名接受癌症治疗的患者。43项研究采用调查方法进行定量研究,6项研究采用定性研究,4项研究采用混合方法设计。MMAT分数大多是2分或3分。确定了四个主题:情感方面和生活质量;心理社会方面;新冠肺炎疫情对自身的影响;2019冠状病毒病对癌症的影响,主题重叠。虽然焦虑、孤立、就业恐惧和对未来的不确定性等情绪/心理影响在大流行早期可能是普遍关注的问题,但对于癌症患者来说,这些影响可能特别严重,并且代表了复杂的、重叠的因素。随着COVID-19继续影响卫生服务和社会,必须关注对癌症患者经历的任何持续影响。回顾的大多数研究使用的工具并不能更深入地了解癌症患者的情绪状态是如何以及为什么受到影响的。进一步的定性工作可能会揭示大流行期间癌症患者与一般人群相比所特有的模式。
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引用次数: 7
期刊
Seminars in oncology
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