目前已知,在癌症病患中感染新冠肺炎與提高致死率的風險有顯著相關;在這史無前例嚴峻的情況下,對癌症病患的醫療照護可分為以下四種情況:1.治療沒有時間的急迫性,可以利用遠距方式開立處置;2.治療無法以遠距方式開立處置,但延期治療並不會影響其生活質量;3.若無及時治療會影響其生活品質甚至存活情況,此時腫瘤醫師應考慮使用替代療法或以其他形式開立藥物,例如:

靜脈注射改為口服;4.需要及時治療不然會影響其存活機率者,此時腫瘤醫師應評估並協調醫療資源,並確保此類病患不會因新冠肺炎疫情而導致其錯過黃金治療時機;除此之外,對於正在進行的臨床試驗,應確保不影響參與臨床試驗病患的權益以及臨床試驗的假設不會受新冠肺炎疫情所影響;此次新冠肺炎全球大流行,對於癌症病患的臨床治療方案所做的調整,將有助於腫瘤醫師與病患本身日後治療照護的參考依據。

(財團法人國家衛生研究院 蔡慧如博士摘要整理)

In just a few short weeks, the coronavirus disease 2019 (COVID-19) pandemic has transformed health care delivery around the globe. The crisis has dismantled how care is delivered and forced clinicians to make difficult triage decisions about what types and components of care have limited immediate value and which are essential for optimal outcomes. Because some malignancies could pose an immediate threat to survival, cancer provides a lens into the major shifts currently underway in clinical care. Cancer and cancer-related treatments frequently cause immunosuppression, and patients with cancer have excess mortality risk from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The magnitude of this risk is not yet known but early reports suggest a substantial increased risk of death associated with COVID-19 infection among patients with cancer, perhaps highest among those older than 60 years and those with pulmonary compromise.1,2

Author:Deborah Schrag, Dawn L. Hershman, Ethan Basch, et al.     
原文連結:https://jamanetwork.com/journals/jama/fullarticle/2764728