학술논문

Changes in Cancer Management due to COVID-19 Illness in Patients with Cancer in Northern California.
Document Type
article
Source
JCO Oncology Practice. 17(3)
Subject
Biomedical and Clinical Sciences
Oncology and Carcinogenesis
Cancer
Administration
Oral
Adolescent
Adult
Aged
Aged
80 and over
Antineoplastic Agents
COVID-19
California
Child
Child
Preschool
Female
Humans
Infusions
Intravenous
Injections
Intramuscular
Male
Middle Aged
Neoplasms
Palliative Care
Radiotherapy
Retrospective Studies
SARS-CoV-2
Surgical Procedures
Operative
Time Factors
Time-to-Treatment
Young Adult
Oncology and carcinogenesis
Language
Abstract
PurposeThe response to the COVID-19 pandemic has affected the management of patients with cancer. In this pooled retrospective analysis, we describe changes in management patterns for patients with cancer diagnosed with COVID-19 in two academic institutions in the San Francisco Bay Area.Materials and methodsAdult and pediatric patients diagnosed with COVID-19 with a current or historical diagnosis of malignancy were identified from the electronic medical record at the University of California, San Francisco, and Stanford University. The proportion of patients undergoing active cancer management whose care was affected was quantified and analyzed for significant differences with regard to management type, treatment intent, and the time of COVID-19 diagnosis. The duration and characteristics of such changes were compared across subgroups.ResultsA total of 131 patients were included, of whom 55 were undergoing active cancer management. Of these, 35 of 55 (64%) had significant changes in management that consisted primarily of delays. An additional three patients not undergoing active cancer management experienced a delay in management after being diagnosed with COVID-19. The decision to change management was correlated with the time of COVID-19 diagnosis, with more delays identified in patients treated with palliative intent earlier in the course of the pandemic (March/April 2020) compared with later (May/June 2020) (OR, 4.2; 95% CI, 1.03 to 17.3; P = .0497). This difference was not seen among patients treated with curative intent during the same timeframe.ConclusionWe found significant changes in the management of cancer patients with COVID-19 treated with curative and palliative intent that evolved over time. Future studies are needed to determine the impact of changes in management and treatment on cancer outcomes for patients with cancer and COVID-19.