The same outcome of cancer patients treated with radiotherapy or chemoradiotherapy regardless COVID-19 status

JOURNAL OF CLINICAL ONCOLOGY(2023)

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摘要
e18866 Background: COVID-19 has spread all over the world and infects people including cancer patients. The aim of this study is to explore the influence of COVID-19 infection on various cancer patients in China. Methods: A total of 167 cancer patients receiving radiotherapy or chemoradiotherapy from July 2022 to February 2023 were included in this study. Tumor types included lung, breast, esophageal, nasopharyngeal, cervical, pancreatic, thymus, rectal, bladder, testicular cancers, and glioblastoma, etc. The patients were divided into three groups: no COVID-19 infection during the therapy cycle (group A, n = 52), therapy beginning at least 10 days after the first positive COVID-19 tests (group B, n = 43), and therapy beginning less than 10 days after the first positive COVID-19 tests (group C, n = 72). The COVID-19 variants in this study were BA5.5.6, BA.5.2, and BF.7. Results: Some infection-related parameters were increased in COVID-19 positive cancer patients, such as SAA (group A vs group B, p= 0.0006; group A vs group C, p= 0.0004), hsCRP (group A vs group B, p= 0.0043; group A vs group C, p= 0.0144), ferritin (group A vs group B, p= 0.0417; group A vs group C, p= 0.0319) and PA (group A vs group C, p= 0.011), yet IL-6 and PCT were of no difference among three groups. Similarly, the serum markers for the myocardial and hepatic lesions, such as LDH (group A vs group B, p= 0.0064; group A vs group C, p= 0.0369), HBDH (group A vs group B, p= 0.0116; group A vs group C, p= 0.0414), and CHE (group A vs group B, p= 0.0303; group A vs group C, p= 0.0256), were raised in both group B and group C, but AST, CK, CK-MB, ADA, GGT, cTnT, and proBNP showed no difference between COVID-19 positive and negative cancer patients. The cancer patients receiving radiotherapy or chemoradiotherapy showed no differences in the lowest WBC, Hgb, platelets, NLR (Neutrophil to Lymphocyte Ratio), and lymphocyte subtype counts among three groups. Nevertheless, the leukopenia was apparent in group C (group A vs group C, p= 0.0031; group B vs group C, p= 0.0194), and no obvious difference between group A and group B. Finally, the dropout rates in three groups were nearly the same (group A, 4/52; group B, 6/43; group C, 6/72), and the causes of treatment interruption varied, including pneumonia, deep venous thrombosis, mucosal damage, headache, diarrhea, agranulocytosis, esophageal fistula, etc. Moreover, the completion rate of treatment was not affected by the radiation dose or antitumor drugs in COVID-19 infected cancer patients. Conclusions: This study found that COVID-19 infection did not change the completion rate of radiotherapy or chemoradiotherapy in cancer patients, although some hematological and serum parameters altered during the treatment and infection. In contrast to NCCN guidelines, cancer patients positive for COVID-19 could be treated safely by radiotherapy or chemoradiotherapy.
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chemoradiotherapy,cancer patients,same outcome
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