Life-prolonging treatment restrictions and outcomes in patients with cancer and COVID-19: an update from the Dutch Oncology COVID-19 Consortium

被引：7

作者：

de Joode, Karlijn ^{[1
]}

Tol, Jolien ^{[2
]}

Hamberg, Paul ^{[3
]}

Cloos, Marissa ^{[4
]}

Kastelijn, Elisabeth A. ^{[5
]}

Borgers, Jessica S. W. ^{[6
]}

Nuij, Veerle J. A. A. ^{[2
]}

Klaver, Yarne ^{[7
]}

Herder, Gerarda J. M. ^{[8
]}

Mutsaers, Pim G. N. J. ^{[9
]}

Dumoulin, Daphne W. ^{[10
]}

Oomen-de Hoop, Esther ^{[1
]}

van Diemen, Nico G. J. ^{[11
]}

Libourel, Eduard J. ^{[12
]}

Geraedts, Erica J. ^{[13
]}

Bootsma, Gerben P. ^{[14
]}

van der Leest, Cor H. ^{[15
]}

Peerdeman, Anne L. ^{[11
]}

Herbschleb, Karin H. ^{[16
]}

Visser, Otto J. ^{[17
]}

Bloemendal, Haiko J. ^{[18
]}

van Laarhoven, Hanneke W. M. ^{[19
]}

de Vries, Elisabeth G. E. ^{[20
]}

Hendriks, Lizza E. L. ^{[21
]}

Beerepoot, Laurens, V ^{[7
]}

Westgeest, Hans M. ^{[22
]}

van den Berkmortel, Franchette W. P. J. ^{[23
]}

Haanen, John B. A. G. ^{[6
]}

Dingemans, Anne-Marie C. ^{[10
]}

van der Veldt, Astrid A. M. ^{[24
]}

机构：

[1] Erasmus MC, Univ Med Ctr, Dept Med Oncol, Canc Inst, Rotterdam, Netherlands

[2] Jeroen Bosch Hosp, Dept Internal Med, Shertogenbosch, Netherlands

[3] Franciscus Gasthuis & Vlietland, Dept Oncol, Rotterdam, Netherlands

[4] Groene Hart Hosp, Dept Internal Med, Gouda, Netherlands

[5] St Antonius Hosp Utrecht Nieuwegein, Dept Pulmonol, Utrecht, Netherlands

[6] Netherlands Canc Inst NKI, Dept Med Oncol, Amsterdam, Netherlands

[7] Elisabeth Tweesteden Hosp, Dept Internal Med, Tilburg, Netherlands

[8] Meander Med Ctr, Dept Pulm Med, Amersfoort, Netherlands

[9] Erasmus MC, Dept Hematol, Rotterdam, Netherlands

[10] Erasmus MC, Univ Med Ctr, Dept Pulm Med, Canc Inst, Rotterdam, Netherlands

[11] Bernhoven, Dept Internal Med, Uden, Netherlands

[12] Franciscus Gasthuis & Vlietland, Dept Internal Med, Rotterdam, Netherlands

[13] Groene Hart Hosp, Dept Pulmonol, Gouda, Netherlands

[14] Zuyderland Med Ctr, Dept Pulmonol, Heerlen, Netherlands

[15] Amphia Hosp, Dept Pulmonol, Breda, Netherlands

[16] St Antonius Hosp Utrecht Nieuwegein, Dept Internal Med, Utrecht, Netherlands

[17] Isala Hosp, Dept Hematol, Zwolle, Netherlands

[18] Radboud Univ Nijmegen, Dept Med Oncol, Med Ctr, Nijmegen, Netherlands

[19] Univ Amsterdam, Amsterdam Univ Med Ctr, Canc Ctr Amsterdam, Dept Med Oncol, Amsterdam, Netherlands

[20] Univ Groningen, Univ Med Ctr Groningen, Dept Med Oncol, Groningen, Netherlands

[21] Maastricht Univ, Dept Pulm Dis, GROW Sch Oncol & Dev Biol, Med Ctr, Maastricht, Netherlands

[22] Amphia Hosp, Dept Internal Med, Breda, Netherlands

[23] Zuyderland Med Ctr, Dept Internal Med, Sittard Geleen, Netherlands

[24] Erasmus MC, Univ Med Ctr, Dept Radiol & Nucl Med, Canc Inst, Rotterdam, Netherlands

来源：

EUROPEAN JOURNAL OF CANCER | 2022年 / 160卷

关键词：

COVID-19; Cancer; Cancer treatment; Treatment restrictions; Advanced care planning; CORONAVIRUS DISEASE 2019; CLINICAL CHARACTERISTICS; IMPACT; RISK;

D O I：

10.1016/j.ejca.2021.10.009

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Aim of the study: The coronavirus disease 2019 (COVID-19) pandemic significantly impacted cancer care. In this study, clinical patient characteristics related to COVID-19 outcomes and advanced care planning, in terms of non-oncological treatment restrictions (e.g. do not-resuscitate codes), were studied in patients with cancer and COVID-19.Methods: The Dutch Oncology COVID-19 Consortium registry was launched in March 2020 in 45 hospitals in the Netherlands, primarily to identify risk factors of a severe COVID-19 outcome in patients with cancer. Here, an updated analysis of the registry was performed, and treatment restrictions (e.g. do-not-intubate codes) were studied in relation to COVID19 outcomes in patients with cancer. Oncological treatment restrictions were not taken into account.Results: Between 27th March 2020 and 4th February 2021, 1360 patients with cancer and COVID-19 were registered. Follow-up data of 830 patients could be validated for this analysis. Overall, 230 of 830 (27.7%) patients died of COVID-19, and 60% of the remaining 600 patients with resolved COVID-19 were admitted to the hospital. Patients with haematological malignancies or lung cancer had a higher risk of a fatal outcome than other solid tumours. No correlation between anticancer therapies and the risk of a fatal COVID-19 outcome was found. In terms of end-of-life communication, 50% of all patients had restrictions regarding life prolonging treatment (e.g. do-not-intubate codes). Most identified patients with treatment restrictions had risk factors associated with fatal COVID-19 outcome.Conclusion: There was no evidence of a negative impact of anticancer therapies on COVID-19 outcomes. Timely end-of-life communication as part of advanced care planning could save patients from prolonged suffering and decrease burden in intensive care units. Early discussion of treatment restrictions should therefore be part of routine oncological care, especially during the COVID-19 pandemic. 2021 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

引用

页码：261 / 272

页数：12

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