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Acta Oncol ; 60(1): 4-12, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33031010


BACKGROUND: The COVID-19 pandemic is an international public health crisis. The risk of getting an infection with COVID-19 might impact the emotional well-being in patients with cancer. The aim of this study was to investigate quality of life (QoL) for patients with cancer during the COVID-19 pandemic. PATIENTS AND METHODS: A cross-sectional survey, including questions about demographics, concerns of COVID-19 impact on cancer treatment and outpatient clinic visits, and the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 questionnaire was sent to patients with cancer at the Department of Oncology, Odense University Hospital, Denmark. The survey was open from 15th May to 29th May 2020, and 4.571 responded. Results were compared to the Danish 'Barometer Study' conducted by the Danish Cancer Society to elucidate experiences with the Danish healthcare system prior to COVID-19 pandemic. RESULTS: In total, 9% of patients with cancer had refrained from consulting a doctor or the hospital due to fear of COVID-19 infection, and 80% were concerned about contracting COVID-19 to some extent. Seventeen patients were tested positive for COVID-19. The mean global QoL and emotional functioning (EF) scores were 71.3 and 82.8, respectively. In comparison to the 'Barometer Study', no clinical significant differences in QoL and EF scores were observed. Multivariate analysis demonstrated that being 'Concerned about contracting corona-virus' was correlated with lower QoL and EF scores. Factors associated with being concerned of contracting COVID-19 were comorbid conditions, incurable cancer, receiving medical cancer treatment and female gender. CONCLUSION: Danish patients with cancer during the COVID-19 pandemic did not have lower scores of QoL and emotional functioning compared to the Danish 'Barometer Study'. However, the study suggests that concerns of contracting COVID-19 was correlated with lower scores of QoL.

COVID-19 , Cognição , Neoplasias/fisiopatologia , Funcionamento Psicossocial , Qualidade de Vida , Adolescente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Comorbidade , Estudos Transversais , Dinamarca , Emprego , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias/psicologia , Características de Residência , Papel (figurativo) , SARS-CoV-2 , Fatores Sexuais , Interação Social , Adulto Jovem
J Geriatr Oncol ; 9(6): 575-582, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-29871849


OBJECTIVES: Overall survival ï´¾OSï´¿ for patients with localized non-small cell lung cancer ï´¾NSCLCï´¿ treated with stereotactic body radiotherapy ï´¾SBRTï´¿ is poorer than for patients undergoing surgery. Patients who undergo SBRT are often ineligible for surgery due to significant comorbidities that can impact their mortality. A comprehensive geriatric assessment (CGA) that identifies and treats aging related comorbidities could improve OS and quality of life (QoL). This randomized study investigated if a CGA added to SBRT impacts QoL, survival, and unplanned admissions. MATERIALS AND METHODS: From January 2015 to June 2016, 51 patients diagnosed with T1-2N0M0 NSCLC treated with SBRT were enrolled. The patients were randomized 1:1 to receive SBRT +/- CGA. EuroQoL Group 5D (EQ-5D) health index and visual analogue scale (VAS) scores were assessed at start of SBRT, at five weeks, and every third month for a year after SBRT. RESULTS: There were 26 and 25 patients randomized to receive ± CGA, respectively. The repeated measures one-way analysis of variance (ANOVA) test of the EQ-5D health index and VAS scores did not show statistically significant differences between groups. For the EQ-5D VAS scores at twelve months follow-up there was a small difference between the groups although not statistically significant. Even though more patients deceased in the no-CGA group, no statistically significant difference in survival rates and unplanned admission rate was observed between groups. CONCLUSION: In patients with localized NSCLC treated with SBRT, a CGA did not impact the overall QoL, the prevalence/length of unplanned admissions, or survival. There was an indication of small differences in QoL and survival in the data, but such differences can only be validated in larger studies.

Carcinoma Pulmonar de Células não Pequenas/radioterapia , Avaliação Geriátrica , Neoplasias Pulmonares/radioterapia , Qualidade de Vida , Radiocirurgia/métodos , Idoso , Idoso de 80 Anos ou mais , Carcinoma Pulmonar de Células não Pequenas/mortalidade , Carcinoma Pulmonar de Células não Pequenas/psicologia , Feminino , Hospitalização/estatística & dados numéricos , Humanos , Neoplasias Pulmonares/mortalidade , Neoplasias Pulmonares/psicologia , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Radiocirurgia/mortalidade , Inquéritos e Questionários
Lung Cancer ; 100: 90-95, 2016 10.
Artigo em Inglês | MEDLINE | ID: mdl-27597286


OBJECTIVES: Chronic obstructive pulmonary disease (COPD) and non-small cell lung cancer (NSCLC) are often co-existing diseases with poor prognosis. The aim of this study was to compare survival in COPD patients with localized NSCLC treated with stereotactic body radiotherapy (NSCLC group) with COPD patients without a malignant diagnosis (non-malignant group). MATERIALS AND METHODS: The NSCLC group was prospectively recorded at the Department of Oncology from 2007 to 2013. The non-malignant group was selected among patients referred to the Department of Respiratory Medicine from 2005 until 2011 suspected of thoracic malignancy but without the malignant diagnosis maintained. RESULTS: In a propensity score matched comparison the median overall survival was 53 vs. 71 months in the NSCLC and non-malignant groups, respectively (p<0.001). Subgroup analyses showed survival for patients with mild/moderate COPD was affected statistically significant with a higher mortality rate by a diagnosis of localized NSCLC with hazard ratio=2.62 (95% CI: 1.47-4.68) while an insignificant higher mortality rate with hazard ratio=1.22 (95% CI: 0.71-2.08) was found in patient with severe/very severe COPD. CONCLUSION: Despite the serious prognosis of COPD, a localized NSCLC diagnosis negatively affects survival in COPD patients. However, stereotactic body radiotherapy should still be considered for COPD patients diagnosed with localized NSCLC.

Carcinoma Pulmonar de Células não Pequenas/complicações , Neoplasias Pulmonares/complicações , Doença Pulmonar Obstrutiva Crônica/complicações , Taxa de Sobrevida , Idoso , Idoso de 80 Anos ou mais , Carcinoma Pulmonar de Células não Pequenas/mortalidade , Carcinoma Pulmonar de Células não Pequenas/patologia , Dinamarca/epidemiologia , Feminino , Humanos , Neoplasias Pulmonares/mortalidade , Neoplasias Pulmonares/patologia , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Prognóstico , Estudos Prospectivos , Doença Pulmonar Obstrutiva Crônica/diagnóstico , Doença Pulmonar Obstrutiva Crônica/mortalidade , Radiocirurgia/métodos
Acta Oncol ; 52(7): 1552-8, 2013 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-23902274


INTRODUCTION: Stereotactic body radiation therapy (SBRT) for early stage non-small cell lung cancer (NSCLC) is now an accepted and patient friendly treatment, but still controversy exists about its comparability to conventional radiation therapy (RT). The purpose of this single-institutional report is to describe survival outcome for medically inoperable patients with early stage NSCLC treated with SBRT compared with high dose conventional RT. MATERIAL AND METHODS: From August 2005 to June 2012, 100 medically inoperable patients were treated with SBRT at Odense University Hospital. The thoracic RT consisted of 3 fractions (F) of 15-22 Gy delivered in nine days. For comparison a group of 32 medically inoperable patients treated with conventional RT with 80 Gy/35-40 F (5 F/week) in the period of July 1998 to August 2011 were analyzed. All tumors had histological or cytological proven NSCLC T1-2N0M0. RESULTS: The median overall survival was 36.1 months versus 24.4 months for SBRT and conventional RT, respectively (p = 0.015). Local failure-free survival rates at one year were in SBRT group 93% versus 89% in the conventional RT group and at five years 69% versus 66%, SBRT and conventional RT respectively (p = 0.99). On multivariate analysis, female gender and performance status of 0-1 and SBRT predicted improved prognosis. CONCLUSION: In a cohort of patients with NSCLC there was a significant difference in overall survival favoring SBRT. Performance status of 0-1, female gender and SBRT predicted improved prognosis. However, staging procedure, confirmation procedure of recurrence and technical improvements of radiation treatment is likely to influence outcomes. However, SBRT seems to be as efficient as conventional RT and is a more convenient treatment for the patients.

Carcinoma Pulmonar de Células não Pequenas/radioterapia , Carcinoma Pulmonar de Células não Pequenas/cirurgia , Radiocirurgia , Radioterapia Conformacional , Adenocarcinoma/patologia , Adenocarcinoma/radioterapia , Adenocarcinoma/cirurgia , Idoso , Idoso de 80 Anos ou mais , Carcinoma Pulmonar de Células não Pequenas/patologia , Carcinoma de Células Escamosas/patologia , Carcinoma de Células Escamosas/radioterapia , Carcinoma de Células Escamosas/cirurgia , Relação Dose-Resposta à Radiação , Feminino , Humanos , Neoplasias Pulmonares/patologia , Neoplasias Pulmonares/radioterapia , Neoplasias Pulmonares/cirurgia , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Estudos Retrospectivos , Taxa de Sobrevida , Falha de Tratamento