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1.
J Exp Clin Cancer Res ; 39(1): 177, 2020 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-32873322

RESUMO

BACKGROUND: A pronounced polarization of healthcare resources and workforce towards the prevention of the rapid spread of SARS-CoV-2 occurred at the expenses of the majority of chronic diseases and cancer, thus jeopardizing continuity of care and therapy outcomes. In this challenging and overwhelming scenario, our Institute confirmed its mission to provide expert cancer care. Here, we provide a report of strategic decisions made and of articulated measures developed to limit virus spreading while striving to make our hospital closer to patients. CONCLUSIONS: We hope our experience may serve as a resource to inform clinical care models in case of future epidemiological outbreaks.


Assuntos
Betacoronavirus/patogenicidade , Doença Crônica/epidemiologia , Infecções por Coronavirus/epidemiologia , Oncologia/tendências , Pneumonia Viral/epidemiologia , Benchmarking , Infecções por Coronavirus/virologia , Humanos , Pandemias , Pneumonia Viral/virologia , Fatores de Risco
3.
Anticancer Res ; 40(10): 5853-5860, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32988915

RESUMO

BACKGROUND/AIM: The optimal treatment sequencing for asymptomatic de novo metastatic rectal cancer is unclear. The aim of this study was to investigate the role of upfront radiotherapy, with or without chemotherapy on risk for local complications, in patients with asymptomatic advanced metastatic rectal cancer treated with palliative intention. PATIENTS AND METHODS: All patients with de novo metastatic rectal cancer diagnosed between January 2008 and December 2017 in two healthcare regions in Sweden (Örebro län, Sörmland) were identified and data were extracted from electronic medical records. Patients were divided into 3 groups based on treatment sequence: upfront radiotherapy, upfront chemotherapy, and only palliative surgery. RESULTS: In total, 102 patients were included in the study cohort, 30 patients in upfront radiotherapy group, 54 in upfront chemotherapy, and 18 in only palliative surgery group. Patients with only upfront CT [odds ratio (OR)= 5.10; 95% confidence interval (CI)=1.24-20.91, p=0.024] had a higher risk to suffer from a local complication compared to those who received upfront radiotherapy. Cause-specific Cox regression analysis among patients who received oncological therapy revealed that female patients [cause-specific hazard ratio (csHR)=3.61; 95% confidence interval (CI)=1.67-7.81] and upfront chemotherapy [csHR=1.85; 95% CI=1.11-3.77] were associated with increased cumulative incidence of local complication over time, whereas primary surgery with ostomy or stent with lower risk [csHR=0.45; 95% CI=0.21-0.99]. CONCLUSION: Patients who received upfront radiotherapy, with or without chemotherapy, had fewer local complications due to primary tumor compared to patients who only received chemotherapy. This could indicate that radiotherapy to the primary tumor could be discussed with the patients as a first treatment option for asymptomatic metastatic rectal cancer to prevent local complications later during the disease.


Assuntos
Doenças Assintomáticas/terapia , Doenças Raras/radioterapia , Neoplasias Retais/radioterapia , Adulto , Idoso , Idoso de 80 Anos ou mais , Doenças Assintomáticas/epidemiologia , Estudos de Coortes , Terapia Combinada , Feminino , Humanos , Masculino , Oncologia/tendências , Pessoa de Meia-Idade , Cuidados Paliativos , Modelos de Riscos Proporcionais , Doenças Raras/tratamento farmacológico , Doenças Raras/patologia , Doenças Raras/cirurgia , Neoplasias Retais/tratamento farmacológico , Neoplasias Retais/patologia , Neoplasias Retais/cirurgia , Suécia/epidemiologia
4.
JCO Glob Oncol ; 6: 1461-1471, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32997537

RESUMO

PURPOSE: In response to the COVID-19 pandemic, the ASCO launched a Global Webinar Series to address various aspects of cancer care during the pandemic. Here we present the lessons learned and recommendations that have emerged from these webinars. METHODS: Fifteen international health care experts from different global regions and oncology disciplines participated in one of the six 1-hour webinars to discuss the latest data, share their experiences, and provide recommendations to manage cancer care during the COVID-19 pandemic. These sessions include didactic presentations followed by a moderated discussion and questions from the audience. All recommendations have been transcribed, categorized, and reviewed by the experts, who have also approved the consensus recommendations. RESULTS: The summary recommendations are divided into different categories, including risk minimization; care prioritization of patients; health care team management; virtual care; management of patients with cancer undergoing surgical, radiation, and systemic therapy; clinical research; and recovery plans. The recommendations emphasize the protection of patients and health care teams from infections, delivery of timely and appropriate care, reduction of harm from the interruption of care, and preparation to handle a surge of new COVID-19 cases, complications, or comorbidities thereof. CONCLUSION: The recommendations from the ASCO Global Webinar Series may guide practicing oncologists to manage their patients during the ongoing pandemic and help organizations recover from the crisis. Implementation of these recommendations may improve understanding of how COVID-19 has affected cancer care and increase readiness to manage the current and any future outbreaks effectively.


Assuntos
Infecções por Coronavirus/prevenção & controle , Saúde Global , Oncologia/normas , Neoplasias/terapia , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Guias de Prática Clínica como Assunto , Betacoronavirus/patogenicidade , Consenso , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/imunologia , Infecções por Coronavirus/transmissão , Acesso aos Serviços de Saúde/organização & administração , Acesso aos Serviços de Saúde/normas , Acesso aos Serviços de Saúde/tendências , Humanos , Controle de Infecções/organização & administração , Controle de Infecções/normas , Oncologia/organização & administração , Oncologia/tendências , Neoplasias/diagnóstico , Neoplasias/imunologia , Oncologistas/organização & administração , Oncologistas/normas , Pneumonia Viral/epidemiologia , Pneumonia Viral/imunologia , Pneumonia Viral/transmissão , Telemedicina/organização & administração , Telemedicina/normas , Telemedicina/tendências
5.
JCO Glob Oncol ; 6: 1455-1460, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32997540

RESUMO

The core pillars of multimodal care of patients with cancer are surgical, radiation, and medical oncology. The global pandemic of coronavirus disease 2019 (COVID-19) has suddenly resurrected a new pillar in oncology care: teleoncology. With oncologists reaching out to patients through telemedicine, it is possible to evaluate and fulfill patients' needs; triage patients for elective procedures; screen them for influenza-like illness; provide them with guidance for hospital visits, if needed; and bridge oral medications and treatments when a hospital visit is not desirable because of any high risk-benefit ratio. Teleoncology can bring great reassurance to patients at times when reaching an oncology center is challenging, and more so in resource-constrained countries. Evidence-based treatment protocols, dispensable by teleoncology, already exist for many sites of cancer and they can provide a bridge to treatment when patients are unable to reach cancer centers for their standard treatment. The young pillar of teleoncology is going to remain much longer than COVID-19.


Assuntos
Infecções por Coronavirus/prevenção & controle , Controle de Infecções/organização & administração , Oncologia/organização & administração , Neoplasias/diagnóstico , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Telemedicina/organização & administração , Betacoronavirus/patogenicidade , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/transmissão , Infecções por Coronavirus/virologia , Medicina Baseada em Evidências/métodos , Medicina Baseada em Evidências/organização & administração , Medicina Baseada em Evidências/normas , Medicina Baseada em Evidências/tendências , Humanos , Controle de Infecções/métodos , Controle de Infecções/normas , Oncologia/métodos , Oncologia/normas , Oncologia/tendências , Neoplasias/terapia , Seleção de Pacientes , Pneumonia Viral/epidemiologia , Pneumonia Viral/transmissão , Pneumonia Viral/virologia , Telemedicina/normas , Telemedicina/tendências , Triagem/métodos , Triagem/organização & administração , Triagem/normas
8.
Curr Oncol ; 27(4): e420-e432, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32905290

RESUMO

Because of the global coronavirus pandemic, the 2020 annual scientific meeting of the American Society of Clinical Oncology took place virtually, 29-30 May. At the meeting, results from key studies about the treatment of chronic lymphocytic leukemia (cll) were disseminated. Studies examined the efficacy and safety of ibrutinib, acalabrutinib, zanubrutinib, and venetoclax as monotherapy or in combination with novel agents for patients with treatment-naïve and relapsed or refractory cll. Our meeting report describes the foregoing studies and presents interviews with investigators and commentaries by Canadian hematologists about potential effects on Canadian practice.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Congressos como Assunto , Leucemia Linfocítica Crônica de Células B/tratamento farmacológico , Oncologia/métodos , Inibidores de Proteínas Quinases/administração & dosagem , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Canadá , Ensaios Clínicos como Assunto , Humanos , Oncologia/organização & administração , Oncologia/tendências , Inibidores de Proteínas Quinases/efeitos adversos , Sociedades Médicas , Resultado do Tratamento
9.
Urologe A ; 59(9): 1026-1034, 2020 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-32821957

RESUMO

In the past 10 years, the methods of artificial intelligence (AI) have experienced breakthroughs that have opened up a multitude of new fields of application for information technology. AI is particularly strong in those areas where patterns have to be recognized and conclusions and forecasts based on large, multiparametric data sets have to be drawn. Computers are superior to us in terms of precision and speed in these problems. These advances in information technology reach us at a time when innovations in diagnostics and sensor technology enable more precise patient stratification and confront medical personnel with an increasing quantity and quality of patient data. Urology is symbolic of this new complexity of medicine, in which multi-layered diagnostic cascades require a high degree of interdisciplinarity and, especially in uro-oncology, therapeutic strategies are becoming more differentiated and require the interpretation of multiple clinical and diagnostic data. Here, methods of Artificial Intelligence will in future support medical personnel in diagnostics and therapy decisions and thus come closer to the goal of precision medicine. A prerequisite for the success of AI-based support tools will be the transparent development and validation of the software, as well as the population-based visualization of decision parameters.


Assuntos
Inteligência Artificial , Urologistas , Urologia/tendências , Humanos , Oncologia/tendências , Medicina de Precisão , Software
12.
J Oncol Pharm Pract ; 26(7): 1732-1734, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32791938

RESUMO

Cancer patients are at higher risk to be infected with COVID-19 and to develop a more severe form. Breast cancer (BC) treatments, including chemotherapy (CT), targeted therapy and immunotherapy can weaken the immune system and possibly cause lung problems. For all these reasons Salah Azaiez Institute's department of Medical Oncology took drastic actions to protect patients. In this article we will discuss protocol adjustments taken during the COVID-19 pandemic for breast cancer patients.


Assuntos
Protocolos Antineoplásicos , Neoplasias da Mama , Controle de Doenças Transmissíveis , Infecções por Coronavirus , Oncologia/tendências , Pandemias , Administração dos Cuidados ao Paciente , Pneumonia Viral , Betacoronavirus , Neoplasias da Mama/epidemiologia , Neoplasias da Mama/patologia , Neoplasias da Mama/terapia , Controle de Doenças Transmissíveis/métodos , Controle de Doenças Transmissíveis/organização & administração , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Feminino , Humanos , Estadiamento de Neoplasias , Inovação Organizacional , Pandemias/prevenção & controle , Administração dos Cuidados ao Paciente/métodos , Administração dos Cuidados ao Paciente/organização & administração , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Risco Ajustado/métodos , Telemedicina/métodos , Tunísia/epidemiologia
13.
Future Oncol ; 16(28): 2191-2195, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32857603

RESUMO

Background: Telemedicine is seen as a savior during the COVID-19 pandemic. Materials & methods: This study is a descriptive cross-sectional study conducted with cancer patients who were interviewed via telemedicine from a tertiary care comprehensive oncology center. Results: A total of 421 patients were included in the study and 118 of them (28.0%) were >65 years old. Communication was provided most frequently by voice call (n = 213; 50.5%). The majority of the patients contacted by telemedicine had breast cancer (n = 270; 64.1%). For 135 patients (32.1%) no further examination or intervention was required and the previously planned follow-up visit was postponed by the clinician. Conclusion: This study showed that telemedicine could open a new era for medical oncology specialists.


Assuntos
Neoplasias da Mama/tratamento farmacológico , Sobreviventes de Câncer , Infecções por Coronavirus/prevenção & controle , Oncologia/organização & administração , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Telemedicina/organização & administração , Administração Oral , Adulto , Assistência ao Convalescente/métodos , Assistência ao Convalescente/organização & administração , Assistência ao Convalescente/normas , Assistência ao Convalescente/tendências , Idoso , Idoso de 80 Anos ou mais , Antineoplásicos/uso terapêutico , Betacoronavirus/patogenicidade , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/mortalidade , Neoplasias da Mama Masculina , Institutos de Câncer/organização & administração , Institutos de Câncer/normas , Institutos de Câncer/tendências , Neoplasias Colorretais/diagnóstico , Neoplasias Colorretais/tratamento farmacológico , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/transmissão , Infecções por Coronavirus/virologia , Estudos Transversais , Feminino , Neoplasias dos Genitais Femininos/diagnóstico , Neoplasias dos Genitais Femininos/tratamento farmacológico , Humanos , Controle de Infecções/organização & administração , Controle de Infecções/normas , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/tratamento farmacológico , Masculino , Oncologia/métodos , Oncologia/normas , Oncologia/tendências , Conduta do Tratamento Medicamentoso/organização & administração , Conduta do Tratamento Medicamentoso/normas , Conduta do Tratamento Medicamentoso/tendências , Pessoa de Meia-Idade , Pneumonia Viral/epidemiologia , Pneumonia Viral/transmissão , Pneumonia Viral/virologia , Neoplasias da Próstata/diagnóstico , Neoplasias da Próstata/tratamento farmacológico , Telemedicina/normas , Telemedicina/tendências
15.
Oncology (Williston Park) ; 34(7): 244, 2020 07 15.
Artigo em Inglês | MEDLINE | ID: mdl-32674205

RESUMO

Now that the world has been dealing with the coronavirus disease 2019 (COVID-19) pandemic for several months, we have learned so much. Some of the modifications we have made have been "good" and will hopefully help oncology care, education, and research going forward. Here are some of the issues and changes that the pandemic engendered.


Assuntos
Inovação Organizacional , Telemedicina/métodos , Betacoronavirus , Pesquisa Biomédica , Ensaios Clínicos como Assunto/métodos , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Detecção Precoce de Câncer/métodos , Detecção Precoce de Câncer/tendências , Humanos , Oncologia/métodos , Oncologia/organização & administração , Oncologia/tendências , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Telecomunicações/tendências
16.
Oncology (Williston Park) ; 34(7): 265-269, 2020 07 15.
Artigo em Inglês | MEDLINE | ID: mdl-32674214

RESUMO

The coronavirus disease 2019 (COVID-19) pandemic has rapidly spread all over the world in the past several months. No effective treatment for COVID-19 has been established. High transmissibility and considerable mortality rates have forced many national governments to implement quarantine measures. Many patients with cancer rely on clinical trials to receive their oncologic care, but the routine conduct of clinical trials has substantially changed because of the COVID-19 pandemic. The oncology research community should implement formal policies based on the guidance given from regulatory agencies, with the goal of minimizing the risks of COVID-19 infection while maintaining appropriate oncologic treatments for patients during this pandemic.


Assuntos
Infecções por Coronavirus , Controle de Infecções/organização & administração , Oncologia , Neoplasias/terapia , Inovação Organizacional , Pandemias/prevenção & controle , Pneumonia Viral , Betacoronavirus , Gestão de Mudança , Ensaios Clínicos como Assunto/métodos , Ensaios Clínicos como Assunto/organização & administração , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Humanos , Oncologia/métodos , Oncologia/tendências , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Gestão da Segurança
17.
Oncology (Williston Park) ; 34(7): 280-282, 2020 07 15.
Artigo em Inglês | MEDLINE | ID: mdl-32674217

RESUMO

The coronavirus disease 2019 (COVID-19) pandemic has rapidly spread all over the world in the past several months. No effective treatment for COVID-19 has been established. High transmissibility and considerable mortality rates have forced many national governments to implement quarantine measures. Many patients with cancer rely on clinical trials to receive their oncologic care, but the routine conduct of clinical trials has substantially changed because of the COVID-19 pandemic. The oncology research community should implement formal policies based on the guidance given from regulatory agencies, with the goal of minimizing the risks of COVID-19 infection while maintaining appropriate oncologic treatments for patients during this pandemic.


Assuntos
Ensaios Clínicos como Assunto/organização & administração , Infecções por Coronavirus , Oncologia , Neoplasias/terapia , Pandemias , Pneumonia Viral , Telemedicina , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Humanos , Controle de Infecções , Oncologia/métodos , Oncologia/tendências , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Quarentena , Telemedicina/métodos , Telemedicina/tendências
19.
Br J Radiol ; 93(1113): 20200112, 2020 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-32706978

RESUMO

Interventional oncology (IO) has proven to be highly efficient in the local therapy of numerous malignant tumors in addition to surgery, chemotherapy, and radiotherapy. Due to the advent of immune-oncology with the possibility of tumor control at the molecular and cellular levels, a system change is currently emerging. This will significantly rule oncology in the coming decades. Therefore, one cannot think about IO in the 21st century without considering immunology. For IO, this means paying much more attention to the immunomodulatory effects of the interventional techniques, which have so far been neglected, and to explore the synergistic possibilities with immuno-oncology. It can be expected that the combined use of IO and immuno-oncology will help to overcome the limitations of the latter, such as limited local effects and a high rate of side-effects. To do this, however, sectoral boundaries must be removed and interdisciplinary research efforts must be strengthened. In case of success, IO will face an exciting future.


Assuntos
Imunoterapia/tendências , Oncologia/tendências , Neoplasias/terapia , Vacinas Anticâncer/uso terapêutico , Quimioembolização Terapêutica/métodos , Quimioembolização Terapêutica/tendências , História do Século XXI , Humanos , Imunização Passiva/métodos , Imunomodulação , Imunoterapia/métodos , Imunoterapia Ativa/métodos , Neoplasias/imunologia , Radioterapia (Especialidade)/tendências , Ablação por Radiofrequência/métodos , Ablação por Radiofrequência/tendências , Radioisótopos de Ítrio/uso terapêutico
20.
Cancer Discov ; 10(9): 1263-1266, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32669285
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