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Deprecated: Implicit conversion from float 243.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Orv+Hetil 2021 ; 162 (16): 611-614 Nephropedia Template TP
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Tartos SARS-CoV-2-PCR-pozitivitashoz tarsulo, lokoregionalisan elorehaladott emlodaganat komplex onkologiai kezelese #MMPMID33830935
Drozgyik A; Kollar D; Knausz M; Sipocz I; Molnar FT; Kullmann T
Orv Hetil 2021[Apr]; 162 (16): 611-614 PMID33830935show ga
Osszefoglalo. A COVID-19 mortalitasat a sulyos tarsbetegsegek, kozottuk bizonyos daganatos betegsegek is novelik. Immunszuppressziv hatasuk miatt felmerulhet a citotoxikus kezelesek rizikonovelo hatasa is. Ugyanakkor az onkologiai terapia megszakitasa vagy halasztasa, kulonosen az agresszivebb, kiterjedtebb es fiatalkorban jelentkezo daganatok eseteben ronthatja a korjoslatot. Egy 39 eves nobeteg esetet ismertetjuk. A jarvany soran keslekedve felismert, lokoregionalisan kiterjedt emlodaganat miatt primer szisztemas kemoterapiaban reszesult. A kezeles 5. ciklusa soran enyhe leguti tunetek kapcsan, az onkologiai ambulancian SARS-CoV-2-fertozese igazolodott. Kemoterapias kezeleset felfuggesztettuk. A diagnozistol szamitott 3. napon tunetmentesse valt, am SARS-CoV-2-PCR-pozitivitasa meg a 43. napon is fennallt. A 19. napon hormongatlo kezelest inditottunk. Az 51. napon mastectomia es axillaris block dissectio tortent. A 82. napon a megszakitott kemoterapiat a hormongatlo kezeles leallitasat kovetoen G-CSF-profilaxis mellett ujrainditottuk. A kezeles soran fertozeses szovodmenyt nem eszleltunk. Kemoterapia es mutet SARS-CoV-2-fertozott, tunetmentes daganatos betegnel szovodmenymentesen vegezheto elhuzodo virologiai pozitivitas eseten, felszabadito vizsgalat nelkul is. A daganatos betegek koronavirus-fertozese eseten az onkologiai protokolltol torteno elteres egyenre szabott optimalizalasaval es a multidiszciplinaris team szorosabb egyuttmukodesevel az infektologiai es az onkologiai kockazat egyuttes alacsonyan tartasa is megvalosithato. Orv Hetil. 2021; 162(16): 611-614. Summary. Mortality of COVID-19 is increased when certain co-morbidities, among others advanced malignancies are present. Deleterious effect of cytotoxic therapy, related to its immunosuppressive effect, may also be hypothesised. However, postponing or cancelling oncologic treatment, especially in younger patients with advanced and more aggressive tumors may worsen the prognosis. The case of a 39-year-old female patient is presented, who was diagnosed with loco-regionally advanced breast cancer during the pandemic. Primary systemic chemotherapy was started. The patient presented with acute respiratory tract symptoms during the fifth cycle and subsequently SARS-CoV-2 infection was diagnosed. Chemotherapy was cancelled. Symptoms resolved in three days after diagnosis. SARS-CoV-2 PCR remained positive up to day 43. Antihormonal therapy was introduced on day 19 and she underwent mastectomy with axillary lymph node dissection on day 51. Chemotherapy was reset postoperatively on day 82 with prophylactic G-CSF protection. No adverse event was observed throughout the treatment. Cytotoxic chemotherapy and surgery can be successfully delivered in breast cancer patients with prolonged asymptomatic SARS-CoV-2 PCR positivity, even without negative swab result. Individual optimisation of the therapy may require deviations from standard protocols. Closer multidisciplinary cooperation may contribute to the minimisation of both oncologic and infectious risks. Orv Hetil. 2021; 162(16): 611-614.
Orv+Hetil 2021 ; 162 (16): 611-614
