新型冠状病毒肺炎疫情期间妇科恶性肿瘤腹腔热灌注化疗的思考

Thinking of Hyperthermic Intraperitoneal Chemotherapy for Gynecological Malignant Tumors during Epidemic of Novel Coronavirus Pneumonia

2019年12月底以来,新型冠状病毒肺炎(COVID-19)在我国及境外多个国家流行,主要通过呼吸道飞沫传播及密切接触传播,也存在气溶胶、粪口等传播途径可能,潜伏期长,所有人群对其普遍易感。腹腔热灌注化疗(HIPEC)作为腹腔内肿瘤的治疗手段之一,目前在妇科恶性肿瘤领域应用广泛。COVID-19疫情期间妇科恶性肿瘤患者因自身免疫力低下等原因,较普通人群更容易感染新型冠状病毒(2019-nCoV),导致疫情期间进行HIPEC的风险明显增加,因此妇科恶性肿瘤患者进行HIPEC前必须严格执行COVID-19相关筛查,明确无2019-nCoV感染,认真把控适应证和禁忌证,建立多学科联合会诊制度,根据患者病情制定个性化诊疗方案,兼顾疫情防控与肿瘤治疗的平衡。HIPEC治疗期间应当注意加强医患防护及各项指标监测。HIPEC治疗后需进行严密随访及健康指导。本文针对疫情期间如何安全有效地进行妇科恶性肿瘤腹腔热灌注化疗进行详细阐述,以期对临床诊疗有所帮助。

Since the end of December 2019,novel coronavirus pneumonia(COVID-19)has been prevalent in China and many foreign countries,mainly through respiratory droplets and close contact transmission.There are also possible transmission routes such as aerosols and feces.Its incubation period is long,and all people are generally susceptible to it.As one of the treatment methods for intraperitoneal tumors,hyperthermic intraperitoneal chemotherapy(HIPEC)is widely used in the field of gynecological malignant tumors.During the epidemic period of COVID-19,patients with gynecologic malignant tumors were more susceptible to 2019 novel coronavirus(2019-nCoV)than the general population due to low autoimmunity and other reasons,resulting in a significantly increased risk of HIPEC.Therefore,before performing HIPEC,patients with gynecological malignant tumors must strictly perform COVID-19-related screening to exclude 2019-nCoV infections.We should carefully control indications and contraindications,establish a multidisciplinary joint consultation system,develop personalized diagnosis and treatment plans according to the patient′s condition,and take the balance between epidemic prevention and control and cancer treatment into account.During the treatment of HIPEC,attention should be paid to strengthening doctor-patient protection and monitoring of various indicators.Strict follow-up and health guidance after HIPEC treatment are necessary.In order to better guide clinical diagnosis and treatment,this article tend to described how to perform HIPEC safely and effectively for patients with gynecological malignant tumors during the COVID-19 epidemic period.