Management guidelines for high-level gliomas during the 2020 New Crown outbreak.

Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) wreaks havoc around the world, and cancer patients are at greater risk of complications after contracting the virus, so a risk balance must be struck between the negative effects of the pandemic and primary tumorsWriting by Denise Bernhardt of the Department of Radiation Oncology at the Faculty of Medicine of the Technical University of Munich, Germany, published the consensus of the International Panel on high-level glioma (HGG) treatment strategies during the 2019 coronavirus epidemic, published online in May 2020 in Neuro-OncologyResearch Methodology The standard treatment for high-level glioma (HGG) is combined chemotherapy after maximum safety removal and monthly tmz-assisted chemotherapyDue to the outbreak, surgery, ICU, personal protection, regular follow-up, etchave problems that require adjustment of standard treatment optionssurgery: Removal of HGG is the primary treatment, but during the COVID-19 pandemic, neurosurgeons need to determine which patients need emergency surgery, which patients can delay surgery, which patients may need to stay in the ICU or ventilator support, etc., as far as possible to reduce the use of medical resourcesThe purpose of the surgery has changed, and some tumor patients can only use the purpose of reducing stress, in an attempt to fully cut the tumor can lead to longer postoperative observation in the ICUTherefore, treatment decisions must be based on individual and individual medical institutions, and patients who have not adequately removed tumors should undergo complementary surgery after the virus epidemic is stable and resourcedDiagnosis: Treatment of high-level gliomas relies on histological and molecular diagnostics, so MGMT, IDH and 1p19q status determinations are still recommendedFollow-up and MRI tests: There are restrictions on patient access to the hospital during the outbreak, and it is recommended to rely as much on telephone and telemedicine for follow-up as much as possibleMRI checks are carried out in accordance with the standardsPatients with low levels of glioma and stable condition are at greater risk of exposure to the new coronavirus to the hospital during the epidemic, and the frequency of follow-up can be adjustedRadiotherapy: Most HGG patients require 6 weeks of radiotherapy, which is non-disruptiveThe impact of the new crown outbreak on radiotherapy facilities led to the corresponding adjustment of HGG radiotherapy strategiesIt is recommended that patients under 60-65 years of age, in good physical condition, MGMT methylation maintain a standard radiotherapy program, and if the outbreak crisis can not be completed according to the standard, it is recommended that 40Gy divided 15 radiotherapy, while taking TMZ, does not significantly affect the survival prognosisChemotherapy: It is not recommended to stop chemotherapy during the outbreak, but extra caution is requiredFourteen percent of patients taking TMZ may have a 3-4 level of hematological toxic reaction, which not only creates susceptibility to the new coronavirus, but also makes it difficult to correct blood transfusions during the outbreak, thus balancing the risk of improved chemotherapy with improved survival and new coronavirus infection, especially those who lack evidence of MGMT methylation New coronavirus-positive patients: It is not yet possible to recommend treatment for such patients For patients with asymptomatic or stable viral infection, at least radiotherapy should continue Patients recovering from the new coronavirus infection should begin treatment (Table 1) table 1 Recommendations for the treatment of neurotumors during the epidemic of the new coronavirus Conclusion In short, during the epidemic of the new coronavirus, the decision-making of high-level glioma surgery should be based on the patient's condition, surgical scope and ICU capacity to develop an individualized plan; radiotherapy can be carried out in small division; chemotherapy should be more careful observation of the response, not recommended to stop chemotherapy for all patients Patients should wear protective equipment to the clinic at the advice of the local health department and follow up on the virtual line as much as possible Copyright Notice The copyright scopyrights published by the God's External Information APP are not limited to the copyrights of the sponsor/original author and outside of God information, and no one may steal any content directly or indirectly by way of adaptation, tailoring, reproduction, reproduction, recording, etc without the express authorization of outside information Works authorized by outside information should be used within the scope of authorization, please indicate the source: Outside God Information In the event of a violation, The Outside Information will reserve the right to further pursue the legal liability of the infringer Outside the God's Information welcomes individuals to forward and share works published under this number