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. 2022 Feb;5(2):e1426.
doi: 10.1002/cnr2.1426. Epub 2021 May 22.

Risk factors and clinical outcomes of systemic cancer treatment delays in Filipino patients with solid tumor malignancy during the COVID-19 pandemic: A single tertiary center study

Jessa Gilda Pandy  1 , Omar Maaño  1 , Joanmarie C Balolong-Garcia  1 , Jay T Y Datukan  1
Affiliations

Risk factors and clinical outcomes of systemic cancer treatment delays in Filipino patients with solid tumor malignancy during the COVID-19 pandemic: A single tertiary center study

Jessa Gilda Pandy et al. Cancer Rep (Hoboken). 2022 Feb.

Abstract

Background: Cancer care during the Covid-19 pandemic has been challenging especially in a developing country such as the Philippines. Oncologists were advised to prioritize chemotherapy based on the absolute benefit that the patient may receive, which outbalances the risks of Covid-19 infection. The results of this study will allow re-examination of how to approach cancer care during the pandemic and ultimately, help optimize treatment recommendations during this crisis.

Aim: This study described the factors contributing to treatment delays during the pandemic and their impact on disease progression.

Materials and results: This retrospective cohort study was done in St. Luke's Medical Center, a private tertiary healthcare institution based in Metro Manila, Philippines, composed of two facilities in Quezon City and Global City. Patients with solid malignancy with ongoing systemic cancer treatment prior to the peak of the pandemic were identified. Clinical characteristics and treatment data were compared between those with delayed and continued treatments. Multivariate analysis was done to determine factors for treatment delays and association of delays with disease progression and Covid-19 infection. Of the 111 patients, 33% experienced treatment delays and 67% continued treatment during the pandemic. There was a higher percentage of patients on palliative intent who underwent treatment delay, and 64% of delays were due to logistic difficulties. Treatment delays were significantly associated with disease progression (p < .0001). There was no evidence of association between delay or continuation of treatment and risk of Covid-19 infection.

Conclusions: There was no difference in Covid-19 infection between those who delayed and continued treatment during the pandemic; however, treatment delays were associated with a higher incidence of disease progression. Our findings suggest that the risks of cancer progression due to treatment delays exceed the risks of Covid-19 infection in cancer patients implying that beneficial treatment should not be delayed as much as possible. Logistic hindrances were also identified as the most common cause of treatment delay among Filipino patients, suggesting that efforts should be focused into assistance programs that will mitigate these barriers to ensure continuity of cancer care services during the pandemic.

Keywords: Covid-19; Philippines; cancer; treatment delays.

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Conflict of interest statement

The authors have stated explicitly that there are no conflicts of interest in connection with this article.

Figures

FIGURE 1
FIGURE 1
Map of the Philippines. (Areas in red) Luzon island placed on enhanced community quarantine. Modified from: https://filipinotimes.net/wp‐content/uploads/2020/03/luzon
See this image and copyright information in PMC

References

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    1. European Society for Medical Oncology . ESMO: Cancer patient management during the COVID‐19 pandemic. https://www.esmo.org/guidelines/cancer-patient-management-during-the-cov.... Accessed on August 17, 2020.

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