ArticleNeuro-oncology2020
A Quantitative Framework for Modeling COVID-19 Risk During Adjuvant Therapy Using Published Randomized Trials of Glioblastoma in the Elderly.
Article in Neuro-oncology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
11 citing papers in PubMed.
- Accelerated tumor progression after COVID-19 infection in patients with glioblastoma: A retrospective case-control study.Neuro-oncology practice · 2024Article
- The Korean Society for Neuro-Oncology (KSNO) Guideline for the Management of Brain Tumor Patients During the Crisis Period: A Consensus Recommendation Using the Delphi Method (Version 2023.1).Brain tumor research and treatment · 2023Article
- Effects of postoperative radiotherapy and docetaxel and PD-1 inhibitors on the survival and safety of glioblastoma patients: a systematic review and meta-analysis.Annals of translational medicine · 2022Article
- How has the COVID-19 pandemic impacted clinical care and research in Neuro-Oncology?Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia · 2022Review
- Optimal managements of elderly patients with glioblastoma.Japanese journal of clinical oncology · 2022Review
- Tackling brain metastases from lung cancer during the COVID-19 pandemic.Cancer reports (Hoboken, N.J.) · 2022Article
- Newly Diagnosed Glioblastoma in Elderly Patients.Current oncology reports · 2022Review
- Older people at the beginning of the COVID-19 pandemic: A scoping review.Journal of health monitoring · 2021Article
- Assessment of Simulated SARS-CoV-2 Infection and Mortality Risk Associated With Radiation Therapy Among Patients in 8 Randomized Clinical Trials.JAMA network open · 2021Article
- Review
- Cancer or COVID-19? A Review of Guidelines for Safe Cancer Care in the Wake of the Pandemic.SN comprehensive clinical medicine · 2020Review
Corrections and comments
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDuring the ongoing COVID-19 pandemic, contact with the healthcare system for cancer treatment can increase risk of infection and associated mortality. Treatment recommendations must consider this risk for elderly and vulnerable cancer patients. We re-analyzed trials in elderly glioblastoma (GBM) patients, incorporating COVID-19 risk, in order to provide a quantitative framework for comparing different radiation (RT) fractionation schedules on patient outcomes.
methodsWe extracted individual patient-level data (IPLD) for 1,321 patients from Kaplan-Meier curves from five randomized trials on treatment of elderly GBM patients including available subanalyses based on MGMT methylation status. We simulated trial data with incorporation of COVID-19 associated mortality risk in several scenarios (low, medium, and high infection and mortality risks). Median overall survival and hazard ratios were calculated for each simulation replicate.
resultsOur simulations reveal how COVID-19-associated risks affect survival under different treatment regimens. Hypofractionated RT with concurrent and adjuvant temozolomide (TMZ) demonstrated the best outcomes in low and medium risk scenarios. In frail elderly patients, shorter courses of RT are preferable. In patients with methylated MGMT receiving single modality treatment, TMZ-alone treatment approaches may be an option in settings with high COVID-19-associated risk.
conclusionsIncorporation of COVID-19-associated risk models into analysis of randomized trials can help guide clinical decisions during this pandemic. In elderly GBM patients, our results support prioritization of hypofractionated RT and highlight the utility of MGMT methylation status in decision-making in pandemic scenarios. Our quantitative framework can serve as a model for assessing COVID-19 risk associated with treatment across neuro-oncology.
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