Abstract：
OBJECTIVE: The coronavirus disease 2019 (covid-19) caused by the severe acute respiratory syndrome coronavirus 2 (Sars-Cov-2) is at the origin of a global pandemic. This pandemic has prompted the current health system to reorganize and rethink the care offered by health establishments. We report the early and late toxicity in patients infected with covid-19 treated at the same time for early-stage breast cancer.
METHODS: This is a monocentric prospective study of patients treated in our hospital between March and June 2020 who were diagnosed with covid-19 infection. The inclusion criteria were to be irradiated for early-stage breast cancer and to have a positive covid diagnosis on a polymerase chain reaction (PCR) test and/or a lung computed tomography (CT) scan and/or suggestive clinical symptoms. All of them needed 6 months follow-up clinic after the end of the radiotherapy with clinical examination, mammogram, as well as CT scan to evaluate the lung status. Radiotherapy consisted of breast or chest wall irradiation with or without lymph node irradiation, with protocols adapted to pandemic situation. The treatment-related toxicity was graded according to the Common Toxicology Criteria for Adverse Events (version 4.03).
RESULTS: All 350 patients treated for early-stage breast cancer were studied. Of them, 16 presented clinical symptoms of covid-19 infection, and of them 12 had clinical, CT scan and PCR confirmation. This entire cohort of 12 patients with median age of 56years (range: 42-72 years) underwent their radiotherapy. During the radiotherapy, nine patients presented radiodermatitis: eight grade 1 (66%) and one grade 2 (8%). Two patients with lymph nodes irradiation presented grade 2 oesophagitis. Late toxicity was evaluated 6 months after the end of the radiotherapy, and there was no radiation or covid lung sequel on the CT scans. One patient presented covid-related dyspnoea, and two had fibrosis.
CONCLUSIONS: The half-year follow-up of prospective covid-19 cohort, treated for early-stage breast cancer demonstrated an acceptable toxicity profile with few low-grade adverse events. It seems that the covid-19 infection does not appear to increase the side effects of radiotherapy. Therefore radiotherapy should not be delayed.
METHODS: This is a monocentric prospective study of patients treated in our hospital between March and June 2020 who were diagnosed with covid-19 infection. The inclusion criteria were to be irradiated for early-stage breast cancer and to have a positive covid diagnosis on a polymerase chain reaction (PCR) test and/or a lung computed tomography (CT) scan and/or suggestive clinical symptoms. All of them needed 6 months follow-up clinic after the end of the radiotherapy with clinical examination, mammogram, as well as CT scan to evaluate the lung status. Radiotherapy consisted of breast or chest wall irradiation with or without lymph node irradiation, with protocols adapted to pandemic situation. The treatment-related toxicity was graded according to the Common Toxicology Criteria for Adverse Events (version 4.03).
RESULTS: All 350 patients treated for early-stage breast cancer were studied. Of them, 16 presented clinical symptoms of covid-19 infection, and of them 12 had clinical, CT scan and PCR confirmation. This entire cohort of 12 patients with median age of 56years (range: 42-72 years) underwent their radiotherapy. During the radiotherapy, nine patients presented radiodermatitis: eight grade 1 (66%) and one grade 2 (8%). Two patients with lymph nodes irradiation presented grade 2 oesophagitis. Late toxicity was evaluated 6 months after the end of the radiotherapy, and there was no radiation or covid lung sequel on the CT scans. One patient presented covid-related dyspnoea, and two had fibrosis.
CONCLUSIONS: The half-year follow-up of prospective covid-19 cohort, treated for early-stage breast cancer demonstrated an acceptable toxicity profile with few low-grade adverse events. It seems that the covid-19 infection does not appear to increase the side effects of radiotherapy. Therefore radiotherapy should not be delayed.
摘要：
目标：由严重急性呼吸道综合症冠状病毒2（Sars-Cov-2）引起的2019年冠状病毒病（covid-19）是全球大流行的起源。这种流行病促使当前的卫生系统重组和重新考虑卫生机构提供的护理。我们报告了同时治疗早期乳腺癌的covid-19感染患者的早期和晚期毒性。
方法：这是一项针对2020年3月至6月在我院接受治疗的诊断为covid-19感染的患者的单中心前瞻性研究。纳入标准是对早期乳腺癌进行照射，并在聚合酶链反应（PCR）测试和/或肺部计算机断层扫描（CT）扫描和/或提示临床症状方面具有阳性诊断。所有患者均需在放疗结束后6个月随访临床检查，乳房X线照片,以及CT扫描来评估肺部状况。放疗包括乳房或胸壁照射，伴有或不伴有淋巴结照射，与适应大流行情况的协议。根据不良事件的常见毒理学标准（4.03版）对治疗相关毒性进行分级。
结果：研究了350例早期乳腺癌患者。其中,16出现了covid-19感染的临床症状，其中12人有临床，CT扫描和PCR确认。整个队列中的12名患者中位年龄为56岁（范围：42-72岁）接受了放疗。在放疗期间,9例患者出现放射性皮炎:8例1级(66%)和1例2级(8%).两名淋巴结照射患者出现2级食管炎。放疗结束后6个月评估晚期毒性，CT扫描没有辐射或肺部后遗症。一名患者出现了covid相关的呼吸困难，两个有纤维化。
结论：前瞻性covid-19队列的半年随访，对早期乳腺癌的治疗显示出可接受的毒性特征,且很少发生低度不良事件.似乎covid-19感染似乎不会增加放疗的副作用。因此放疗不应延迟。
方法：这是一项针对2020年3月至6月在我院接受治疗的诊断为covid-19感染的患者的单中心前瞻性研究。纳入标准是对早期乳腺癌进行照射，并在聚合酶链反应（PCR）测试和/或肺部计算机断层扫描（CT）扫描和/或提示临床症状方面具有阳性诊断。所有患者均需在放疗结束后6个月随访临床检查，乳房X线照片,以及CT扫描来评估肺部状况。放疗包括乳房或胸壁照射，伴有或不伴有淋巴结照射，与适应大流行情况的协议。根据不良事件的常见毒理学标准（4.03版）对治疗相关毒性进行分级。
结果：研究了350例早期乳腺癌患者。其中,16出现了covid-19感染的临床症状，其中12人有临床，CT扫描和PCR确认。整个队列中的12名患者中位年龄为56岁（范围：42-72岁）接受了放疗。在放疗期间,9例患者出现放射性皮炎:8例1级(66%)和1例2级(8%).两名淋巴结照射患者出现2级食管炎。放疗结束后6个月评估晚期毒性，CT扫描没有辐射或肺部后遗症。一名患者出现了covid相关的呼吸困难，两个有纤维化。
结论：前瞻性covid-19队列的半年随访，对早期乳腺癌的治疗显示出可接受的毒性特征,且很少发生低度不良事件.似乎covid-19感染似乎不会增加放疗的副作用。因此放疗不应延迟。
