The results suggest that the majority of FCs of Egyptian cancer patients prefer CDD to patients. The finding that the vast majority of FCs of aware patients preferred CDD suggests that the reaction of Egyptian patients to CDD is acceptable by FCs. Family caregivers with a negative attitude toward CDD may be reflecting their own fears.
Background: In many countries, especially the lower-income ones, the COVID-19 pandemic had a significant negative impact on the services provided to cancer patients. This necessitated setting guidelines for the management of cancer during the pandemic and resulted in changes in its practice. Aim: To explore the change in practice of cancer treatment in cancer centers during the COVID-19 pandemic in Egypt, a lower-income country. Methods: Oncologists from six geographically-distributed Egyptian cancer centers were invited to complete a semistructured questionnaire evaluating their cancer treatment practice changes. This included systemic anti-cancer treatment, radiotherapy, surgery and supportive and palliative care. Results: Regarding systemic chemotherapy, there was a switch from weekly to 3-4 weekly schedules, from longer to shorter courses and from parenteral to oral administration whenever possible in the majority of centers. Single agents were encouraged and regimens more likely to cause neutropenia were avoided. Hormonal and palliative care treatments were prescribed for longer durations. For many indications, especially the palliative, a switch to hypofractionated radiotherapy regimens was adopted. Excluding emergencies, surgeries were postponed in many centers. The number of elective hospital admissions was minimized and the time interval of follow up visits was prolonged. The majority used phone calls to follow up patients. Conclusion: The COVID-19 pandemic has been associated with many changes in cancer treatment practice in Egyptian cancer care facilities. These changes are likely to minimize the risk of exposure of patients and health care professionals and to utilize the limited resources in a better way.
Background: Lung cancer remains the most common primary tumor responsible for brain-metastases (BM) leading to 40%-50% of cases. BM from Non-Small Cell Lung Cancer (NSCLC) is associated with poor prognosis. Aim: This study aimed to analyze risk factors and treatment outcome of patients with NSCLC who developed BM, and also to identify which subgroup of these patients is associated with better survival outcome. Methods: This retrospective study included data of 714 patients with NSCLC presented to an Egyptian cancer center during the period between January 2006 and December 2012. Of them, 132 patients had clinical evidence of BM. results: The median time to development of BM (TTBM) was 6 months. Factors associated with longer TTBM were better Eastern Cooperative Oncology Group (ECOG) performance status score 1-2 (p = 0.004), early stages at presentation (stage I-II) (p < 0.0001), and administration of chemotherapy (p < 0.0001). Median OS (OS) from the time of development of BM was 5 months. Factors associated with longer OS were better performance status (ECOG 1-2) at development of BM (p <0.0001), controlled lung primary (p <0.0001), absence of extracranial metastases (p =0.019), the use of chemotherapy after development of BM (p <0.0001) and whole brain irradiation (p =0.001). Controlled lung primary and administration of chemotherapy were independent favorable prognostic factors associated with higher OS (p = 0.006 and 0.02, respectively). conclusion: After the development of BM; NSCLC patients with good performance status, controlled lung primary and without extracranial metastases have a better outcome.
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