Table 1: Scoring system for patients with cancer to weigh risk/benefit of chemotherapy during outbreak of COVID-19.
|
Supporting chemotherapy |
|
Discouraging chemotherapy |
|||||||
|
|
+4 |
+3 |
+2 |
+1 |
Factor |
-1 |
-2 |
-3 |
-4 |
|
TUMOR |
Curative |
x |
x |
x |
Therapy intention |
x |
x |
x |
Palliative |
|
High |
|
|
|
Acuity of type and manifestation |
|
|
|
Low |
|
|
High |
|
|
|
3 m risk of relapse / progression |
|
|
|
Low |
|
|
|
|
|
|
|
|
|
|
|
|
|
TREATMENT |
High |
|
|
|
Improvement of OS |
|
|
|
Low |
|
High |
|
|
|
Improvement of TTP |
|
|
|
Low |
|
|
High |
|
|
|
Estimated response |
|
|
|
Low |
|
|
Major complications expected |
|
|
|
Safety of delaying treatment to affect end outcome |
|
|
|
Safe |
|
|
Low |
|
|
|
Risk of immunsuppression |
|
|
|
High |
|
|
|
|
|
|
|
|
|
|
|
|
|
COVID19 |
Low |
|
|
|
Risk of COVID19 infection (region, family..etc) |
|
|
|
High |
|
Low |
|
|
|
Estimated risk of death in case of COVID19 infection (age, current condition.etc) |
|
|
|
High |
|
|
|
|
|
|
|
|
|
|
|
|
|
PATIENT |
None |
|
|
|
Comorbidities influencing course of possible COVID19 infection |
|
|
|
Significant |
|
Close (<1h) |
|
|
|
Distance to tertiary care hospital |
|
|
|
Very far (>2hrs) |
|
|
High |
|
|
|
Patient’s complaince |
|
|
|
Low |
|
|
|
|
|
|
|
|
|
|
|
|
|
HOSPITAL |
Outpatient |
x |
x |
x |
Delivering treatment |
x |
x |
x |
Inpatient |
|
Excellent |
|
|
|
Beds availability |
|
|
|
Major shortage |
|
|
Excellent |
|
|
|
Staff availability |
|
|
|
Major shortage |
|
|
Low |
|
|
|
Risk to be infected inside hospital |
|
|
|
High |
|
Abbreviations: 3 m: 3 months; OS: overall survival; TTP: time to progression.