CovidNeuroOnc: A UK multicenter, prospective cohort study of the impact of the COVID-19 pandemic on the neuro-oncology service

BackgroundThe COVID-19 pandemic has profoundly affected cancer services. Our objective was to determine the effect of the COVID-19 pandemic on decision making and the resulting outcomes for patients with newly diagnosed or recurrent intracranial tumors.MethodsWe performed a multicenter prospective study of all adult patients discussed in weekly neuro-oncology and skull base multidisciplinary team meetings who had a newly diagnosed or recurrent intracranial (excluding pituitary) tumor between 01 April and 31 May 2020. All patients had at least 30-day follow-up data. Descriptive statistical reporting was used.ResultsThere were 1357 referrals for newly diagnosed or recurrent intracranial tumors across 15 neuro-oncology centers. Of centers with all intracranial tumors, a change in initial management was reported in 8.6% of cases (n = 104/1210). Decisions to change the management plan reduced over time from a peak of 19% referrals at the start of the study to 0% by the end of the study period. Changes in management were reported in 16% (n = 75/466) of cases previously recommended for surgery and 28% of cases previously recommended for chemotherapy (n = 20/72). The reported SARS-CoV-2 infection rate was similar in surgical and non-surgical patients (2.6% vs. 2.4%, P > .9).ConclusionsDisruption to neuro-oncology services in the UK caused by the COVID-19 pandemic was most marked in the first month, affecting all diagnoses. Patients considered for chemotherapy were most affected. In those recommended surgical treatment this was successfully completed. Longer-term outcome data will evaluate oncological treatments received by these patients and overall survival

Herkunft numerischer und struktureller Aberrationen des X-Chromosoms

Nachdem 1956 durch Tjio und Levan die Darstellung der Metaphasenchromosomen eingeführt worden war, wurden in kurzer Folge ab 1959 verschiedene menschliche Aneuploidien als Ursache häufiger und z.T. bereits vorher bekannter klinischer Syndrome entdeckt (47,XXY als Ursache des Klinefelter-Syndroms: Jacobs u. Strong 1959; Trisomie 21 beim Down-Syndrom: Lejeune et al. 1959; 45,X als Basis des Turner-Syndroms: Ford et al. 1959). Später stellte sich heraus, daß fast die Hälfte der Patienten mit den klinischen Befunden des Turner-Syndroms 46 Chromosomen besitzt, aber entweder ein Mosaik oder eine strukturelle Aberration eines X-Chromosoms oder beides aufweist (Schmid et al. 1974)