6061 Background: Treatment (ttm) of cancer patients (pts) was compromised during the first wave of COVID19 pandemic due to collapse of healthcare systems. Standard of care (SOC) for LA-HNSCC pts had to be adapted as operating rooms were temporarily unavailable, and to reduce risk of COVID19 exposure. The IMPACCT study evaluated the outcome of LA-HNSCC pts treated at the Catalan Institute of Oncology during the first semester of 2020 and compared it to a control cohort previously treated in the same institution. Methods: Retrospective single institution analysis of two consecutively-treated cohorts of newly-diagnosed HNSCC pts: from January to June of 2020 (CT20) and same period of 2018 and 2019 (CT18-19). Pt demographics and disease characteristics were obtained from our in-site prospective database. Ttm modifications from SOC as per COVID19-contingency protocol in CT20 for LA-HNSCC were collected. Chi-squared was used to compare variables and ttm response between cohorts. One-year recurrence-free survival (1yRFS) and overall survival (1yOS) of LA-HNSCC pts were estimated by Kaplan-Meier method and compared by Log-rank test. Results: A total of 306 pts were included: CT20=99; CT18-19=207. Baseline characteristics were balanced between cohorts (Table1). In pts treated with conservative ttm (non-surgical approach), persistence disease was higher in CT20 vs CT18-19 (26 vs. 10% p=0.02). Median follow-up of CT20 and CT18-19 was 6.8 months (IQR 5.1-7.9) and 12.3 (6.7-18.4), respectively. A trend towards lower 1yRFS and 1yOS was observed in CT20 vs CT18-19 (72 vs 83% p=0.06; 80 vs 84% p=0.07), respectively. Within CT20, 37 pts (37%) had one or more ttm modifications: switch from surgery to conservative ttm (n=13); altered radiotherapy fractionation (n=14); reduced cisplatin cumulative dose to 200mg/m2 (n=19); no adjuvant ttm (n=1). Pts who received modified ttm had no differences in 1yRFS vs those who did not (80 vs 66% p=0.31), but higher 1yOS was observed (97 vs 67% p<0.01). When stratified by stage, 1yOS difference remained significant in stage III/IVA (100 vs 61% p<0.01) but not in I/II (100 vs 77% p=0.28) or IVB (67 vs 50% p=0.54). Conclusions: COVID19 pandemic had a negative impact on ttm outcomes and survival in LA-HNSCC pts when compared to our historical cohort. Ttm modifications based on COVID19-contingency protocol did not compromise ttm efficacy in terms of RFS and was associated with better OS in Stage III/IVA.[Table: see text]

The pandemic caused by the newly discovered severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the disease it produces (COVID-19) has had a great social and health impact worldwide, and represents a public health challenge. The first cases were detected in December 2019, and to this day the number of confirmed cases and deaths continues to rise.

Resumen Objetivo: Conocer las virtudes profesionales más valoradas por los pacientes y su importancia respecto a las habilidades técnicas. Método: Estudio cuantitativo, tipo descriptivo, mediante el empleo de encuestas. El estudio se ha realizado en pacientes paliativos del Hospital Centro de Cuidados Laguna. Resultados: Muestra de 42 pacientes. Entre las 10 prestaciones que escogió el paciente, 6 fueron virtudes del profesional sanitario. Las 5 prestaciones más valoradas fueron las siguientes: alegría (61,9%), respeto (57,1%), control del dolor (52,4%), ayuda ante la sensación del paciente de encontrarse mal (47,6%) y la sinceridad (47,3%). Con respecto a la prioridad concedida a los 10 ítems elegidos por cada paciente, las primeras posiciones las ocuparon el control del dolor (85%), la alegría (72%), la ayuda ante la sensación del paciente de encontrarse mal (67%), el respeto (58%), la asistencia ante el desánimo (54%) y la sinceridad (51%). Conclusiones: Los pacientes de Cuidados Paliativos valoran las virtudes por encima de las habilidades técnicas en los profesionales que les atienden. De entre todas las virtudes, la más valorada fue la alegría, que es precisamente aquella que exige mayor compromiso existencial de entre todas. Sin embargo, para confirmar la conclusión de este estudio piloto y dado que la muestra aquí manejada es pequeña se hace necesario planear una investigación que evalúe a un mayor número de pacientes

Uso inadecuado de opioides en pacientes con dolor oncológico: revisión sistemática integradora de la literatura. / Opioid misuse in patients with cancer pain: an integrative systematic review of the literature.