open access

Vol 26, No 1 (2021)
Research paper
Published online: 2021-01-22
Submitted: 2021-01-07
Get Citation

COVID-RO study: the radiation oncology practice at times of COVID-19 outbreak — international survey

Sarit Appel, Yaacov Richard Lawrence, Zvi Symon, Orit Kaidar-Person
DOI: 10.5603/RPOR.a2021.0003
·
Rep Pract Oncol Radiother 2021;26(1):20-28.

open access

Vol 26, No 1 (2021)
Original research articles
Published online: 2021-01-22
Submitted: 2021-01-07

Abstract

Background: Radiation therapy (RT), an essential treatment of cancer, involves multiple hospital visits. We hypothesized that radiation departments would adjust their work patterns and RT protocols in response to the SARS-CoV-2 pandemic.

Materials and methods: An electronic survey was sent during April 2020 to an international sample of radiation oncologists. The survey explored various aspects of departmental preparedness, and changes to their institutional RT protocols.

Results: A total of 68 radiation oncologists from 13 countries answered the survey. Healthcare systems were at least moderately affected in 76%. Most institutes appeared well prepared for the outbreak: regarding the availability of personal protective equipment, tests, and telemedicine/videoconference facilities. Screening for SARS-CoV-2 was applied in 59% of responders. Modification of RT protocols were minor in 66%, significant in 19% and no changes made in 15%. The extent to which protocols were modified correlated with overall healthcare disruption (p = 0.028). Normal fractionation was recommended to continue in 83% and 85% of head & neck, and cervical cancers vs. 64% of lung cancers (p = 0.001). In case the pandemic worsens, there was strong agreement to prioritize RT for aggressive cancers (80%), delay RT for slow-growing tumors (78%) and change to evidance-based hypofractionations protocols (79.4%). The option of delayed/omitted adjuvant RT  (not site specific) was selected in 47%. 

Conclusion: This international survey concludes that, by making significant organizational adjustments and minor protocol modifications, RT may be safely continued during this pandemic. If the crisis worsens, there was strong agreement to continue the treatment of aggressive tumors and utilize evidence-based hypofractionated protocols.

Abstract

Background: Radiation therapy (RT), an essential treatment of cancer, involves multiple hospital visits. We hypothesized that radiation departments would adjust their work patterns and RT protocols in response to the SARS-CoV-2 pandemic.

Materials and methods: An electronic survey was sent during April 2020 to an international sample of radiation oncologists. The survey explored various aspects of departmental preparedness, and changes to their institutional RT protocols.

Results: A total of 68 radiation oncologists from 13 countries answered the survey. Healthcare systems were at least moderately affected in 76%. Most institutes appeared well prepared for the outbreak: regarding the availability of personal protective equipment, tests, and telemedicine/videoconference facilities. Screening for SARS-CoV-2 was applied in 59% of responders. Modification of RT protocols were minor in 66%, significant in 19% and no changes made in 15%. The extent to which protocols were modified correlated with overall healthcare disruption (p = 0.028). Normal fractionation was recommended to continue in 83% and 85% of head & neck, and cervical cancers vs. 64% of lung cancers (p = 0.001). In case the pandemic worsens, there was strong agreement to prioritize RT for aggressive cancers (80%), delay RT for slow-growing tumors (78%) and change to evidance-based hypofractionations protocols (79.4%). The option of delayed/omitted adjuvant RT  (not site specific) was selected in 47%. 

Conclusion: This international survey concludes that, by making significant organizational adjustments and minor protocol modifications, RT may be safely continued during this pandemic. If the crisis worsens, there was strong agreement to continue the treatment of aggressive tumors and utilize evidence-based hypofractionated protocols.

Get Citation

Keywords

radiation oncology; coronavirus; SARS-CoV-2; health care services

About this article
Title

COVID-RO study: the radiation oncology practice at times of COVID-19 outbreak — international survey

Journal

Reports of Practical Oncology and Radiotherapy

Issue

Vol 26, No 1 (2021)

Article type

Research paper

Pages

20-28

Published online

2021-01-22

DOI

10.5603/RPOR.a2021.0003

Bibliographic record

Rep Pract Oncol Radiother 2021;26(1):20-28.

Keywords

radiation oncology
coronavirus
SARS-CoV-2
health care services

Authors

Sarit Appel
Yaacov Richard Lawrence
Zvi Symon
Orit Kaidar-Person

References (12)
  1. Coronavirus disease (COVID-19) pandemic. https://www.who.int/emergencies/diseases/novel-coronavirus-2019.
  2. Liang W, Guan W, Chen R, et al. Cancer patients in SARS-CoV-2 infection: a nationwide analysis in China. Lancet Oncol. 2020; 21(3): 335–337.
  3. Zhang H, Wang L, Chen Y, et al. Outcomes of novel coronavirus disease 2019 (COVID-19) infection in 107 patients with cancer from Wuhan, China. Cancer. 2020; 126(17): 4023–4031.
  4. Baskar R, Lee KA, Yeo R, et al. Cancer and radiation therapy: current advances and future directions. Int J Med Sci. 2012; 9(3): 193–199.
  5. Appel S, Kaidar-Person O, Lawrence YR, et al. The Coronavirus Pandemic in Israel: Implications for Radiation Oncology Departments. Isr Med Assoc J. 2020; 22(4): 211–213.
  6. Combs SE, Belka C, Niyazi M, et al. First statement on preparation for the COVID-19 pandemic in large German Speaking University-based radiation oncology departments. Radiat Oncol. 2020; 15(1): 74.
  7. Thomson DJ, Palma D, Guckenberger M, et al. Practice recommendations for risk-adapted head and neck cancer radiotherapy during the COVID-19 pandemic: An ASTRO-ESTRO consensus statement. Radiother Oncol. 2020; 151: 314–321.
  8. Thomson DJ, Palma D, Guckenberger M, et al. Practice recommendations for risk-adapted head and neck cancer radiotherapy during the COVID-19 pandemic: An ASTRO-ESTRO consensus statement. Radiother Oncol. 2020; 151: 314–321.
  9. Guckenberger M, Belka C, Bezjak A, et al. Practice recommendations for lung cancer radiotherapy during the COVID-19 pandemic: An ESTRO-ASTRO consensus statement. Radiother Oncol. 2020; 146(4): 223–229.
  10. Xu Y, Liu H, Hu Ke, et al. [Clinical Management of Lung Cancer Patients during the Outbreak of 2019 Novel Coronavirus Disease (COVID-19)]. Zhongguo Fei Ai Za Zhi. 2020; 23(3): 136–141.
  11. You B, Ravaud A, Canivet A, et al. The official French guidelines to protect patients with cancer against SARS-CoV-2 infection. Lancet Oncol. 2020; 21(5): 619–621.
  12. Murray Br, Haviland JS, Wheatley DA, et al. Hypofractionated breast radiotherapy for 1 week versus 3 weeks (FAST-Forward): 5-year efficacy and late normal tissue effects results from a multicentre, non-inferiority, randomised, phase 3 trial. Lancet. 2020; 395(10237): 1613–1626.

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

By "Via Medica sp. z o.o." sp.k., ul. Świętokrzyska 73, 80–180 Gdańsk, Poland
tel.:+48 58 320 94 94, fax:+48 58 320 94 60, e-mail: journals@viamedica.pl