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Riano I, Alas-Pineda C, Reyes Garcia S, Murillo R, Gutiérrez-Delgado F, Cazap E, Pais Viegas CM, Torre MDL, Barahona KC, Sarria GJ, Del Castillo Bahi R, Luongo-Céspedes Á, Ovalles B, Umaña Herrera FV, Sánchez R, McVorran S, Williams B, Kascmar J, Kennedy LS, Lyons KD, Bejarano S, Wong SL. Community-Led Action Research in Oncology: Pandemic-Appropriate Radiotherapy Innovations Evaluated (CLARO PARTE) for Latin America and the Caribbean Countries. JCO Glob Oncol 2024; 10:e2400051. [PMID: 39159409 DOI: 10.1200/go.24.00051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Revised: 04/03/2024] [Accepted: 06/18/2024] [Indexed: 08/21/2024] Open
Abstract
PURPOSE This study aimed to identify, evaluate, and rank suitable safety innovations developed during the COVID-19 pandemic in Latin American and Caribbean (LAC) radiation oncology centers. METHODS We conducted a multimodal participatory engagement collaboration with the Latin-American and Caribbean Society of Medical Oncology. The study consisted of four phases. Innovations were collected from a panel of radiotherapy experts representing a diverse group of 11 countries from LAC (Phase I). Next, a medical scientific team compared the innovations against international standards regarding their potential impact on risk of infection, clinical operation, and continuity of quality cancer care (Phase II). Their findings were supplied to the country representatives who rated the innovations for acceptability in their cancer centers (Phase III), resulting in a final report of the panel's recommendations (Phase IV). RESULTS A total of 81 innovations were reported by the country representatives and merged by the medical scientific team into 24 innovations that combined similar innovations. The 24 innovations were grouped into six categories including practices aimed at (1) reducing clinic crowding (n = 3), (2) increasing screening and vaccinations for COVID-19 disease (n = 5), (3) implementing social distancing (n = 6), (4) strengthening personal infection equipment and disinfection (n = 6), (5) avoiding delaying or shortening treatment protocols (n = 2), and (6) mixed procedures (n = 2). The medical scientific team found nearly all innovations were supported by international recommendations and rated as safe, efficient, and acceptable. CONCLUSION By using the lessons learned from the Community-Led Action Research in Oncology: Pandemic-Appropriate Radiotherapy Innovations Evaluated study, a manual of scalable practices in radiation oncology clinics may be developed to guide actions during future large-scale public health crises in low- and middle-income countries of LAC.
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Affiliation(s)
- Ivy Riano
- Division of Hematology and Oncology, Dartmouth Cancer Center, Dartmouth Health, Geisel School of Medicine at Dartmouth, Lebanon, NH
| | - César Alas-Pineda
- Division of Radiation Oncology, Liga Contra El Cáncer, San Pedro Sula, Honduras
| | - Sarahi Reyes Garcia
- Division of Radiation Oncology, Liga Contra El Cáncer, San Pedro Sula, Honduras
| | - Raúl Murillo
- Centro Javeriano de Oncología, Hospital Universitario San Ignacio, Faculty of Medicine, Pontificia Universidad Javeriana, Bogotá, Colombia
| | | | - Eduardo Cazap
- Latin-American and Caribbean Society of Medical Oncology (SLACOM), Buenos Aires, Argentina
| | - Celia Maria Pais Viegas
- Department of Radiation Oncology, Instituto Nacional de Cáncer, Brazil National Cancer Institute, Rio de Janeiro, Brazil
| | - Marcela de la Torre
- Division of Oncology, Hospital de Clínicas, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Kaory C Barahona
- Division of Radiation Oncology, International Cancer Center, Diagnostic Hospital, San Salvador, El Salvador
| | - Gustavo J Sarria
- Dirección General de Control de Cancer, Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru
| | - Ramón Del Castillo Bahi
- Department of Radiation Oncology, Instituto Nacional de Oncología y Radiobiología, La Habana, Cuba
| | | | - Beatriz Ovalles
- Department of Radiation Oncology, Centro de Cancer Homs, Santiago de los Caballeros, Dominican Republic
| | | | - Ricardo Sánchez
- Centro Javeriano de Oncología, Hospital Universitario San Ignacio, Faculty of Medicine, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Shauna McVorran
- Department of Radiation Oncology and Applied Science, Dartmouth Cancer Center, Lebanon, NH
| | - Benjamin Williams
- Department of Radiation Oncology and Applied Science, Dartmouth Cancer Center, Lebanon, NH
| | - Joseph Kascmar
- Department of Surgery, Dartmouth Health, Geisel School of Medicine at Dartmouth, Lebanon, NH
| | - Linda S Kennedy
- Strategic Initiatives & Global Oncology at the Dartmouth Cancer Center, Dartmouth Health, Lebanon, NH
| | - Kathleen D Lyons
- Department of Occupational Therapy, Massachusetts General Hospital (MGH) Institute of Health Professions, Boston, MA
| | - Suyapa Bejarano
- Division of Radiation Oncology, Liga Contra El Cáncer, San Pedro Sula, Honduras
| | - Sandra L Wong
- Department of Surgery, Dartmouth Cancer Center, Dartmouth Health, Geisel School of Medicine at Dartmouth, Lebanon, NH
- The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, NH
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Penrod D, Hirsch B. Nursing Care for Metastatic Bone Cancer: Trends for the Future. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6483. [PMID: 37569024 PMCID: PMC10418383 DOI: 10.3390/ijerph20156483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 07/20/2023] [Accepted: 07/27/2023] [Indexed: 08/13/2023]
Abstract
To effectively treat patients and minimize viral exposure, oncology nurses and radiology departments during COVID-19 had to re-examine the ability to offer palliative radiation treatments to people with metastatic bone cancer. Decreasing potential exposure to the virus resulted in extra measures to keep patients and personnel safe. Limiting radiotherapy treatments, social distancing, and limiting caregivers were a few of the ways that oncology patients were impacted by the pandemic. Hypofractionated radiation therapy (HFRT), or the delivery of fewer higher-dose treatments, was a method of providing care but also limiting exposure to infection for immunocompromised patients as well as healthcare staff. As oncology radiation centers measure the impact of patient care during the pandemic, a trend toward HFRT may occur in treating the painful symptoms of bone cancer. In anticipation that HFRT may be increasingly used in patient treatment plans, oncology nurses should consider patient perspectives and outcomes from the pandemic to further determine how to manage future trends in giving personalized care, and supportive care.
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Affiliation(s)
- Debra Penrod
- Nursing, School of Health Sciences, Southern Illinois University, Carbondale, IL 62901, USA
| | - Brandon Hirsch
- Radiological Sciences, School of Health Sciences, Southern Illinois University, Carbondale, IL 62920, USA;
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Piras A, Venuti V, D’Aviero A, Cusumano D, Pergolizzi S, Daidone A, Boldrini L. Covid-19 and radiotherapy: a systematic review after 2 years of pandemic. Clin Transl Imaging 2022; 10:611-630. [PMID: 35910079 PMCID: PMC9308500 DOI: 10.1007/s40336-022-00513-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 07/12/2022] [Indexed: 02/08/2023]
Abstract
Introduction Following the Covid-19 pandemic spread, changes in clinical practice were necessary to limit the pandemic diffusion. Also, oncological practice has undergone changes with radiotherapy (RT) treatments playing a key role.Although several experiences have been published, the aim of this review is to summarize the current evidence after 2 years of pandemic to provide useful conclusions for clinicians. Methods A Pubmed/MEDLINE and Embase systematic review was conducted. The search strategy was "Covid AND Radiotherapy" and only original articles in the English language were considered. Results A total of 2.733 papers were obtained using the mentioned search strategy. After the complete selection process, a total of 281 papers were considered eligible for the analysis of the results. Discussion RT has played a key role in Covid-19 pandemic as it has proved more resilient than surgery and chemotherapy. The impact of the accelerated use of hypofractionated RT and telemedicine will make these strategies central also in the post-pandemic period.
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Affiliation(s)
- Antonio Piras
- Radioterapia Oncologica, Villa Santa Teresa, Palermo, Italy
| | - Valeria Venuti
- Radioterapia Oncologica, Università degli Studi di Palermo, Palermo, Italy
| | - Andrea D’Aviero
- Radiation Oncology, Mater Olbia Hospital, Olbia, Sassari Italy
| | | | - Stefano Pergolizzi
- Radiation Oncology Unit, Department of Biomedical, Dental Science and Morphological and Functional Images, University of Messina, Messina, Italy
| | | | - Luca Boldrini
- Dipartimento di Diagnostica per immagini, Radioterapia Oncologica ed Ematologia, UOC Radioterapia Oncologica - Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy
- Università Cattolica del Sacro Cuore, Roma, Italy
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Chaput G, Regnier L. Radiotherapy: Clinical pearls for primary care. CANADIAN FAMILY PHYSICIAN MEDECIN DE FAMILLE CANADIEN 2021; 67:753-757. [PMID: 34649900 PMCID: PMC8516179 DOI: 10.46747/cfp.6710753] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Affiliation(s)
- Genevieve Chaput
- Assistant Professor at McGill University in Montreal, Que, an attending physician in the departments of family medicine and secondary care and oncology at the McGill University Health Centre, and Medical Director of the Vaudreuil-Soulanges Palliative Care Residence
| | - Laura Regnier
- Assistant Professor in the Department of Family Medicine at the University of Ottawa in Ontario, and a general practitioner in oncology in the Radiation Oncology Department at The Ottawa Hospital Cancer Centre
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Palliative radiotherapy indications during the COVID-19 pandemic and in future complex logistic settings: the NORMALITY model. Radiol Med 2021; 126:1619-1656. [PMID: 34570309 PMCID: PMC8475365 DOI: 10.1007/s11547-021-01414-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 08/30/2021] [Indexed: 12/03/2022]
Abstract
Introduction The COVID-19 pandemic has challenged healthcare systems worldwide over the last few months, and it continues to do so. Although some restrictions are being removed, it is not certain when the pandemic is going to be definitively over. Pandemics can be seen as a highly complex logistic scenario. From this perspective, some of the indications provided for palliative radiotherapy (PRT) during the COVID-19 pandemic could be maintained in the future in settings that limit the possibility of patients achieving symptom relief by radiotherapy.
This paper has two aims: (1) to provide a summary of the indications for PRT during the COVID-19 pandemic; since some indications can differ slightly, and to avoid any possible contradictions, an expert panel composed of the Italian Association of Radiotherapy and Clinical Oncology (AIRO) and the Palliative Care and Supportive Therapies Working Group (AIRO-palliative) voted by consensus on the summary; (2) to introduce a clinical care model for PRT [endorsed by AIRO and by a spontaneous Italian collaborative network for PRT named “La Rete del Sollievo” (“The Net of Relief”)]. The proposed model, denoted “No cOmpRoMise on quality of life by pALliative radiotherapy” (NORMALITY), is based on an AIRO-palliative consensus-based list of clinical indications for PRT and on practical suggestions regarding the management of patients potentially suitable for PRT but dealing with highly complex logistics scenarios (similar to the ongoing logistics limits due to COVID-19).
Material and Methods First, a summary of the available literature guidelines for PRT published during the COVID-19 pandemic was prepared. A systematic literature search based on the PRISMA approach was performed to retrieve the available literature reporting guideline indications fully or partially focused on PRT. Tables reporting each addressed clinical presentation and respective literature indications were prepared and distributed into two main groups: palliative emergencies and palliative non-emergencies. These summaries were voted in by consensus by selected members of the AIRO and AIRO-palliative panels. Second, based on the summary for palliative indications during the COVID-19 pandemic, a clinical care model to facilitate recruitment and delivery of PRT to patients in complex logistic scenarios was proposed. The summary tables were critically integrated and shuffled according to clinical presentations and then voted on in a second consensus round. Along with the adapted guideline indications, some methods of performing the first triage of patients and facilitating a teleconsultation preliminary to the first in-person visit were developed.
Results After the revision of 161 documents, 13 papers were selected for analysis. From the papers, 19 clinical presentation items were collected; in total, 61 question items were extracted and voted on (i.e., for each presentation, more than one indication was provided from the literature). Two tables summarizing the PRT indications during the COVID-19 pandemic available from the literature (PRT COVID-19 summary tables) were developed: palliative emergencies and palliative non-emergencies. The consensus of the vote by the AIRO panel for the PRT COVID-19 summary was reached. The PRT COVID-19 summary tables for palliative emergencies and palliative non-emergencies were adapted for clinical presentations possibly associated with patients in complex clinical scenarios other than the COVID-19 pandemic. The two new indication tables (i.e., “Normality model of PRT indications”) for both palliative emergencies and palliative non-emergencies were voted on in a second consensus round. The consensus rate was reached and strong. Written forms facilitating two levels of teleconsultation (triage and remote visits) were also developed, both in English and in Italian, to evaluate the patients for possible indications for PRT before scheduling clinical visits. Conclusion We provide a comprehensive summary of the literature guideline indications for PRT during COVID-19 pandemic. We also propose a clinical care model including clinical indications and written forms facilitating two levels of teleconsultation (triage and remote visits) to evaluate the patients for indications of PRT before scheduling clinical visits. The normality model could facilitate the provision of PRT to patients in future complex logistic scenarios.
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Decker KM, Lambert P, Feely A, Bucher O, Kim JO, Hebbard P, Thiessen M, Fatoye T, Pitz M, Koul R, Czaykowski P. Evaluating the Impact of the COVID-19 Pandemic on New Cancer Diagnoses and Oncology Care in Manitoba. ACTA ACUST UNITED AC 2021; 28:3081-3090. [PMID: 34436035 PMCID: PMC8395519 DOI: 10.3390/curroncol28040269] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 07/27/2021] [Accepted: 08/06/2021] [Indexed: 12/23/2022]
Abstract
Individuals with cancer are vulnerable to infection with SARS-CoV-2, the virus causing COVID-19. Physical distancing, the reallocation of health care resources, and the implementation of procedures to reduce the spread of COVID-19 may also have serious consequences for people with cancer. We evaluated the impact of COVID-19 on new cancer diagnoses and oncology care in Manitoba, Canada using an interrupted time series design and data from the Manitoba Cancer Registry and CancerCare Manitoba's (CCMB) electronic medical record. In April 2020, there was a 23% decrease in new cancer diagnoses, a 21% decrease in pathology reports, and a 43% reduction in surgical resections. There was no difference in new cancer diagnoses by August 2020, surgery by July 2020, and pathology reports by September 2020. From April 2020 to June 2021, there was a 13% decrease in radiotherapy (RT) fractions, an 18% decrease in UCC visits, and a 52% decrease in in-person visits. There was no change in intravenous chemotherapy visits per month, first RT visits, or overall patient visits. The impact of COVID-19 on shifts in the stage at diagnosis and survival will be assessed in future analyses.
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Affiliation(s)
- Kathleen M. Decker
- CancerCare Manitoba Research Institute, CancerCare Manitoba, 675 McDermot Avenue, Winnipeg, MB R3E 0V9, Canada; (P.L.); (J.O.K.); (M.P.); (R.K.)
- Department of Community Health Sciences, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, 750 Bannatyne Avenue, Winnipeg, MB R3E 0V9, Canada;
- Department of Epidemiology and Cancer Registry, CancerCare Manitoba, 675 McDermot Avenue, Winnipeg, MB R3E 0V9, Canada; (A.F.); (O.B.)
- Correspondence: ; Tel.: +1-204-390-3912
| | - Pascal Lambert
- CancerCare Manitoba Research Institute, CancerCare Manitoba, 675 McDermot Avenue, Winnipeg, MB R3E 0V9, Canada; (P.L.); (J.O.K.); (M.P.); (R.K.)
- Department of Epidemiology and Cancer Registry, CancerCare Manitoba, 675 McDermot Avenue, Winnipeg, MB R3E 0V9, Canada; (A.F.); (O.B.)
| | - Allison Feely
- Department of Epidemiology and Cancer Registry, CancerCare Manitoba, 675 McDermot Avenue, Winnipeg, MB R3E 0V9, Canada; (A.F.); (O.B.)
| | - Oliver Bucher
- Department of Epidemiology and Cancer Registry, CancerCare Manitoba, 675 McDermot Avenue, Winnipeg, MB R3E 0V9, Canada; (A.F.); (O.B.)
| | - Julian O. Kim
- CancerCare Manitoba Research Institute, CancerCare Manitoba, 675 McDermot Avenue, Winnipeg, MB R3E 0V9, Canada; (P.L.); (J.O.K.); (M.P.); (R.K.)
- Department of Radiology, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, 820 Sherbrook Street GA216, Winnipeg, MB R3T 2N2, Canada
- Department of Radiation Oncology, CancerCare Manitoba, 675 McDermot Avenue, Winnipeg, MB R3E 0V9, Canada
| | - Pamela Hebbard
- Department of Surgery, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, 820 Sherbrook Street, Winnipeg, MB R3A 1R9, Canada;
| | - Maclean Thiessen
- Department of Internal Medicine, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, 820 Sherbrook Street, Winnipeg, MB R3E 0V9, Canada;
- Department of Medical Oncology and Hematology, CancerCare Manitoba, 675 McDermot Avenue, Winnipeg, MB R3E 0V9, Canada
| | - Tunji Fatoye
- Department of Primary Care Oncology, CancerCare Manitoba, 675 McDermot Avenue, Winnipeg, MB R3E 0V9, Canada;
- Department of Family Medicine, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, 750 Bannatyne Avenue, Winnipeg, MB R3E 0V9, Canada
| | - Marshall Pitz
- CancerCare Manitoba Research Institute, CancerCare Manitoba, 675 McDermot Avenue, Winnipeg, MB R3E 0V9, Canada; (P.L.); (J.O.K.); (M.P.); (R.K.)
- Department of Internal Medicine, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, 820 Sherbrook Street, Winnipeg, MB R3E 0V9, Canada;
- Department of Medical Oncology and Hematology, CancerCare Manitoba, 675 McDermot Avenue, Winnipeg, MB R3E 0V9, Canada
| | - Rashmi Koul
- CancerCare Manitoba Research Institute, CancerCare Manitoba, 675 McDermot Avenue, Winnipeg, MB R3E 0V9, Canada; (P.L.); (J.O.K.); (M.P.); (R.K.)
- Department of Radiology, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, 820 Sherbrook Street GA216, Winnipeg, MB R3T 2N2, Canada
- Department of Radiation Oncology, CancerCare Manitoba, 675 McDermot Avenue, Winnipeg, MB R3E 0V9, Canada
| | - Piotr Czaykowski
- Department of Community Health Sciences, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, 750 Bannatyne Avenue, Winnipeg, MB R3E 0V9, Canada;
- Department of Internal Medicine, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, 820 Sherbrook Street, Winnipeg, MB R3E 0V9, Canada;
- Department of Medical Oncology and Hematology, CancerCare Manitoba, 675 McDermot Avenue, Winnipeg, MB R3E 0V9, Canada
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Siavashpour Z, Goharpey N, Mobasheri M. Radiotherapy based management during Covid-19 pandemic - A systematic review of presented consensus and guidelines. Crit Rev Oncol Hematol 2021; 164:103402. [PMID: 34214608 PMCID: PMC8242203 DOI: 10.1016/j.critrevonc.2021.103402] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 02/17/2021] [Accepted: 06/18/2021] [Indexed: 01/18/2023] Open
Abstract
Treatment management of cancer patients in the radiation oncology departments during the current COVID-19 pandemic is challenging. A systematic review of published consensus/guidelines on the role of radiotherapy prioritization, suggested treatment protocols, and set up management was undertaken based on the PRISMA protocol and through PubMed/PMC, Scopus, Google Scholar, Web of Science databases until 01/20/2021. One hundred and sixty-eight publications or regional consensus were included. Summary of recommendations contained: (1) using hypo-fractionated (Hypo-F) regimens for therapeutic/palliative indications, (2) delaying radiotherapy for several weeks or until pandemic over, (3) omitting radiotherapy by replacement of alternative therapies or active surveillance, (4) applying safer patients' setup and preparation protocols, (5) developing telemedicine/telehealth service. To conclude, it is essential to carefully weigh the risk of exposure to COVID-19 infection and the benefit of treating cancer patients during the pandemic. Trying to have a global guideline facing this or any other probable crisis is crucial for health care service.
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Affiliation(s)
- Zahra Siavashpour
- Radiotherapy Oncology Department, Shohada-e Tajrish Educational Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Neda Goharpey
- Radiotherapy Oncology Department, Shohada-e Tajrish Educational Hospital, Tehran, Iran.
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Samper Ots PM, Zapatero Ortuño J, Pedraza Fernández S, Mayrata Canellas E, González San Segundo C, Campo Vargas M, Caballero B, Ramos Albiac M, Vázquez Masedo G, Álvarez B, Rodríguez Villalba S, Muñoz Miguelañez T, Diezhandino Garcia P, Sancho G, Guzmán Gómez L, Tripero J, Rico Oses MR, Ibañez Villoslada C, Soler Rodríguez AMS, Chust ML, Fondevilla Soler A, Lozano Martin EM, Morillo Macias V, Fuentes Sánchez C, Torrado Moya L, Fernández López J, Solé JM, Guijarro Verdú M, Mira Flores M, Wals A, Expósito Hernández J. Impact of covid-19 on patients in radiotherapy oncology departaments in Spain. Radiother Oncol 2021; 161:148-151. [PMID: 34118358 PMCID: PMC8189749 DOI: 10.1016/j.radonc.2021.06.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 06/01/2021] [Accepted: 06/02/2021] [Indexed: 12/11/2022]
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Alom S, Chiu CM, Jha A, Lai SHD, Yau THL, Harky A. The Effects of COVID-19 on Cancer Care Provision: A Systematic Review. Cancer Control 2021; 28:1073274821997425. [PMID: 33631953 PMCID: PMC8482720 DOI: 10.1177/1073274821997425] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 01/06/2021] [Accepted: 01/29/2021] [Indexed: 12/18/2022] Open
Abstract
This systematic review aims to gather primary data from cancer institutions that have implemented changes to cancer service provision amid the COVID-19 outbreak to inform future intervention and health care facility response strategies. A comprehensive literature search was done on Global Health Medline and EMBASE using pertinent key words and MeSH terms relating to COVID-19 and Cancer service provision. A total of 72 articles were selected for inclusion in this systematic review. Following the narrative synthesis that was conducted of the literature, 6 core themes that encompassed common cancer service intervention adopted by institutions were identified: (1) Testing and Tracking, (2) Outreach and Communication, (3) Protection, (4) Social Distancing (5) Treatment Management, (6) Service Restructuring. Since cancer patients are a high-risk population amid the COVID-19 pandemic, these areas of targeted intervention can be used to inform necessary actions in institutions facing similar risks, based on previous learning from numerous cancer centers globally.
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Affiliation(s)
- Samiha Alom
- School of Public Health, Imperial College London, London, UK
- Equal contribution
| | - Chun Ming Chiu
- Brighton and Sussex Medical School, University of Sussex, East Sussex, UK
- Equal contribution
| | - Ashwarya Jha
- School of Medical Sciences, University of Manchester, Manchester, UK
| | | | - Thomas Ho Lai Yau
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Amer Harky
- Department of Cardiothoracic Surgery, Liverpool Heart and Chest Hospital, Liverpool, UK
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Thomson DJ, Yom SS, Saeed H, El Naqa I, Ballas L, Bentzen SM, Chao ST, Choudhury A, Coles CE, Dover L, Guadagnolo BA, Guckenberger M, Hoskin P, Jabbour SK, Katz MS, Mukherjee S, Rembielak A, Sebag-Montefiore D, Sher DJ, Terezakis SA, Thomas TV, Vogel J, Estes C. Radiation Fractionation Schedules Published During the COVID-19 Pandemic: A Systematic Review of the Quality of Evidence and Recommendations for Future Development. Int J Radiat Oncol Biol Phys 2020; 108:379-389. [PMID: 32798063 PMCID: PMC7834196 DOI: 10.1016/j.ijrobp.2020.06.054] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 06/21/2020] [Indexed: 12/15/2022]
Abstract
PURPOSE Numerous publications during the COVID-19 pandemic recommended the use of hypofractionated radiation therapy. This project assessed aggregate changes in the quality of the evidence supporting these schedules to establish a comprehensive evidence base for future reference and highlight aspects for future study. METHODS AND MATERIALS Based on a systematic review of published recommendations related to dose fractionation during the COVID-19 pandemic, 20 expert panelists assigned to 14 disease groups named and graded the highest quality of evidence schedule(s) used routinely for each condition and also graded all COVID-era recommended schedules. The American Society for Radiation Oncology quality of evidence criteria were used to rank the schedules. Process-related statistics and changes in distributions of quality ratings of the highest-rated versus recommended COVID-19 era schedules were described by disease groups and for specific clinical scenarios. RESULTS From January to May 2020 there were 54 relevant publications, including 233 recommended COVID-19-adapted dose fractionations. For site-specific curative and site-specific palliative schedules, there was a significant shift from established higher-quality evidence to lower-quality evidence and expert opinions for the recommended schedules (P = .022 and P < .001, respectively). For curative-intent schedules, the distribution of quality scores was essentially reversed (highest levels of evidence "pre-COVID" vs "in-COVID": high quality, 51.4% vs 4.8%; expert opinion, 5.6% vs 49.3%), although there was variation in the magnitude of shifts between disease sites and among specific indications. CONCLUSIONS A large number of publications recommended hypofractionated radiation therapy schedules across numerous major disease sites during the COVID-19 pandemic, which were supported by a lower quality of evidence than the highest-quality routinely used dose fractionation schedules. This work provides an evidence-based assessment of these potentially practice-changing recommendations and informs individualized decision-making and counseling of patients. These data could also be used to support radiation therapy practices in the event of second waves or surges of the pandemic in new regions of the world.
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Affiliation(s)
- David J Thomson
- Department of Clinical Oncology, The Christie NHS Foundation Trust, Manchester, United Kingdom; Division of Cancer Sciences, University of Manchester, Manchester, United Kingdom
| | - Sue S Yom
- Department of Radiation Oncology, University of California San Francisco, San Francisco, California.
| | - Hina Saeed
- Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Issam El Naqa
- Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan
| | - Leslie Ballas
- Department of Radiation Oncology, University of Southern California, Los Angeles, California
| | - Soren M Bentzen
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland
| | - Samuel T Chao
- Department of Radiation Oncology, Cleveland Clinic, Cleveland, Ohio
| | - Ananya Choudhury
- Department of Clinical Oncology, The Christie NHS Foundation Trust, Manchester, United Kingdom; Division of Cancer Sciences, University of Manchester, Manchester, United Kingdom
| | - Charlotte E Coles
- Department of Oncology, University of Cambridge, Cambridge, United Kingdom
| | - Laura Dover
- Department of Radiation Oncology, University of Alabama at Birmingham, Birmingham, Alabama
| | | | - Matthias Guckenberger
- Department of Radiation Oncology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Peter Hoskin
- Division of Cancer Sciences, University of Manchester, Manchester, United Kingdom; Mount Vernon Cancer Centre, Northwood, and University of Manchester, Manchester, United Kingdom
| | - Salma K Jabbour
- Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey, Robert Wood Johnson Medical School, Rutgers University, New Brunswick, New Jersey
| | - Matthew S Katz
- Department of Radiation Medicine, Lowell General Hospital, Lowell, Massachusetts
| | | | - Agata Rembielak
- Department of Clinical Oncology, The Christie NHS Foundation Trust, Manchester, United Kingdom; Division of Cancer Sciences, University of Manchester, Manchester, United Kingdom
| | | | - David J Sher
- Department of Radiation Oncology, University of Texas - Southwestern, Dallas, Texas
| | | | - Toms V Thomas
- Department of Radiation Oncology, University of Mississippi Medical Center, Jackson, Mississippi
| | - Jennifer Vogel
- Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University, Baltimore, Maryland
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11
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Garg PK, Kaul P, Choudhary D, Turaga KK, Singh MP, Tiwari AR, Arora V, Agrawal N, Rau B, Yendamuri S. Discordance of COVID-19 guidelines for patients with cancer: A systematic review. J Surg Oncol 2020; 122:579-593. [PMID: 32668034 PMCID: PMC7405271 DOI: 10.1002/jso.26110] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 06/28/2020] [Accepted: 06/29/2020] [Indexed: 12/13/2022]
Abstract
This review was aimed to systematically evaluate the available literature on the impact of COVID-19 on cancer care and to critically analyze the diagnostic and therapeutic strategies suggested by various healthcare providers, societies, and institutions. Majority guidelines for various types of cancers favored a delay in treatment or a nonsurgical approach wherever feasible. These guidelines are based on a low level of evidence and have significant discordance for the role and timing of surgery, especially in early tumors.
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Affiliation(s)
- Pankaj Kumar Garg
- Department of Surgical OncologyAll India Institute of Medical SciencesRishikeshUttarakhandIndia
| | - Pallvi Kaul
- Department of Surgical OncologyAll India Institute of Medical SciencesRishikeshUttarakhandIndia
| | - Deepti Choudhary
- Department of Obstetrics and GynaecologyAll India Institute of Medical SciencesRishikeshUttarakhandIndia
| | - Kiran Kalyan Turaga
- Section of Surgery and Surgical Oncology, Department of SurgeryThe University of Chicago MedicineChicagoIllinois
| | - Mahendra Pal Singh
- Department of Surgical OncologyAll India Institute of Medical SciencesRishikeshUttarakhandIndia
| | - Ajeet Ramamani Tiwari
- Department of Surgical OncologyAll India Institute of Medical SciencesRishikeshUttarakhandIndia
| | - Vipin Arora
- Department of ENT and Head Neck SurgeryUniversity College of Medical Sciences and Guru Teg Bahadur Hospital, University of DelhiDelhiIndia
| | - Nishant Agrawal
- Section of Otolaryngology‐Head and Neck Surgery, Department of SurgeryThe University of Chicago Medicine, ChicagoChicagoIllinois
| | - Beat Rau
- Department of Surgery, Campus Virchow‐KlinikumCharité‐UniversitätsmedizinBerlinGermany
| | - Sai Yendamuri
- Department of Thoracic SurgeryRoswell Park Cancer InstituteBuffaloNew York
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12
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Evolution of clinical radiotherapy physics practice under COVID-19 constraints. Radiother Oncol 2020; 148:274-278. [PMID: 32474126 PMCID: PMC7256544 DOI: 10.1016/j.radonc.2020.05.034] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Revised: 05/09/2020] [Accepted: 05/17/2020] [Indexed: 12/14/2022]
Abstract
As the COVID-19 spread continues to challenge the societal and professional norms, radiotherapy around the globe is pushed into an unprecedented transformation. We will discuss how clinical physics has transformed to ascertain safety and quality standards across four facilities around the world through diversity of action, innovation, and scientific flexibility.
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13
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Rathod S, Dubey A, Chowdhury A, Bashir B, Koul R. A Call for a Radiation Oncology Model Based on New 4R's During the COVID-19 Pandemic. Adv Radiat Oncol 2020; 5:608-609. [PMID: 32363246 PMCID: PMC7195347 DOI: 10.1016/j.adro.2020.04.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Affiliation(s)
- Shrinivas Rathod
- CancerCare Manitoba and University of Manitoba, Winnipeg, Manitoba, Canada
| | - Arbind Dubey
- CancerCare Manitoba and University of Manitoba, Winnipeg, Manitoba, Canada
| | - Amitava Chowdhury
- CancerCare Manitoba and University of Manitoba, Winnipeg, Manitoba, Canada
| | - Bashir Bashir
- CancerCare Manitoba and University of Manitoba, Winnipeg, Manitoba, Canada
| | - Rashmi Koul
- CancerCare Manitoba and University of Manitoba, Winnipeg, Manitoba, Canada
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